Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Flecainide
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Flecainide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cobicistat inhibits CYP2D6, the main enzyme clearing flecainide, so flecainide levels can rise. Higher exposure raises the risk of proarrhythmia, conduction block and other dose-related toxicity.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Cobicistat inhibits CYP2D6-mediated metabolism of flecainide, reducing its clearance.
What to do
Avoid or reduce the flecainide dose and monitor ECG (PR, QRS) and flecainide plasma concentrations. Consider an alternative antiretroviral regimen or antiarrhythmic.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Elvitegravir / cobicistat / emtricitabine / tenofovir df and Flecainide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Flecainide?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cobicistat inhibits CYP2D6, the main enzyme clearing flecainide, so flecainide levels can rise. Higher exposure raises the risk of proarrhythmia, conduction block and other dose-related toxicity.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Flecainide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid or reduce the flecainide dose and monitor ECG (PR, QRS) and flecainide plasma concentrations. Consider an alternative antiretroviral regimen or antiarrhythmic.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
