Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluoxetine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluoxetine: moderate 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 and may raise fluoxetine concentrations, while elvitegravir is a weak inducer of CYP2C9 and may lower them. The net effect on fluoxetine exposure is unpredictable. Fluoxetine also inhibits CYP2D6 and may modestly alter exposure to some antiretroviral components.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Cobicistat inhibits CYP2D6 and elvitegravir induces CYP2C9, both of which contribute to fluoxetine metabolism.
What to do
Monitor clinical response and for serotonergic adverse effects after starting or stopping the combination, and titrate fluoxetine to effect.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Fluoxetine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluoxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat inhibits CYP2D6 and may raise fluoxetine concentrations, while elvitegravir is a weak inducer of CYP2C9 and may lower them. The net effect on fluoxetine exposure is unpredictable. Fluoxetine also inhibits CYP2D6 and may modestly alter exposure to some antiretroviral components.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluoxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response and for serotonergic adverse effects after starting or stopping the combination, and titrate fluoxetine to effect.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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