Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone: 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
The cobicistat component strongly inhibits CYP3A4 and substantially increases systemic fluticasone levels. This can result in Cushing syndrome and adrenal suppression with inhaled or nasal fluticasone.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone 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 CYP3A4, reducing fluticasone metabolism.
What to do
Avoid long-term coadministration and use beclomethasone or another alternative corticosteroid. If used together, monitor for Cushingoid features and adrenal suppression.
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?
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Other interactions of Fluticasone
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Fluticasone?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone 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. The cobicistat component strongly inhibits CYP3A4 and substantially increases systemic fluticasone levels. This can result in Cushing syndrome and adrenal suppression with inhaled or nasal fluticasone.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Fluticasone?
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 long-term coadministration and use beclomethasone or another alternative corticosteroid. If used together, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Fluticasone?
MediHelp also lists interactions of Fluticasone with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Fluticasone page.
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