Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Glyburide-metformin
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Glyburide-metformin: 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 is a CYP3A and P-gp inhibitor, and elvitegravir weakly induces some CYP enzymes, so the net effect on glyburide exposure is unpredictable. Cobicistat also inhibits MATE1 and may modestly raise metformin levels. Glycemic control may therefore change after the regimen is started or stopped.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Glyburide-metformin 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 CYP3A, P-gp and MATE1, which may increase glyburide and metformin exposure, while elvitegravir may weakly induce CYP2C9 and offset this effect.
What to do
Monitor blood glucose after starting or stopping the antiretroviral regimen and adjust the glyburide-metformin dose as needed. Monitor renal function because tenofovir and cobicistat also affect renal handling.
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 Glyburide-metformin
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Glyburide-metformin?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Glyburide-metformin 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 is a CYP3A and P-gp inhibitor, and elvitegravir weakly induces some CYP enzymes, so the net effect on glyburide exposure is unpredictable. Cobicistat also inhibits MATE1 and may modestly raise metformin levels. Glycemic control may therefore change after the regimen is started or stopped.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Glyburide-metformin?
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 blood glucose after starting or stopping the antiretroviral regimen and adjust the glyburide-metformin dose as needed. Monitor renal function because tenofovir and cobicistat also affect renal handling.
What other medicines interact with Glyburide-metformin?
MediHelp also lists interactions of Glyburide-metformin with, for example, Bosentan, Cholic acid, Clarithromycin. The full list is on the Glyburide-metformin page.
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