Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ivabradine
Severity: Contraindicated
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ivabradine: contraindicated 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 raises ivabradine exposure. This increases the risk of severe bradycardia and conduction disturbances.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ivabradine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Cobicistat-mediated CYP3A4 inhibition decreases ivabradine clearance.
What to do
Do not co-administer. Use an alternative to ivabradine or switch to an antiretroviral regimen without a CYP3A4 booster.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ivabradine
- Atazanavir + Ivabradine Contraindicated
- Clarithromycin + Ivabradine Contraindicated
- Cobicistat + Ivabradine Contraindicated
- Conivaptan + Ivabradine Contraindicated
- Darunavir + Ivabradine Contraindicated
- Diltiazem + Ivabradine Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ivabradine?
MediHelp rates the interaction as contraindicated. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ivabradine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. The cobicistat component strongly inhibits CYP3A4 and raises ivabradine exposure. This increases the risk of severe bradycardia and conduction disturbances.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ivabradine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer. Use an alternative to ivabradine or switch to an antiretroviral regimen without a CYP3A4 booster.
What other medicines interact with Ivabradine?
MediHelp also lists interactions of Ivabradine with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Ivabradine page.
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