Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ketamine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketamine: 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 CYP3A4, which contributes to ketamine metabolism, so ketamine exposure and duration of effect may increase. This can mean deeper or prolonged sedation, dissociative effects, and cardiovascular stimulation.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketamine 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 inhibition of CYP3A4-mediated ketamine N-demethylation.
What to do
Use the lowest effective ketamine dose and titrate to effect with monitoring of sedation, blood pressure and respiration. Extra caution is needed with repeated or prolonged dosing.
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 Ketamine
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ketamine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketamine 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 CYP3A4, which contributes to ketamine metabolism, so ketamine exposure and duration of effect may increase. This can mean deeper or prolonged sedation, dissociative effects, and cardiovascular stimulation.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketamine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective ketamine dose and titrate to effect with monitoring of sedation, blood pressure and respiration. Extra caution is needed with repeated or prolonged dosing.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Benzhydrocodone / acetaminophen, Brexanolone, Buprenorphine buccal. The full list is on the Ketamine page.
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