Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Liposomal doxorubicin
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Liposomal doxorubicin: 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
Cobicistat inhibits CYP3A4, CYP2D6 and P-glycoprotein, and may increase exposure to doxorubicin released from the liposome. This could worsen myelosuppression, mucositis, hand-foot syndrome and cardiotoxicity.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Liposomal doxorubicin 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, CYP2D6 and P-glycoprotein, reducing clearance of doxorubicin.
What to do
Prefer an unboosted antiretroviral regimen during therapy. If combined, monitor blood counts, mucocutaneous toxicity and cardiac function, and reduce the doxorubicin dose if toxicity appears.
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 Liposomal doxorubicin
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Liposomal doxorubicin?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Liposomal doxorubicin 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. Cobicistat inhibits CYP3A4, CYP2D6 and P-glycoprotein, and may increase exposure to doxorubicin released from the liposome. This could worsen myelosuppression, mucositis, hand-foot syndrome and cardiotoxicity.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Liposomal doxorubicin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an unboosted antiretroviral regimen during therapy. If combined, monitor blood counts, mucocutaneous toxicity and cardiac function, and reduce the doxorubicin dose if toxicity appears.
What other medicines interact with Liposomal doxorubicin?
MediHelp also lists interactions of Liposomal doxorubicin with, for example, Dengue vaccine, Belatacept, Cyclosporine. The full list is on the Liposomal doxorubicin page.
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