Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lurasidone
Severity: Contraindicated
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Lurasidone: 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
Cobicistat in this combination product is a potent CYP3A inhibitor and is expected to greatly increase lurasidone exposure. Excess lurasidone can cause marked sedation, extrapyramidal effects and other dose-related toxicity. Coadministration is contraindicated.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Lurasidone 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 inhibits CYP3A4, reducing the metabolic clearance of lurasidone.
What to do
Avoid the combination; switch to an antipsychotic with less CYP3A dependence or use a regimen without a pharmacokinetic 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 Lurasidone
- Apalutamide + Lurasidone Contraindicated
- Atazanavir + Lurasidone Contraindicated
- Carbamazepine + Lurasidone Contraindicated
- Clarithromycin + Lurasidone Contraindicated
- Cobicistat + Lurasidone Contraindicated
- Conivaptan + Lurasidone Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Lurasidone?
MediHelp rates the interaction as contraindicated. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Lurasidone 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. Cobicistat in this combination product is a potent CYP3A inhibitor and is expected to greatly increase lurasidone exposure. Excess lurasidone can cause marked sedation, extrapyramidal effects and other dose-related toxicity. Coadministration is contraindicated.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Lurasidone?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; switch to an antipsychotic with less CYP3A dependence or use a regimen without a pharmacokinetic booster.
What other medicines interact with Lurasidone?
MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.
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