Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Methylprednisolone
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methylprednisolone: 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 strongly inhibits CYP3A4, raising methylprednisolone exposure and prolonging its effect. This increases the risk of systemic corticosteroid effects, including adrenal suppression and Cushing syndrome.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methylprednisolone 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-mediated metabolism of methylprednisolone, reducing its clearance.
What to do
Use the lowest effective methylprednisolone dose for the shortest time and monitor for Cushingoid features, hyperglycemia and adrenal suppression. For long-term use, consider an alternative steroid less dependent on CYP3A4, such as prednisolone or dexamethasone-sparing strategies.
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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Methylprednisolone?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methylprednisolone 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 strongly inhibits CYP3A4, raising methylprednisolone exposure and prolonging its effect. This increases the risk of systemic corticosteroid effects, including adrenal suppression and Cushing syndrome.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methylprednisolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective methylprednisolone dose for the shortest time and monitor for Cushingoid features, hyperglycemia and adrenal suppression. For long-term use, consider an alternative steroid less dependent on CYP3A4, such as prednisolone or dexamethasone-sparing strategies.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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