Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Metoprolol
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Metoprolol: 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 CYP2D6 and can raise metoprolol concentrations. This may lead to excessive beta-blockade with bradycardia and hypotension.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Metoprolol 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
Inhibition of CYP2D6-mediated metoprolol metabolism by cobicistat.
What to do
Monitor heart rate and blood pressure and lower the metoprolol dose if required. Consider a non-CYP2D6 beta-blocker such as atenolol or bisoprolol.
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 Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Metoprolol?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Metoprolol 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 CYP2D6 and can raise metoprolol concentrations. This may lead to excessive beta-blockade with bradycardia and hypotension.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Metoprolol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor heart rate and blood pressure and lower the metoprolol dose if required. Consider a non-CYP2D6 beta-blocker such as atenolol or bisoprolol.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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