Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Mifepristone
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Mifepristone: 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 is a strong CYP3A inhibitor, so mifepristone exposure will rise, and mifepristone also inhibits CYP3A4. This can lead to higher mifepristone effects, including adrenal insufficiency, hypokalemia and QT prolongation.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Mifepristone 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
Mutual CYP3A4 inhibition, with cobicistat markedly raising mifepristone exposure.
What to do
Avoid the combination where possible. If used, monitor potassium, ECG and clinical signs of glucocorticoid antagonism and seek HIV specialist advice.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Mifepristone?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Mifepristone 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 is a strong CYP3A inhibitor, so mifepristone exposure will rise, and mifepristone also inhibits CYP3A4. This can lead to higher mifepristone effects, including adrenal insufficiency, hypokalemia and QT prolongation.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Mifepristone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If used, monitor potassium, ECG and clinical signs of glucocorticoid antagonism and seek HIV specialist advice.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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