Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Nimodipine
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Nimodipine: 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
Nimodipine is extensively metabolized by CYP3A4 and has high first-pass clearance, so cobicistat can substantially increase its levels. This can cause marked hypotension, which is particularly harmful in patients with subarachnoid hemorrhage.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Nimodipine 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 inhibition of intestinal and hepatic CYP3A4 metabolism of nimodipine.
What to do
Monitor blood pressure closely, and consider splitting the nimodipine dose (for example 30 mg every 2 hours) if hypotension occurs. Discontinue nimodipine if hypotension persists.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Elvitegravir / cobicistat / emtricitabine / tenofovir df and Nimodipine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Nimodipine?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Nimodipine 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. Nimodipine is extensively metabolized by CYP3A4 and has high first-pass clearance, so cobicistat can substantially increase its levels. This can cause marked hypotension, which is particularly harmful in patients with subarachnoid hemorrhage.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Nimodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely, and consider splitting the nimodipine dose (for example 30 mg every 2 hours) if hypotension occurs. Discontinue nimodipine if hypotension persists.
What other medicines interact with Nimodipine?
MediHelp also lists interactions of Nimodipine with, for example, Apalutamide, Carbamazepine, Ceritinib. The full list is on the Nimodipine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
