Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Oxycodone
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Oxycodone: 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 inhibits CYP3A4, the main pathway for oxycodone clearance, which can substantially raise oxycodone levels. This increases the risk of sedation and respiratory depression.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Oxycodone 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 oxycodone metabolism.
What to do
Start with a reduced oxycodone dose and titrate by clinical effect, monitoring for sedation and respiratory depression. Lower the dose when cobicistat is started and reassess when it is stopped.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Oxycodone?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Oxycodone 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 inhibits CYP3A4, the main pathway for oxycodone clearance, which can substantially raise oxycodone levels. This increases the risk of sedation and respiratory depression.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Oxycodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a reduced oxycodone dose and titrate by clinical effect, monitoring for sedation and respiratory depression. Lower the dose when cobicistat is started and reassess when it is stopped.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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