Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Paroxetine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Paroxetine: 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, the main pathway for paroxetine clearance, so paroxetine concentrations may rise. This can increase adverse effects such as nausea, sedation, anticholinergic effects and serotonergic toxicity.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Paroxetine 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
Cobicistat inhibits CYP2D6-mediated metabolism of paroxetine.
What to do
Start paroxetine at a low dose and titrate to clinical response. Monitor for adverse effects and reduce the dose if they develop.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Paroxetine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Paroxetine 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, the main pathway for paroxetine clearance, so paroxetine concentrations may rise. This can increase adverse effects such as nausea, sedation, anticholinergic effects and serotonergic toxicity.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start paroxetine at a low dose and titrate to clinical response. Monitor for adverse effects and reduce the dose if they develop.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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