Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Primaquine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Primaquine: 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 CYP3A4 and may raise primaquine concentrations. Primaquine can cause dose-related hemolysis in G6PD deficiency and has QT-prolonging potential, so higher exposure could increase toxicity. Clinical data are limited and the effect is mainly predicted.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Primaquine 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 CYP3A4 and may reduce primaquine metabolism.
What to do
Monitor for adverse effects such as hemolysis, methemoglobinemia and QT changes, and obtain an ECG if other QT-prolonging drugs are used. Confirm G6PD status before primaquine.
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 Primaquine
- Pimozide + Primaquine Contraindicated
- Amiodarone + Primaquine Major
- Amisulpride + Primaquine Major
- Anagrelide + Primaquine Major
- Arsenic trioxide + Primaquine Major
- Asenapine + Primaquine Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Primaquine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Primaquine 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 CYP3A4 and may raise primaquine concentrations. Primaquine can cause dose-related hemolysis in G6PD deficiency and has QT-prolonging potential, so higher exposure could increase toxicity. Clinical data are limited and the effect is mainly predicted.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Primaquine?
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 for adverse effects such as hemolysis, methemoglobinemia and QT changes, and obtain an ECG if other QT-prolonging drugs are used. Confirm G6PD status before primaquine.
What other medicines interact with Primaquine?
MediHelp also lists interactions of Primaquine with, for example, Pimozide, Amiodarone, Amisulpride. The full list is on the Primaquine page.
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