Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Quetiapine
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Quetiapine: 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 in this combination strongly inhibits CYP3A4 and can greatly raise quetiapine levels. This may cause excess sedation, hypotension and QT prolongation.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Quetiapine 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
CYP3A4 inhibition by cobicistat reduces quetiapine clearance.
What to do
Reduce the quetiapine dose to about one-sixth of the current dose and monitor for sedation, hypotension and QTc. Retitrate after cobicistat is discontinued.
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 Quetiapine
- Adagrasib + Quetiapine Major
- Amiodarone + Quetiapine Major
- Amisulpride + Quetiapine Major
- Amoxapine + Quetiapine Major
- Anagrelide + Quetiapine Major
- Apalutamide + Quetiapine Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Quetiapine?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Quetiapine 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 in this combination strongly inhibits CYP3A4 and can greatly raise quetiapine levels. This may cause excess sedation, hypotension and QT prolongation.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Quetiapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the quetiapine dose to about one-sixth of the current dose and monitor for sedation, hypotension and QTc. Retitrate after cobicistat is discontinued.
What other medicines interact with Quetiapine?
MediHelp also lists interactions of Quetiapine with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Quetiapine page.
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