Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ranolazine
Severity: Contraindicated
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ranolazine: contraindicated 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, which is the main metabolic route of ranolazine. Ranolazine exposure can rise markedly, increasing dose-related QT prolongation and the risk of arrhythmia and other adverse effects.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ranolazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Cobicistat inhibits CYP3A4 (and P-glycoprotein), reducing ranolazine clearance and raising plasma concentrations.
What to do
Do not co-administer; ranolazine labeling prohibits use with strong CYP3A4 inhibitors. Choose an alternative antianginal or a different antiretroviral regimen.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ranolazine?
MediHelp rates the interaction as contraindicated. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ranolazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cobicistat in this combination strongly inhibits CYP3A4, which is the main metabolic route of ranolazine. Ranolazine exposure can rise markedly, increasing dose-related QT prolongation and the risk of arrhythmia and other adverse effects.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ranolazine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer; ranolazine labeling prohibits use with strong CYP3A4 inhibitors. Choose an alternative antianginal or a different antiretroviral regimen.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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