Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ruxolitinib
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ruxolitinib: 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 is a strong CYP3A4 inhibitor and increases ruxolitinib exposure, raising the risk of cytopenias such as thrombocytopenia and neutropenia. It is not an absolute contraindication, but dose reduction is needed.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ruxolitinib 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, decreasing ruxolitinib clearance.
What to do
Reduce the ruxolitinib dose per labeling for strong CYP3A4 inhibitors and monitor blood counts frequently. Titrate according to safety and response.
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 Ruxolitinib
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ruxolitinib?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ruxolitinib 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 is a strong CYP3A4 inhibitor and increases ruxolitinib exposure, raising the risk of cytopenias such as thrombocytopenia and neutropenia. It is not an absolute contraindication, but dose reduction is needed.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ruxolitinib?
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 ruxolitinib dose per labeling for strong CYP3A4 inhibitors and monitor blood counts frequently. Titrate according to safety and response.
What other medicines interact with Ruxolitinib?
MediHelp also lists interactions of Ruxolitinib with, for example, Atazanavir, Ceritinib, Chloramphenicol. The full list is on the Ruxolitinib page.
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