Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Theophylline
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Theophylline: 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 strongly inhibits CYP3A4 and also CYP2D6, which may reduce theophylline clearance and raise its levels. Elevated theophylline can cause nausea, tachycardia, arrhythmias and seizures. The effect is moderate because CYP1A2 is the main pathway for theophylline.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Theophylline 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 inhibition of CYP3A4 reduces theophylline metabolism.
What to do
Monitor serum theophylline concentrations and for toxicity when starting or stopping the antiretroviral regimen, and lower the theophylline dose as needed.
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 Theophylline
- Riociguat + Theophylline Contraindicated
- Adenosine + Theophylline Major
- Apalutamide + Theophylline Major
- Bupropion + Theophylline Major
- Carvedilol + Theophylline Major
- Cimetidine + Theophylline Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Theophylline?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Theophylline 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 strongly inhibits CYP3A4 and also CYP2D6, which may reduce theophylline clearance and raise its levels. Elevated theophylline can cause nausea, tachycardia, arrhythmias and seizures. The effect is moderate because CYP1A2 is the main pathway for theophylline.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Theophylline?
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 serum theophylline concentrations and for toxicity when starting or stopping the antiretroviral regimen, and lower the theophylline dose as needed.
What other medicines interact with Theophylline?
MediHelp also lists interactions of Theophylline with, for example, Riociguat, Adenosine, Apalutamide. The full list is on the Theophylline page.
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