Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ticlopidine
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ticlopidine: 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 is a strong CYP3A inhibitor, but ticlopidine is mainly cleared by multiple pathways, and ticlopidine itself inhibits CYP2C19 and CYP2B6 with minor effect on this regimen. A clinically important change in ticlopidine exposure is uncertain, and the interaction is not well documented.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ticlopidine 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
Possible reduced ticlopidine metabolism through cobicistat's CYP3A inhibition; the clinical relevance is not established.
What to do
Monitor blood counts, including neutrophils and platelets, and for bleeding or hematologic toxicity. Consider an alternative antiplatelet such as aspirin if appropriate.
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 Ticlopidine
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ticlopidine?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ticlopidine 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 is a strong CYP3A inhibitor, but ticlopidine is mainly cleared by multiple pathways, and ticlopidine itself inhibits CYP2C19 and CYP2B6 with minor effect on this regimen. A clinically important change in ticlopidine exposure is uncertain, and the interaction is not well documented.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ticlopidine?
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 blood counts, including neutrophils and platelets, and for bleeding or hematologic toxicity. Consider an alternative antiplatelet such as aspirin if appropriate.
What other medicines interact with Ticlopidine?
MediHelp also lists interactions of Ticlopidine with, for example, Mavacamten, Abrocitinib, Acetylsalicylic acid. The full list is on the Ticlopidine page.
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