Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Trimipramine
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Trimipramine: 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 inhibits CYP3A4 and CYP2D6, both of which metabolize trimipramine. Higher tricyclic levels can cause QT prolongation, arrhythmia, sedation and anticholinergic toxicity.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Trimipramine 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 inhibition of CYP2D6 and CYP3A4 decreases trimipramine metabolism.
What to do
Start trimipramine at a low dose and titrate to clinical effect, or choose an alternative antidepressant. Monitor ECG and for signs of tricyclic toxicity.
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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Trimipramine?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Trimipramine 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 inhibits CYP3A4 and CYP2D6, both of which metabolize trimipramine. Higher tricyclic levels can cause QT prolongation, arrhythmia, sedation and anticholinergic toxicity.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Trimipramine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start trimipramine at a low dose and titrate to clinical effect, or choose an alternative antidepressant. Monitor ECG and for signs of tricyclic toxicity.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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