Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Vardenafil
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Vardenafil: 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
The cobicistat component strongly inhibits CYP3A4 and substantially raises vardenafil levels. This increases the risk of hypotension, syncope, visual changes and priapism.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Vardenafil 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
Inhibition of CYP3A4-mediated vardenafil metabolism by cobicistat.
What to do
Limit vardenafil to the reduced single dose with a long interval per labeling, and monitor blood pressure. Counsel on prolonged erection.
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 Vardenafil
- Amyl nitrite + Vardenafil Contraindicated
- Glyceryl trinitrate pr + Vardenafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Nicorandil + Vardenafil Contraindicated
- Nitroglycerin po + Vardenafil Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Vardenafil?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Vardenafil 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. The cobicistat component strongly inhibits CYP3A4 and substantially raises vardenafil levels. This increases the risk of hypotension, syncope, visual changes and priapism.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Vardenafil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit vardenafil to the reduced single dose with a long interval per labeling, and monitor blood pressure. Counsel on prolonged erection.
What other medicines interact with Vardenafil?
MediHelp also lists interactions of Vardenafil with, for example, Amyl nitrite, Glyceryl trinitrate pr, Isosorbide dinitrate. The full list is on the Vardenafil page.
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