Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Zolpidem
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zolpidem: 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 inhibits CYP3A4, the main pathway for zolpidem clearance, so zolpidem exposure can rise. This may deepen sedation, prolong next-day impairment and increase the risk of complex sleep behaviours or respiratory depression. The effect is usually manageable with dose reduction rather than being an absolute bar.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zolpidem 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 inhibits CYP3A4-mediated metabolism of zolpidem, increasing its plasma concentrations.
What to do
Start with the lowest zolpidem dose and avoid escalating it, and counsel the patient about next-day drowsiness. Monitor sedation and consider an alternative hypnotic such as temazepam if excess sedation occurs.
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 Zolpidem
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Zolpidem?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zolpidem 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 inhibits CYP3A4, the main pathway for zolpidem clearance, so zolpidem exposure can rise. This may deepen sedation, prolong next-day impairment and increase the risk of complex sleep behaviours or respiratory depression. The effect is usually manageable with dose reduction rather than being an absolute bar.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zolpidem?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with the lowest zolpidem dose and avoid escalating it, and counsel the patient about next-day drowsiness. Monitor sedation and consider an alternative hypnotic such as temazepam if excess sedation occurs.
What other medicines interact with Zolpidem?
MediHelp also lists interactions of Zolpidem with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Benzhydrocodone / acetaminophen. The full list is on the Zolpidem page.
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