Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Zonisamide
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zonisamide: 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, which is a main route of zonisamide metabolism, so zonisamide levels may increase. This may lead to more sedation, dizziness and other dose-related adverse effects.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zonisamide 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, reducing the metabolism of zonisamide.
What to do
Monitor for zonisamide adverse effects and consider reducing the dose, guided by clinical response or serum levels.
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 Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Zonisamide?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zonisamide 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, which is a main route of zonisamide metabolism, so zonisamide levels may increase. This may lead to more sedation, dizziness and other dose-related adverse effects.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Zonisamide?
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 for zonisamide adverse effects and consider reducing the dose, guided by clinical response or serum levels.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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