Formulary
Elvitegravir: Indications, Dosing, Side Effects and Interactions
Elvitegravir is an inhibitor of HIV integrase, which is an enzyme required for viral replication.
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Elvitegravir: Indications, Dosing, Side Effects and Interactions
Elvitegravir is an inhibitor of HIV integrase, which is an enzyme required for viral replication.
Drug action
Elvitegravir is an inhibitor of HIV integrase, which is an enzyme required for viral replication.
Indications and dose
**HIV infection without resistance to other inhibitors of HIV integrase, in combination with low-dose ritonavir and atazanavir or lopinavir**
- **Adult** (By Mouth): 85 mg once daily, take at the same time as a once daily ritonavir-boosted regimen or with the first dose of a twice daily ritonavir-boosted regimen.
**HIV infection without resistance to other inhibitors of HIV integrase, in combination with low-dose ritonavir and darunavir or fosamprenavir**
- **Adult** (By Mouth): 150 mg once daily, take with the first dose of a twice daily ritonavir-boosted regimen.
Cautions
Elderly-limited information available
Side effects
Common or very common Diarrhoea; fatigue; headache; nausea; rash; vomiting Uncommon Depression; dizziness; drowsiness; flatulence; gastrointestinal discomfort; insomnia; paraesthesia; suicidal ideation (in patients with history of depression or psychiatric illness); taste altered Frequency not known Hyperglycaemia; osteonecrosis; weight increased
Interactions
**Severe interactions:**
- John's wort ( Hypericum perforatum ), rifampicin, carbamazepine, phenobarbital, and phenytoin may result in significantly decreased cobicistat and elvitegravir plasma concentrations, which may...
- Antimycobacterials Rifabutin (150 mg every other day)/ Elvitegravir (150 mg once daily)/ Cobicistat (150 mg once daily) Coadministration of rifabutin, a potent CYP3A inducer, may significantly...
- ANTICONVULSANTS Carbamazepine (200 mg twice daily)/ Elvitegravir (150 mg once daily)/ Cobicistat (150 mg once daily) Coadministration of carbamazepine, a potent CYP3A inducer, may significantly...
- Coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of salmeterol, which is associated with the potential for...
- Coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of this medicinal product, which is associated with the...
- Due to the presence of cobicistat, coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of this medicinal product,...
- Studies conducted with other medicinal products Based on drugdrug interaction studies conducted with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead or the components of...
**Other interactions (126):**
- Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead should not be coadministered with other antiretroviral medicinal products.
- Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead should not be administered concomitantly with medicinal products containing tenofovir alafenamide, tenofovir disoproxil, lamivudine...
- Elvitegravir Elvitegravir is primarily metabolised by CYP3A, and medicinal products that induce or inhibit CYP3A may affect the exposure of elvitegravir.
- Elvitegravir may have the potential to induce CYP2C9 and/or inducible uridine diphosphate glucuronosyltransferase (UGT) enzymes; as such it may decrease the plasma concentration of substrates of...
- Cobicistat Cobicistat is a strong mechanismbased inhibitor of CYP3A and is also a CYP3A substrate.
- Cobicistat is also a weak CYP2D6 inhibitor and is metabolised, to a minor extent, by CYP2D6.
Pregnancy
Manufacturer advises avoid unless essential-limited data available.
Medicinal forms
Medicinal forms No licensed medicines listed.
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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