https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=11310

Elvitegravir / Cobicistat

Codeine

Dosage adjustment may be necessary.

No pharmaceutical opinion available for this interaction.

Mechanism

Elvitegravir / Cobicistat may inhibit the metabolism (CYP2D6) and decrease the conversion into morphine, active metabolite of Codeine.

Elvitegravir / Cobicistat

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

Integrase inhibitor without cobicistat such as raltegravir, dolutegravir or bictegravir.

Codeine

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Monitor for clinical efficacy and adjust the dosage if necessary.

Alternative solution(s)

Depending on the clinical indication, acetaminophen, NSAIDs when possible, hydromorphone or morphine.

Monitor

Signs and symptoms of opioid withdrawal : craving for opioids, irritability, myalgias, muscle spasms, flushing, abdominal pain, nausea, vomiting, diarrhea, restlessness, diaphoresis, lacrimation, rhinorrhea, mydriasis, yawning, piloerection (goose flesh), tachycardia, tremulousness.

Tests

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Pharmacokinetic parameters

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Comment

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Reference

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