https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13056
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13056
No pharmaceutical opinion available for this interaction.
Elvitegravir / Cobicistat can inhibit the metabolism (CYP 3A4) and increase the plasma concentration of Tadalafil (Cialis).
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Possible increase of adverse effects.
Use as needed: start at 10 mg every two days and if needed increase to 20 mg, maximum of 3 times a week.
If the 10 mg dose is not tolerated, tadalafil treatment should be stopped.
Once-daily use: usual dose of 5 mg QD could be used. If intolerance, reduce the dose to 2.5 mg QD.
Monitor closely clinical efficacy and appearance of adverse effects.
Give extra caution to patients with hepatic or renal insufficiency, or older than 65 years.
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Tadalafil toxicity: hypotension, tachycardia, headache, dizziness, flushing, visual changes (difficulty distinguishing blue and green) and syncope.
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Ritonavir 200 mg BID (a powerful inhibitor of CYP 3A4) increases the AUC of tadalafil 124%. See ritonavir and tadalafil (Cialis).
Caution: Liver impairment and kidney failure (Clcr 31-50 ml/min: increases twice AUC)and age > 65 years old can increase the concentration of tadalafil. See tadalafil (Adcirca).