Elvitegravir / Cobicistat

Aluminium (hydroxide)

Administration time adjustment is recommended.

No pharmaceutical opinion available for this interaction.

Mechanism

Aluminium (hydroxide) can bind (chelation) to elvitegravir and reduce its absorption .

Elvitegravir / Cobicistat

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

The product monograph recommends to separate administration of elvitegravir and antacids by at least 2 hours.

Monitor for clinical efficacy.

Alternative solution(s)

Aluminium (hydroxide)

Pharmacodynamic effects

Recommendations

Alternative solution(s)

H2 receptor antagonists or proton pump inhibitors.

Monitor

Tests

Viral Load

CD4+

Pharmacokinetic parameters

Comment

Ref #2134 : When an aluminum and magnesium hydroxide 20 mL dose is given simultaneously with elvitegravir, elvitegravir AUC and Cmin decreased by 45% and 41%, respectively. While the antacid given 2 or 4 hours before elvitegravir or 2 or 4 hours after elvitegravir does not influence elvitegravir plasma concentration significantly.

See elvitegravir/cobicistat + aluminium/magnesium hydroxide.

See also elvitegravir/cobicistat + famotidine and elvitegravir/cobicistat + omeprazole.

Reference
  • 2570
    Elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3281
    Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide(Genvoya), Gilead, Ontario, Canada, 17 septembre 2018.
  • 2134
    Ramanathan S, Mathias A, Wei X et al. Pharmacokinetics of once-daily boosted-elvitegravir when administered in combination with acid reducing agents. J Acquir Immune Defic Syndr. 2013 Sep 1; 64(1): 45-50.