Elvitegravir / Cobicistat

Phenytoin

Contraindicated.

No pharmaceutical opinion available for this interaction.

Mechanism

Phenytoin can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Elvitegravir / Cobicistat.

Elvitegravir / Cobicistat

Pharmacodynamic effects

Risk of a possible development of resistance to antiretroviral class.

Decreased clinical efficacy.

Recommendations

Monitor for signs and symptoms of therapeutic failure.

Alternative solution(s)

Phenytoin

Pharmacodynamic effects

Recommendations

Contraindicated. Use alternative.

Alternative solution(s)

As clinically indicated : brivaracetam, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, topiramate, vigabatrin, zonisamide.

Monitor

Tests

Elvitegravir plasma level

CD4+

Viral Load

Pharmacokinetic parameters

Comment

See elvitegravir/cobicistat + carbamzepine.

Comment
Reference
  • 2570
    Elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3142
    Phenytoine (Dilantin), Pfizer, Québec, Canada, 22 juil 2013.
  • 3281
    Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya), Gilead, Ontario, Canada, 6 août 2021.