https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=9786

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

Decreased clinical efficacy.

Risk of a possible development of resistance to antiretroviral class.

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.

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.