Elvitegravir / Cobicistat

Clonazepam

Evaluate risk/benefit ratio.

No pharmaceutical opinion available for this interaction.

Mechanism

Elvitegravir / Cobicistat may possibly inhibit the metabolism (CYP 3A4) and consequently increase the plasma concentration of Clonazepam.

Elvitegravir / Cobicistat

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Clonazepam

Pharmacodynamic effects

Increased risk of CNS toxicity.

Risk of prolonged sedation and respiratory depression.

Recommendations

Use with caution the lowest effective dose and adjust according to clinical response and tolerance.

Monitor closely for adverse effects.

Or choose an alternative.

In patients already being treated with this combination and tolerating it, if deemed appropriate, keep actual treatment and exercise close monitoring of adverse effects.

Alternative solution(s)

Lorazepam (Ativan), temazepam (Restoril), oxazepam (Serax)

Monitor

Clonazepam toxicity: drowsiness, dizziness, ataxia, behavior disturbances, and personaily changes, problem of coordination, confusion, decrease of reflexes, excessive sedation, respiratory depression and coma.

Tests

Pharmacokinetic parameters

Comment

Reference
  • 2570
    Elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3304
    Clonazepam (Rivotril), Hoffmann-La Roche, Ontario, Canada, 14 oct 2014.