Elvitegravir

EVG is only available as a component of an STR tablet that also contains COBI, FTC, and either TDF or TAF (Stribild, Genvoya).

ARV U.S. Brand Name

Vitekta

ARV Abbreviation(s)

EVG

ARV Class

Integrase inhibitors

First U.S. Approval

August 27, 2012

U.S. Manufacturer

Gilead Sciences

Generic Available?

Adult dosing

FDCs

Elvitegravir / Cobicistat / Emtricitabine / Tenofovir alafenamide

Elvitegravir / Cobicistat / Tenofovir DF / Emtricitabine

Displaying 101 - 157 of 157

	Interaction Color Code	Clinical Bottom Line	Clinical Effects	Drug 1 effect	Drug 2 dose	Drug 2 effect	Management
Elvitegravir Ethosuximide 180	Green: Administer standard doses	Administer standard doses	Potential for increased anticonvulsant effects				Monitor for ethosuximide adverse effects
Elvitegravir Clonazepam 179	Green: Administer standard doses	Administer standard doses	Potential for increased clonazepam effects (e.g. sedation, respiratory depression)				Frequent clinical monitoring is recommended
Elvitegravir Lamotrigine 178	Green: Administer standard doses	Administer standard doses	Potential for increased anticonvulsant effects				Frequent clinical monitoring is recommended
Elvitegravir Vardenafil 177	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of vardenafil	Potential for increased vardenafil effects (e.g. hypotension, priapism)				Initiate vardenafil 2.5 mg every 72 hours and monitor for adverse effects
Elvitegravir Trazodone 176	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of trazodone	Potential for increased trazodone adverse effects				If coadministering initiate trazodone at lowest dose. Monitor response and titrate according to efficacy, adverse effects.
Elvitegravir Thioridazine 175	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of thioridazine	Potential for increased risk of thioridazine adverse effects				Initiate lowest starting dose or decrease current dose of antipsychotic. Monitor efficacy and adverse effects.
Elvitegravir Terazosin 174	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of terazosin	Potential for increased terazosin adverse effects				Initiate low dose terazosin and titrate dose according to efficacy and adverse effects.
Elvitegravir Tadalafil 173	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of tadalafil	Potential for increased tadalafil effects (e.g. hypotension, priapism)				For erectile dysfunction, initiate tadalafil 5 mg dose and do not exceed 10 mg every 72 hours. Monitor adverse effects. For patients taking a protease inhibitor (stable > 7 days) requiring tadalafil for pulmonary arterial hypertension initiate 20 mg once daily and increase to 40 mg once daily based on tolerability. Patients currently on tadalafil who require a PI should stop tadalafil ³24 hours before PI initiation, take the PI for 7 days, then resume tadalafil at 20 mg. Maximum recommended daily dose for treatment of BPH is 2.5 mg daily.
Elvitegravir Sildenafil 172	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of sildenafil.	Potential for increased sildenafil effects (eg, hypotension, priapism, visual disturbances)				For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension.
Elvitegravir Risperidone 171	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of risperidone	Potential for increased risk of risperidone adverse effects				Initiate lowest starting dose or decrease current dose of antipsychotic. Monitor efficacy and adverse effects.
Elvitegravir Pimavanserin 170	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of pimavanserin	Potential for increased risk of nefazodone adverse effects				Reduce pimavanserin dose to 10 mg
Elvitegravir Perphenazine 169	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of perphenazine	Potential for increased risk of perphenazine adverse effects				Initiate lowest starting dose or decrease current dose of antipsychotic. Monitor efficacy and adverse effects.
Elvitegravir Paroxetine 168	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of paroxetine	Potential for increased risk of paroxetine adverse effects				If coadministering initiate paroxetine at lowest dose. Monitor response and titrate dose according to efficacy and adverse effects.
Elvitegravir Nortriptyline 167	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of nortriptyline	Potential for increased risk of nortriptyline adverse effects				If coadministering initiate nortriptyline at lowest dose. Monitor response and titrate according to efficacy and adverse effects.
Elvitegravir Imipramine 166	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of imipramine	Potential for increased risk of imipramine adverse effects				If coadministering initiate imipramine at lowest dose. Monitor response and titrate according to efficacy and adverse effects.
Elvitegravir Iloperidone 165	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of iloperidone	Potential for increased risk of iloperidone adverse effects				Decrease iloperidone dose by 50%
Elvitegravir Edoxaban 164	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of edoxaban	Potential for increased risk of bleeding				Edoxaban 30 mg once daily if using for DVT / PE. No adjustment needed for stroke prevention in persons with atrial fibrillation.
Elvitegravir Doxepin 163	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of doxepin	Potential for increased risk of doxepin adverse effects (e.g. sedation)				If coadministering initiate doxepin at lowest dose. Monitor response and titrate according to efficacy and adverse effects.
Elvitegravir Doxazosin 162	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of doxazosin	Potential for increased risk of doxazosin adverse effects				Initiate low dose doxazosin and titrate dose according to efficacy and adverse effects.
Elvitegravir Daclatasvir 161	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of daclatasvir					Decrease daclatasvir dose to 30 mg daily
Elvitegravir Colchicine 160	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of colchicine	Potential for increased risk of colchicine adverse effects				If coadministering for treatment of gout flares use 0.6 mg single dose followed by 0.3 mg single dose 1h later and do not repeat for at least 3 days. If coadministering for prophylaxis of gout flares adjust based on original regimen (e.g. reduce 0.6 mg BID to 0.3 mg once daily, reduce 0.6 mg once daily to 0.3 mg every other day). If coadministering for FMF, maximum daily dose is 0.6 mg. Do not coadminister in hepatic or renal impairment.
Elvitegravir Clarithromycin 159	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of clarithromycin					No dose adjustment necessary if patients CrCl > 60 mL / min. Reduce clarithromycin dose by 50% if CrCl is between 50-60 mL / min. Do not coadminster if CrCl > 50 mL / min.
Elvitegravir Cariprazine 158	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of cariprazine	Potential for increased risk of cariprazine adverse effects				If patient is receiving EVG / c, administer cariprazine 1.5 mg on Day 1 and Day 3, with no dose given on Day 2. From Day 4 onward, administer cariprazine 1.5 mg daily. Dose can be increased to a maximum dose of 3 mg daily. If EVG / c is withdrawn, cariprazine dose may need to be increased. If patient is receiving cariprazine 3 mg or 6 mg daily, reduce cariprazine dose by half. For patients taking cariprazine 4.5 mg daily, the dose should be reduced to 1.5 mg or 3 mg daily. For patients taking cariprazine 1.5 mg daily, change to 1.5 mg every other day. If EVG / c is withdrawn, cariprazine dose may need to be increased.
Elvitegravir Calcifediol 157	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of calcifediol					Monitor serum 25-hydroxyvitamin D, intact PTH, and serum Ca concentrations. Adjust dose as needed.
Elvitegravir Buspirone 156	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of buspirone	Potential for increased risk of buspirone adverse effects				If coadministering start with low dose buspirone and titrate accordingly. A dose reduction may be required. Monitor for side effects.
Elvitegravir Bupropion 155	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of bupropion	Potential for increased risk of bupropion adverse effects				If coadministering initiate bupropion at lowest dose. Monitor response and titrate according to efficacy and adverse effects.
Elvitegravir Bosentan 154	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of bosentan	Potential for increased risk of bosentan adverse effects				If patient has been on elvitegravir / cobicistat for more than 10 days, start with bosentan dose of 62.5 mg daily or every other day. If patient is currently on bosentan and requires use of elvitegravir / cobicistat, stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with 62.5 mg daily or every other day.
Elvitegravir Beclomethasone 153	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of Beclomethasone	Potential for increased risk of corticosteroid adverse effects				If coadministering, initiate lower dose and monitor for corticosteroid adverse effects
Elvitegravir Brexpiprazole 152	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of aripiprazole	Potential for increased risk of brexpiprazole adverse effects				Administer 25% of usual bexpiprazole dose and titrate based on efficacy and adverse effects
Elvitegravir Aripiprazole 151	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of aripiprazole	Potential for increased risk of aripiprazole adverse effects	Not reported			Administer 25% of usual aripiprazole dose and titrate based on efficacy and adverse effects
Elvitegravir Amitriptyline 150	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of amitriptyline	Potential for increased risk of amitriptyline adverse effects				If coadministering initiate amitriptyline at lowest dose. Monitor response and titrate according to efficacy and adverse effects.
Elvitegravir Sucralfate 149	Yellow: Adjust dosing	Adjust dosing to avoid decreased elvitegravir efficacy	Potential decrease in antiretroviral efficacy				Separate elvitegravir / cobicistat from sucralfate by at least 2 hours.
Elvitegravir Iron 148	Yellow: Adjust dosing	Adjust dosing to avoid decreased elvitegravir efficacy	Potential decrease in antiretroviral efficacy				Separate elvitegravir / cobicistat from medications containing polyvalent cations by at least 2 hours.
Elvitegravir Calcium carbonate 147	Yellow: Adjust dosing	Adjust dosing to avoid decreased elvitegravir efficacy	Potential decrease in antiretroviral efficacy				Separate elvitegravir / cobicistat from medications containing polyvalent cations by at least 2 hours.
Elvitegravir Calcium carbonate 146	Yellow: Adjust dosing	Adjust dosing to avoid decreased elvitegravir efficacy	Potential decrease in antiretroviral efficacy				Separate elvitegravir / cobicistat from medications containing polyvalent cations by at least 2 hours.
Elvitegravir Saxagliptin 145	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of saxagliptin	Potential for increased saxagliptin adverse effects				Limit saxagliptin dose to 2.5 mg once daily
Elvitegravir Pitavastatin 144	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of pitavastatin	Potential for increased risk of pitavastatin adverse effects				Initiate pitavastatin at lowest dose and titrate carefully. Monitor for adverse effects.
Elvitegravir Aluminum and magnesium hydroxide antacid 143	Yellow: Adjust dosing	Adjust dosing to avoid decreased elvitegravir efficacy	Potential decrease in antiretroviral efficacy	AUC decreased 40-50% when administered simultaneously with antacid; AUC decreased 15-20% when administered 2 hours before or after antacid. No change in AUC if separated by 4-hour interval.	Not reported	Not reported	Administer elvitegravir at least 2 hours before or at least 6 hours after supplements that contain polyvalent cations.
Elvitegravir LDV/SOF 142	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increase in ledipasvir toxicity	Cmax decreased 12%, AUC increased 2%, Cmin increased 36%	90 / 400 mg once daily	Ledipasvir Cmax increased 63%, AUC increased 78%, Cmin increased 91%; Sofosbuvir Cmax increased 33%, AUC increased 36%; Sofosbuvir metabolite Cmax increased 33%, AUC increased 44%, Cmin increased 53%	Manufacturer does not recommend co-administration of ledipasvir / sofosbuvir with Stribild due to interaction with tenofovir disoproxil fumarate. If coadministering, monitor for tenofovir renal toxicity. May coadminister with Genvoya.
Elvitegravir SOF/VEL 141	Green: Administer standard doses	Administer standard doses	Stribild is coformulated with tenofovir disoproxil fumarate and TDF levels are increased by sofosbuvir / velpatasvir.	Cmax decreased 13%; AUC decreased 6%; Cmin increased 8%	400 / 100 mg once daily	Velpatasvir Cmax increased 30%, AUC increased 50%, Cmin increased 60%; Sofosbuvir Cmax increased 23%, AUC increased 37%; Sofosbuvir metabolite Cmax increased 29%, AUC increased 48%, Cmin increased 58%	Monitor TDF-related adverse reactions
Elvitegravir SOF/VEL/VOX 140	Green: Administer standard doses	Administer standard doses		Cmax decreased 21%; AUC decreased 6%; Cmin increased 32%	400 / 100 / 100 mg plus 100 mg voxilaprevir	Voxilaprevir Cmax increased 92%; AUC increased 171%; Cmin increased 350%. Velpatasvir AUC increased 16%; Cmin increased 46%. Sofosbuvir Cmax increased 27%; AUC increased 22%	If coadministering with Stribild, monitor for TDF related adverse effects. Consider monitoring for hepatotoxicity when coadministering with either Stribild or Genvoya
Elvitegravir SOF/VEL 139	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Stribild is coformulated with tenofovir disoproxil fumarate and TDF levels are increased by sofosbuvir / velpatasvir.	Cmax and AUC decreased 7%; Cmin decreased 3%	400 / 100 mg once daily	Velpatasvir Cmax increased 5%, AUC increased 19%, Cmin increased 37%; Sofosbuvir Cmax increased 1%, AUC increased 24%; Sofosbuvir metabolite Cmax increased 13%, AUC increased 35%, Cmin increased 45%	May coadminister with caution. Monitor for adverse reactions associated with TDF
Elvitegravir LDV/SOF 138	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increase in ledipasvir toxicity	AUC increased 11%, Cmin increased 46%	90 / 400 mg once daily	Ledipasvir Cmax increased 65%, AUC increased 79%, Cmin increased 93%; Sofosbuvir Cmax increased 28%, AUC increased 47%; Sofosbuvir metabolite Cmax increased 29%, AUC increased 48%, Cmin increased 66%%	Manufacturer does not recommend co-administration of ledipasvir / sofosbuvir with Stribild due to interaction with tenofovir disoproxil fumarate. May coadminister with Genvoya.
Elvitegravir EE/NGM 137	Orange: Minimal data to guide interaction	Minimal data to guide interaction: risks likely to outweigh benefits	Potential for increased norgestimate effects (e.g. insulin resistance, dyslipidemia, acne, venous thrombosis); Potential decreased ethinyl estradiol effects	Not reported	0.18 / 0.215 / 0.250 mg NGM once daily, 0.025 mg EE once daily	Ethinyl estradiol Cmax decrease 6%, AUC decrease 25%, Cmin decrease 44%; Norgestimate Cmax increased 108%, AUC increased 126%, Cmin increased 167%	Additional or alternative contraception should be considered.
Elvitegravir CBZ 136	Red: Avoid combination	Do not coadminister: Reduced levels of elvitegravir	Potential decrease in antiretroviral efficacy	Cmax decreased 45%, AUC decreased 69%, Cmin decreased 97%	200 mg BID	Cmax increased 40%, AUC increased 43%, Cmin increased 51%. Epoxide metabolite (pharmacologically active) Cmax decreased 73%, AUC decreased 35%, and Cmin decreased 41%.	Contraindicated. Use alternative agents.
Elvitegravir RFB 135	Red: Avoid combination	Do not coadminister: Increased levels of rifabutin, reduced levels of elvitegravir	Increased rifabutin effects, potential loss of antiretroviral activity	Cmax decreased 9%, AUC decreased 21%, Cmin decreased 67%	150 mg every other day	No significant change in rifabutin Cmin, AUC, or Cmax. 25-O-desacetylrifabutin metabolite Cmax increased 384%, AUC increased 625%, Cmin increased 394% as compared to 300 mg rifabutin alone.	Use alternative agents
Elvitegravir Famotidine 134	Green: Administer standard doses	Administer standard doses		No significant change in AUC or Cmax when administered 12 hours apart or if administered simultaneously	40 mg given 12 hours after EVG or 40 mg given simultaneously with EVG	Not reported
Elvitegravir Omeprazole 133	Green: Administer standard doses	Administer standard doses		If omeprazole given 2 hours before EVG, Cmax increased 16%, AUC increased 10%, Cmin increased 13%. If given 12h after, no significant change.	20 mg given 2 hours before or 12 hours after elvitegravir	Not reported
Elvitegravir Methadone 132	Green: Administer standard doses	Administer standard doses		Not reported	80-120 mg daily	No significant change in R-methadone or S-methadone
Elvitegravir Sertraline 131	Green: Administer standard doses	Administer standard doses		Cmax decreased 12%; AUC decreased 6%	50 mg single dose	Cmax increased 14%; AUC decreased 7%
Elvitegravir Naloxone 130	Green: Administer standard doses	Administer standard doses	Potential reduced efficacy of naloxone	Not reported	4-6 mg once daily	Cmax and AUC decrease 28%
Elvitegravir Buprenorphine / naloxone 129	Green: Administer standard doses	Administer standard doses	Potential for increased risk of sedation and decreased cognition	Not reported	16-24 mg once daily	Buprenorphine Cmax increased 12%, AUC increased 35%, Cmin increased 66%. Norbuprenorphine metabolite Cmax increased 24%, AUC increased 42%, Cmin increased 57%	If using, monitor closely for excess sedation and cognitive effects
Elvitegravir Rosuvastatin 128	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of rosuvastatin	Potential for increased risk of rosuvastatin adverse effects (e.g. myopathy)	No significant change	10 mg single dose	Cmax increased 89%, AUC increased 38%, Cmin increased 43%	Initiate rosuvastatin at lowest dose and titrate carefully. Monitor for adverse effects.
Elvitegravir Atorvastatin 127	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of atorvastain	Potential for increased atorvastatin adverse effects (e.g. myopathy)	AUC decreased 8%	10 mg single dose	Cmax increased 132%; AUC increased 160%.	Initiate with lowest Potential dose of atorvastatin. Titrate carefully while monitoring for adverse effects. Do not exceed 20 mg of atorvastatin daily.
Elvitegravir Digoxin 126	Orange: Minimal data to guide interaction	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential for increased digoxin adverse effects	Not reported	0.5 mg single dose	Cmax increased 41%, AUC increased 8%	If coadministering, use with caution. Monitor levels and digoxin adverse effects
Elvitegravir Desipramine 125	Yellow: Adjust dosing	Adjust dosing to avoid increased levels of desipramine	Increased desipramine effects	Not reported	50 mg single dose	Cmax increased 24%, AUC increased 65%	If coadministering, initiate low dose desipramine and titrate according to efficacy and adverse effects.
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