GENVOYA(elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide)tablets(十二)
of respiratory depression and/or prolonged sedation.
Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered.
Based on non-CYP-mediated elimination pathways for lorazepam, no effect on plasma concentrations is expected upon coadministration with GENVOYA.
Beta-Blockers:
e.g.,
metoprolol
timolol ↑ beta-blockers Clinical monitoring is recommended and a dosage decrease of the beta blocker may be necessary when these agents are coadministered with GENVOYA.
Calcium Channel Blockers:
e.g.,
amlodipine
diltiazem
felodipine
nicardipine
nifedipine
verapamil ↑ calcium channel blockers Caution is warranted and clinical monitoring is recommended upon coadministration of calcium channel blockers with GENVOYA.
Corticosteroid:
Systemic:
dexamethasone ↓ elvitegravir
↓ cobicistat An alternative corticosteroid should be considered for coadministration with GENVOYA.
Corticosteroid:
Inhaled/Nasal:
fluticasone ↑ fluticasone Alternative corticosteroids should be considered, particularly for long term use.
Endothelin Receptor Antagonists:
bosentan ↑ bosentan Coadministration of bosentan in patients on GENVOYA:
In patients who have been receiving GENVOYA for at least 10 days, start bosentan at 62.5 mg once daily or every other day based upon individual tolerability.
Coadministration of GENVOYA in patients on bosentan:
Discontinue use of bosentan at least 36 hours prior to initiation of GENVOYA. After at least 10 days following the initiation of GENVOYA, resume bosentan at 62.5 mg once daily or every other day based upon individual tolerability.
HMG-CoA Reductase Inhibitors:
atorvastatin ↑ atorvastatin For contraindicated HMG-CoA reductase inhibitors, [see CONTRAINDICATIONS (4)]
Initiate with the lowest starting dose of atorvastatin and titrate carefully while monitoring for safety.
Hormonal Contraceptives:
norgestimate/ethinyl estradiol ↑ norgestimate
↓ ethinyl estradiol The effects of increases in the concentration of the progestational component norgestimate are not fully known and can include increased risk of insulin resistance, dyslipidemia, acne, and venous thrombosis. The potential risks and benefits associated with coadministration of norgestimate/ethinyl estradiol with GENVOYA should be considered, particularly in women who have risk factors for these events.
The effect of GENVOYA on other hormonal contraceptives (e.g., contraceptive patch, contraceptive vaginal ring, or injectable contraceptives) or oral contraceptives containing progestogens other than norgestimate is not known; therefore, alternative (non-hormonal) methods of contraception can be considered.
Immuno-suppressants:
e.g.,
cyclosporine (CsA)
sirolimus
tacrolimus ↑ immuno-suppressants
↑ elvitegravir (with CsA)
↑ cobicistat (with CsA) Therapeutic monitoring of the immunosuppressive agents is recommended upon coadministration with GENVOYA.
Monitor for adverse events associated with GENVOYA when coadministered with cyclosporine.
Narcotic Analgesics:
buprenorphine/
naloxone‡ ↑ buprenorphine
↑ norbuprenorphine
↓ |
