Liverpool HIV Interactions

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Ibuprofen

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Ibuprofen is metabolized mainly by CYP2C9 and to a lesser extent by CYP2C8 and direct glucuronidation. Bictegravir does not inhibit or induce CYP450 or UGT enzymes. In addition, coadministration with an NSAID is unlikely to be of concern for nephrotoxicity as tenofovir alafenamide results in 90% lower systemic levels of tenofovir compared to tenofovir-DF.

Description:

Because FTC and tenofovir are primarily excreted by the kidneys by a combination of glomerular filtration and active tubular secretion, coadministration of Biktarvy with drugs that reduce renal function or compete for active tubular secretion may increase concentrations of FTC, tenofovir, and other renally eliminated drugs and this may increase the risk of adverse reactions. Some examples of drugs that are eliminated by active tubular secretion include high-dose or multiple NSAIDs.

Biktarvy US Prescribing Information, Gilead Sciences Inc, August 2019.

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Clindamycin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clindamycin is metabolized by CYP3A4. Bictegravir does not inhibit or induce CYP450 enzymes; emtricitabine and tenofovir alafenamide do not interact with clindamycin’s metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Ticagrelor

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Ticagrelor undergoes extensive CYP3A4 metabolism. Bictegravir does not inhibit or induce CYP450 enzymes; emtricitabine and tenofovir alafenamide do not interact with ticagrelor’s metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Atorvastatin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Atorvastatin is metabolized by CYP3A4. Bictegravir does not inhibit or induce P450 enzymes; emtricitabine and tenofovir alafenamide do not interact with atorvastatin’s metabolic pathway.

Description:

Based on drug interaction studies conducted with Biktarvy or the components of Biktarvy, no clinically significant drug interactions are expected with atorvastatin.

Biktarvy Summary of Product Characteristics, Gilead Sciences Ltd, June 2019.

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Sertraline

Quality of Evidence: Very Low

Summary:

Coadministration with bictegravir/emtricitabine/tenofovir alafenamide has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Coadministration of sertraline (50 mg single dose) and emtricitabine/tenofovir alafenamide (200/10 mg once daily, with elvitegravir/cobicistat) increased sertraline Cmax by 14% and decreased AUC by 7%.

Description:

Coadministration of sertraline (50 mg single dose) and tenofovir alafenamide (10 mg once daily, with elvitegravir/cobicistat/emtricitabine 150/150/200 mg once daily) had no significant effect on the AUC or Cmax of tenofovir alafenamide or sertraline. No interaction is expected with bictegravir and emtricitabine. No dose adjustment is required upon co-administration.

Biktarvy Summary of Product Characteristics, Gilead Sciences Ltd, June 2019.

Based on drug interaction studies conducted with Biktarvy or the components of Biktarvy, no clinically significant drug interactions have been observed when Biktarvy is combined with sertraline. Coadministration of sertraline (50 mg single dose) and tenofovir alafenamide (10 mg once daily, with elvitegravir/cobicistat/emtricitabine) increased sertraline Cmax by 14% and decreased AUC by 7%.

Biktarvy Prescribing Information, Gilead Sciences Inc, August 2019.

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Oxybutynin

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Oxybutynin is metabolized by CYP3A4. Bictegravir does not inhibit or induce P450 enzymes; emtricitabine and tenofovir alafenamide do not interact with oxybutynin’s metabolic pathway.

Description:

(See Summary)

No Interaction Expected

Bictegravir/ Emtricitabine/Tenofovir alafenamide (BIC/FTC/TAF)

Betahistine

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Betahistine is metabolized by monoamine oxidase. Betahistine does not induce or inhibit CYP450 enzymes.

Description:

(See Summary)

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