Coadministration has not been studied but is contraindicated with strong cytochrome P450 3A4 inhibitors. Coadministration is likely to increase ivabradine concentrations which may be associated with the risk of excessive bradycardia.

Coadministration has not been studied. In vitro data showed that ketoconazole, a CYP450 inhibitor, can inhibit the metabolism of triclabendazole. As darunavir/cobicistat is an inhibitor of CYP450 enzymes, there is potential to increase levels of triclabendazole if coadministered, however the clinical significance of this interaction is unknown due to the short term dosing of triclabendazole.

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clotrimazole undergoes hepatic metabolism (likely via CYP3A4) and is a moderate inhibitor of CYP3A4. Coadministration of clotrimazole as a pessary or troche is unlikely to cause a clinically significant increase in clotrimazole or darunavir/cobicistat exposure.

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tirzepatide is metabolized by proteolytic cleavage. Tirzepatide delays gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. However, based on available interaction studies, a clinically relevant effect is not expected with darunavir/cobicistat.

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Tirzepatide is metabolized by proteolytic cleavage. Tirzepatide delays gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. However, based on available interaction studies, a clinically relevant effect is not expected with bictegravir, emtricitabine and tenofovir alafenamide.

Coadministration has not been studied. In vitro, triclabendazole and its active sulfoxide metabolite are inhibitors of CYP3A4, and therefore may increase bictegravir exposure. However, due to short term dosing of triclabendazole (usually single dose), the clinical relevance of this interaction is low. Furthermore, renal excretion of unchanged triclabendazole appears to be minimal (<10%); therefore there is little potential for interaction with emtricitabine or tenofovir derived from tenofovir alafenamide. 

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