Genvoya

See Contraindications. Avoid with concurrent or recent use of nephrotoxic agents. Not recommended with other antiretroviral agents, rifabutin, rifapentine, rivaroxaban, ticagrelor, or clopidogrel. Concomitant drugs that reduce renal function or compete for active tubular secretion may potentiate emtricitabine, tenofovir (eg, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides, high-dose or multiple NSAIDs). Separate dosing of drugs, antacids, or oral supplements containing polyvalent cations by at least 2hrs. May potentiate antiarrhythmics, digoxin, clarithromycin (reduce dose by 50% if CrCl 50–60mL/min), telithromycin, IV midazolam, diazepam, ethosuximide, SSRIs, TCAs, ketoconazole (max 200mg/day), itraconazole (max 200mg/day), voriconazole, beta-blockers, calcium channel blockers, atorvastatin (max 20mg/day), trazodone, immunosuppressants (monitor), PDE5 inhibitors (see full labeling for dose adjustments), other sedatives/hypnotics or antipsychotics, quetiapine (consider alternative antiretrovirals; if necessary, reduce quetiapine to ⅙ of current dose and monitor), direct oral anticoagulants (see full labeling), tramadol (reduce dose). Monitor INR with warfarin. Antagonized by oxcarbazepine, corticosteroids (eg, oral dexamethasone, betamethasone, budesonide, fluticasone); consider alternatives. Concomitant colchicine (see full labeling); not recommended in renal or hepatic impairment. Concomitant buprenorphine/naloxone, fentanyl; monitor. Discontinue bosentan ≥36 hours prior to initiation of Genvoya; resume bosentan after ≥10 days following initiation. Concomitant salmeterol: not recommended; increased risk of cardiovascular events. Consider additional or alternative non-hormonal methods of contraception (see full labeling).