Hello from Germany,
I would like to ask about possible interreactions between this medicine (Elvitegravir/Cobicistat/Emtricitabin/Tenofoviralafenamid) and Extasy, GBL/GHB and Crystal Meth (iv). I take this treatment since 1 week. Unfortunately very fresh infection.
Thanks a lot for your Answer.
Thanks for writing and for asking about potential drug interactions between your antiretrovirals and recreational drugs.
Keep in mind that the first four weeks of starting an HIV regimen are the riskiest time for potential drug interactions. I should also say that use of such drugs carries their own risk independent of HIV med interactions. GBL/GHB has a heightened risk because the amount required between the desired effect and risk is small, and meth use as well as IV drug use also create a number of high-risk situations and conditions. In the US, what is sold as MDMA is often highly contaminated.
That said, of the drugs combined in Genvoya, the one that is the most problematic is Cobicistat, a pharmakinetic enhancer. The purpose of this drug is to delay the metabolism of the other drugs, thereby causing those drugs to circulate in the blood for a longer period of time. Unfortunately, Cobicistet also slows the metabolism of methamphetamine, creating the potential for overdose or medical complications (such as pulmonary hypertension).
The other drugs in Genvoya (NRTIs and integrase inhibitors) are not thought to have high interaction potential with HIV medications.
I recommend using extreme caution because many recreational drugs contain contaminants that can be dangerous. There are many support groups to help you stop using drugs. In the meantime please check out this safe drug use guide from the Harm Reduction Coalition for tips on reducing your risk.
All the best,