Stribild interactions: Alcohol, medications, and other factors

In some cases, factors or conditions could prevent your doctor from prescribing Stribild due to the risk of harm. These are known as contraindications. The contraindications of Stribild include:

Taking certain drugs that Stribild affects in terms of breakdown

Stribild slows down the activity of an enzyme called cytochrome P450 3A4 (CYP3A4). An enzyme is a type of protein. CYP3A4 helps break down certain medications so they can be cleared from the body.

Doctors typically will not prescribe Stribild in combination with drugs that rely on this enzyme and cause severe or life threatening side effects. This is because Stribild can prevent these drugs from clearing from your system as well as they should. And this may lead to high levels of these medications in your system, which can increase the risk of side effects from them.

Stribild can affect the way some drugs break down in the body. Below are examples of these drugs. Keep in mind that the table below doesn’t include all drugs that Stribild may affect.

* Sildenafil is also available as the brand-name drug Viagra, which is prescribed to treat erectile dysfunction (ED). When sildenafil is used for ED, doctors may still prescribe this drug in combination with Stribild. In this case, they’ll typically prescribe a lower dosage of sildenafil to help reduce the risk of side effects. To learn more, talk with your doctor.

Before you start treatment with Stribild, it’s important to tell your doctor if you take any of these medications. They can determine whether to prescribe Stribild.

Taking certain drugs that speed up the breakdown of Stribild

Stribild is broken down in your body by an enzyme called CYP3A4.

Doctors typically will not prescribe Stribild in combination with drugs that speed up the activity of this enzyme. Drugs that speed up this enzyme can cause Stribild to break down more quickly. And this may lead to a low level of Stribild in your system.

If the level of Stribild in your system is too low, the drug may not work to treat HIV. This can also cause HIV to become resistant to Stribild and similar medications. This means certain HIV treatments, including Stribild, will not work as well for treating HIV.

Below are examples of drugs that may speed up the breakdown of Stribild. Keep in mind the table below doesn’t include all drugs that may affect Stribild.

St. John’s wort, which is an herbal supplement, may also speed up the breakdown of Stribild. To learn more, see the “Stribild and other interactions” section below.

Before you start treatment with Stribild, it’s important to tell your doctor if you take any of these medications. They can determine whether to prescribe Stribild.

There’s no known interaction between Stribild and alcohol.

However, drinking alcohol while taking Stribild can worsen certain side effects of the drug. Examples include headache, nausea, and severe liver problems.

If you drink alcohol, talk with your doctor. They can recommend whether you should limit the amount of alcohol you consume during Stribild treatment.

Before you start treatment with Stribild, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Stribild interacts with supplements, herbs, or vitamins, see the “Stribild and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Stribild. Keep in mind that this table doesn’t include all drugs that may interact with Stribild. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see “Taking certain drugs that Stribild affects in terms of breakdown” in the “When to avoid Stribild” section above.
† For details about this interaction, see “Taking certain drugs that speed up the breakdown of Stribild” in the “When to avoid Stribild” section above.

Here’s a closer look at certain drug interactions of Stribild.

Certain antidepressants

Antidepressants are prescribed to treat certain mental health conditions, such as depression.

Interaction result. Taking Stribild in combination with certain antidepressants can increase your risk of side effects from antidepressants.

Interaction explained. Stribild slows down the activity of certain enzymes that help break down medications so they can be cleared from the body. (An enzyme is a type of protein.) Examples of these enzymes include cytochrome P450 3A4 (CYP3A4) and CYP2D6.

Certain antidepressants are broken down by CYP3A4 and CYP2D6. By slowing the activity of these enzymes, Stribild can prevent these drugs from leaving your system. This may lead to a high level of antidepressant in your system. And having a high level of certain antidepressants in your body can increase your risk of side effects from them.

Examples of antidepressant drugs. Below are some antidepressants that may interact with Stribild:

• paroxetine (Brisdelle, Paxil, others)
• amitriptyline
• trazodone

Steps you or your doctor may take. If you already take an antidepressant, be sure to tell your doctor before starting Stribild treatment. They can recommend whether certain antidepressants can be taken with Stribild. They may also lower the dose of your antidepressant if they prescribe Stribild to you.

Certain blood thinners

Blood thinners are prescribed to treat or help prevent blot clots in certain situations.

Interaction result. Taking Stribild in combination with certain blood thinners can increase your risk of side effects from blood thinners, such as bleeding.

Interaction explained. Stribild slows down the activity of certain enzymes. These are proteins that help break down medications so the drugs can be removed from your body. Examples of these enzymes include CYP3A4 and P-glycoprotein (P-gp).

Certain blood thinners are broken down by CYP3A4 and P-gp. By slowing the activity of these enzymes, Stribild can prevent these drugs from leaving your system. This may result in a high level of blood thinner in your system, which increases your risk of side effects from these drugs.

Examples of blood thinners. Here are some blood thinners that may interact with Stribild:

• dabigatran (Pradaxa)
• rivaroxaban (Xarelto)
• warfarin (Jantoven)

Steps you or your doctor may take. Before starting Stribild treatment, tell your doctor if you’re taking a blood thinner. Your doctor can advise you on whether it’s safe for you to take these medications together. They may also lower the dose of your blood thinner if they prescribe Stribild to you.

Certain antacids

Antacids can help ease symptoms of conditions such as heartburn and indigestion.

Interaction result. Taking Stribild with certain antiacids can make Stribild less effective. This includes antacids that contain magnesium, calcium, or aluminum.

Interaction explained. When taken with Stribild, the magnesium, calcium, or aluminum in the antacid may attach to Stribild. This can prevent your body from absorbing Stribild. As a result, the level of Stribild in your body may be too low for the drug to be effective.

Examples of antacid drugs. Some antacids that may interact with Stribild include aluminum hydroxide/magnesium hydroxide (Maalox) and calcium carbonate (TUMS).

Steps you or your doctor may take. Due to this risk, you should take Stribild at least 2 hours before or 2 hours after taking an antacid that contains magnesium, calcium, or aluminum. Doing so may help prevent magnesium, calcium, or aluminum from affecting the level of Stribild in your body.

Before taking any antacids with Stribild, talk with your doctor or pharmacist. They can tell you whether specific antacids contain magnesium, calcium, or aluminum.

Stribild may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Stribild.

Stribild interactions with supplements

Before you start treatment with Stribild, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Stribild interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Stribild. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called cytochrome P450 3A4 (CYP3A4). This enzyme helps break down Stribild.

By speeding up this enzyme, St. John’s wort can cause Stribild to break down more quickly. And this may lead to a low level of Stribild in your system.

If the level of Stribild in your system is too low, the drug may not work to treat HIV. Having a drug level that’s too low can also cause HIV to become resistant to Stribild and similar medications. This means certain HIV treatments, including Stribild, will not work as well for treating HIV.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Stribild interactions with minerals and vitamins

Here is information on Stribild, minerals, and vitamins.

Minerals

Mineral supplements such as magnesium, calcium, zinc, or iron may interact with Stribild. If you take these minerals with Stribild, they can decrease the level of the drug in your body. This may make Stribild less effective at treating your condition.

Due to this risk, you should take Stribild at least 2 hours before or 2 hours after taking magnesium, calcium, zinc, or iron supplements. Doing so may help prevent these minerals from affecting the level of Stribild in your body.

Vitamins

Vitamins have not specifically been reported to interact with Stribild. However, multivitamins may contain the minerals magnesium, calcium, zinc, or iron, which are known to interact with Stribild. (For details, see “Minerals” above.)

Before taking any vitamin products with Stribild, talk with your doctor or pharmacist. They can help you determine whether a product contains any magnesium, calcium, zinc, or iron.

Stribild and food

Your doctor may recommend avoiding or reducing the amount of grapefruit or grapefruit juice you consume while taking Stribild. Eating grapefruit or drinking grapefruit juice may increase your risk of side effects from the drug. This is because this interaction may increase the level of Stribild in your body.

If you’d like to learn more about eating certain foods during treatment with Stribild, talk with your doctor.

Stribild and vaccines

There were no reports of vaccine interactions with Stribild. If you’d like to learn more about getting certain vaccines during treatment with Stribild, talk with your doctor.

Stribild and lab tests

There were no reports of lab tests interacting with Stribild. If you’d like to learn more about getting specific lab tests during treatment with Stribild, talk with your doctor.

STRIBILD INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Stribild. Taking Stribild with cannabis products may increase the risk of side effects from Stribild.

Before you start treatment with Stribild, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Stribild. Before you take this drug, be sure to talk with your doctor about your health history. Stribild may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Stribild include:

• Hepatitis B virus. Stopping Stribild treatment can lead to worsened hepatitis B in people with the hepatitis B virus. In fact, the drug has a boxed warning about this risk. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Boxed warning: Risk of worsening hepatitis B” at the top of this article.
• Severe liver problems. It isn’t known whether Stribild is safe for people with severe liver problems, such as liver failure. Before taking Stribild, tell your doctor if you have a severe liver problem. They’ll recommend whether Stribild is the right treatment option for you.
• Bone problems. Before taking Stribild, tell your doctor if you have any bone problems. Examples include osteoporosis, bone loss, or bone fractures. Stribild may worsen these bone problems. Your doctor may recommend a treatment other than Stribild. Or they may advise you on ways to lower your risk of bone-related side effects from the drug.
• Kidney problems. Stribild can cause new or worsened kidney problems. The drug may not be a safe treatment option for people who already have kidney problems, such as kidney failure. If you have a kidney problem, your doctor may prescribe a different treatment option for you instead of Stribild.
• Mental health condition. In rare cases, Stribild may increase the risk of suicidal thoughts or behaviors in people who have mental health conditions, such as depression. If you have a mental health condition, be sure to tell your doctor before starting Stribild treatment. They can advise whether Stribild is the right treatment for your condition.
• Pregnancy. It’s not known whether Stribild is safe to take during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before taking Stribild. To learn more about the drug’s use during pregnancy, see this article.
• Breastfeeding. It’s recommended that you avoid breastfeeding while taking Stribild. The drug can pass into breast milk, which can cause side effects in a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor before taking Stribild. For more details about the drug’s use while breastfeeding, see this article.
• Allergic reaction. If you’ve had an allergic reaction to Stribild or any of its ingredients, your doctor will likely not prescribe Stribild. Taking the drug may cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

You can take certain steps to help prevent interactions with Stribild. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Stribild label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Stribild doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Stribild by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Stribild. These resources might help:

• Overview of Stribild. For a general overview of Stribild, you can see this article.
• Drug comparison. For information about how Stribild compares with Biktarvy, read this article.
• Facts about HIV. To learn more about HIV, see our HIV and AIDS hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.