Stribild (Elvitegravir / Cobicistat / Emtricitabine / Tenofovir) + Antibiotics

There is limited data on research depicting interactions between Stribild and antibiotics. Nonetheless, chances of side effects can increase due to the fact that some antibiotics and EM/TDF cause hepatotoxicity and related problems. Do not combine medications on your own.

Main Information About Stribild

Stribild is a 4-in-1 medicine (also called Quad pill). It’s a complete (fixed-dose combination) anti-HIV therapy that does not require the addition of any other ARVs, unlike the most antiretroviral medications.

It is approved to be administered as an HIV treatment regimen in treatment-naïve patients or who are seeking another antiviral to replace current ARV therapy. As a replacement, the patient must have HIV RNA of less than 50 copies/mL and have been on stable antiretroviral therapy for more than six months with no history of treatment failure/resistance to any component of Stribild [1].

Stribild active substances include elvitegravir, emtricitabine, tenofovir, and cobicistat. Cobicistat is a booster helping elvitegravir work better. Elvitegravir is an integrase inhibitor, while emtricitabine and tenofovir-DF are both NRTIs.

These medicines’ mode of action effectively suppresses viral reproduction and boosts the CD4+ cells count for a stronger immune function. With a stronger immune function, it’s easy to fight any external opportunistic infection and lead a healthier and longer life even with the virus.

Stribild may be used as PEP. It’s highly effective, working with the same effects as Truvada in preventing HIV-1 acquisition. It is a good alternative regimen for HIV PEP because of its ease of use, better tolerability and the high completion rate [2].

Can Stribild Be Used with Antibiotics?

Antibiotics are highly effective in preventing serious bacterial infections in HIV-positive patients, thus reducing their mortality and morbidity.

Despite their efficacy, some antibiotics such as co-trimoxazole induce hepatic injury with hypersensitivity-like reactions when administered. This can be accompanied by symptoms such as rash, fever, and eosinophilia. When administering this substance with ARV meds, it’s highly recommended to assess the patient’s health including testing blood for the presence of liver problems [3].

In the same way, Stribild can cause some serious liver injury and related conditions due to tenofovir-DF, and the addition of an antibiotic that induce the same effect can worsen this condition [4].

Elvitegravir can interact with some antibiotics such as rifabutin causing a potential rise in rifabutin toxicity due to an increase in rifabutin levels and a rise in rifabutin metabolite.

Rifapentine antibiotic is not coadministered with Stribild because a combination poses a significant reduction in elvitegravir and cobicistat levels, leading to a potential loss of Stribild antiretroviral efficacy [5].

There are other possible interactions between this med and antibiotics. Your health is paramount. Always consult with a medical specialist before combining an antibiotic with Stribild.


  1. Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate).
  2. Evaluation of tolerability with the co-formulation elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate for post-HIV exposure prophylaxis. BMC Infectious Diseases. Nadia Valin, Laurent Fonquernie, Anne Daguenel, Pauline Campa, Theresita Anthony, Marguerite Guiguet, Pierre Marie Girard & Marie Caroline Meyohas. Published: 29 November 2016.
  3. Co-trimoxazole-induced hepatic injury–an analysis of cases with hypersensitivity-like reactions. Berg PA, Daniel PT. Infection. 1987;15 Suppl 5:S259-64.
  4. Does tenofovir (TDF) cause liver injury? Retrieved 10 February 2016.
  5. Database of Antiretroviral Drug Interactions. Interactions between Antibiotics (including antimycobacterials) and Antiretrovirals.
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