White Pepper - Biktarvy (Bictegravir, Emtricitabine, Tenofovir Alafenamide) Interaction

Interaction Details

Bictegravir, Emtricitabine, Tenofovir Alafenamide is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro evidence suggests that piperine, a constituent of white pepper, inhibits cytochrome P450 3A4 (CYP3A4). Theoretically, concomitant use with white pepper might increase the effects and side effects of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include some calcium channel blockers (diltiazem, nicardipine, verapamil), chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), glucocorticoids, cisapride (Propulsid), alfentanil (Alfenta), fentanyl (Sublimaze), losartan (Cozaar), fluoxetine (Prozac), midazolam (Versed), omeprazole (Prilosec), ondansetron (Zofran), propranolol (Inderal), fexofenadine (Allegra), and numerous others.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Bictegravir, Emtricitabine, Tenofovir Alafenamide is classified as belonging to the following category: P-Glycoprotein Substrates

Theoretically, white pepper might increase levels of p-glycoprotein substrates. The piperine constituent of white pepper seems to inhibit p-glycoprotein in vitro.
Some drugs metabolized by p-glycoprotein include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), digoxin, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

• Bhardwaj RK, Glaeser H, Becquemont L, et al. Piperine, a major constituent of black pepper, inhibits human P-glycoprotein and CYP3A4. J Pharmacol Exp Ther 2002;302:645-50.
• Han, Y., Chin Tan, T. M., and Lim, L. Y. In vitro and in vivo evaluation of the effects of piperine on P-gp function and expression. Toxicol.Appl.Pharmacol. 8-1-2008;230(3):283-289.
• Aher, S., Biradar, S., Gopu, C. L., and Paradkar, A. Novel pepper extract for enhanced P-glycoprotein inhibition. J Pharm.Pharmacol. 2009;61(9):1179-1186.

Bictegravir, Emtricitabine, Tenofovir Alafenamide Overview

• The combination of bictegravir, emtricitabine, and tenofovir AF is used to treat human immunodeficiency virus (HIV) infection in certain adults and children weighing at least 55 pounds (25 kg) who have not received antiretroviral treatment in the past or who have been stable on other antiretroviral treatment(s). Bictegravir is in a class of medications called integrase strand transfer inhibitors (INSTIs). Emtricitabine and tenofovir AF are in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). The combination of bictegravir, emtricitabine, and tenofovir AF works by decreasing the amount of HIV in the body. Although bictegravir, emtricitabine, and tenofovir AF will not cure HIV, these medications may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the risk of getting or transmitting the HIV virus to other people.

White Pepper - More Interactions

White Pepper interacts with 930 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.