Dexamethasone and Lenacapavir Oral: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Dexamethasone
No brand names on recordLenacapavir Oral
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased dexAMETHasone exposure, an increased risk of Cushing's syndrome and adrenal suppression, reduced lenacapavir exposure and reduced efficacy of lenacapavir
Interaction Deep Dive
Concomitant use of lenacapavir (SUNLENCA®) with dexAMETHasone, a moderate CYP3A inducer is not recommended, as this may result in reduced exposure of lenacapavir, a loss of lenacapavir therapeutic effect and development of resistance to lenacapavir. Concomitant administration of lenacapavir (a moderate CYP3A inhibitor) with dexAMETHasone, a systemic corticosteroid that is a CYP3A substrate whose exposures are significantly increased by CYP3A inhibitors can increase the risk for Cushing's syndrome and adrenal suppression. Initiate with the lowest starting dose and titrate carefully while monitoring for safety2. Dosage modifications and supplemental doses are recommended when initiating dexAMETHasone (a moderate CYP3A inducer) with lenacapavir (YEZTUGO®). Maintain scheduled continuation injection dosing, continue to administer once every 6 months scheduled continuation dosing of lenacapavir 927 mg subcutaneously (2 x 1.5 mL injections). Also, administer supplemental doses of lenacapavir: On the day moderate CYP3A inducer is initiated use 463.5 mg subcutaneously (1 x 1.5 mL injection). If moderate CYP3A inducer is coadministered for longer than 6 months, continue to administer a supplemental dose of lenacapavir as described above for every 6 months from initiation of moderate CYP3A inducer. After stopping the moderate CYP3A inducer, continue the once every 6 months scheduled continuation injection dosing of lenacapavir 1.
Why it happens (mechanism)
Inhibition of CYP3A-substrate metabolism of dexAMETHasone; induction of CYP3A-mediated metabolism of lenacapavir
Literature reports
1 report — tap to read
a) In the drug interaction studies conducted in subjects without HIV-1, concomitant administration of single dose of lenacapavir 300 mg orally with efavirenz (fasted) [inducer of CYP3A (moderate) and P-gp and UGT] 600 mg once daily, the mean ratio for AUC and Cmax of lenacapavir with and without efavirenz were 0.44 (90% CI, 0.32 to 0.59) and 0.64 (90% CI, 0.45 to 0.92) respectively 21.
Common questions
Can I take Dexamethasone and Lenacapavir Oral together?
Increased dexAMETHasone exposure, an increased risk of Cushing's syndrome and adrenal suppression, reduced lenacapavir exposure and reduced efficacy of lenacapavir Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dexamethasone and Lenacapavir Oral interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Dexamethasone or Lenacapavir Oral need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: YEZTUGO(R) oral tablets, subcutaneous injection, lenacapavir oral tablets, subcutaneous injection. Gilead Sciences Inc (per manufacturer), Foster City, CA, 2025. DailyMed
- Product Information: SUNLENCA(R) oral tablets, subcutaneous injection, lenacapavir oral tablets, subcutaneous injection. Gilead Sciences Inc (per FDA), Foster City, CA, 2024. DailyMed
Keep reading about Dexamethasone
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