Yeztugo

Overview

lenacapavir

HIV capsid inhibitor

• CYP3A4 substrate
• UGT1A1 substrate
• P-gp substrate
• CYP3A4 inhibitor, moderate
• BCRP inhibitor
• P-gp inhibitor, weak
• affected by altered fat absorption

• lenacapavir is indicated for treatment of HIV infection (Sunlenca; Bixlenvo in combination w/ bictegravir) and HIV pre-exposure prophylaxis (Yeztugo); drug interaction guidance with strong and moderate CYP3A4 inducers varies by indication; see individual drug interactions for specific details

Contraindicated

• apalutamide
Yeztugo (lenacapavir)

+

apalutamide

1 interaction

Contraindicated

lenacapavir + apalutamide

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start apalutamide at least 2 days after lenacapavir initiation; on day apalutamide is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after apalutamide initiation; if apalutamide use >6mo, continue supplemental SC and PO doses every 6mo from apalutamide initiation; consider alternative if already receiving apalutamide, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, P-gp-mediated transport induced, UGT possibly induced)

• butalbital
Yeztugo (lenacapavir)

+

butalbital

1 interaction

Contraindicated

lenacapavir + butalbital

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start butalbital at least 2 days after lenacapavir initiation; on day butalbital is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after butalbital initiation; if butalbital use >6mo, continue supplemental SC and PO doses every 6mo from butalbital initiation; consider alternative if already receiving butalbital, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced)

• carbamazepine
Yeztugo (lenacapavir)

+

carbamazepine

1 interaction

Contraindicated

lenacapavir + carbamazepine

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start carbamazepine at least 2 days after lenacapavir start; monitor levels during and x9mo after lenacapavir; on day carbamazepine started, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after carbamazepine start; if carbamazepine >6mo, continue supplemental SC and PO doses every 6mo from carbamazepine start; consider alternative if already receiving carbamazepine, dosing regimen undefined: combo may decr. lenacapavir levels, efficacy; may incr. carbamazepine levels, risk of adverse effects (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced; hepatic metabolism inhibited)

• colchicine
Yeztugo (lenacapavir)

+

colchicine

1 interaction

Contraindicated

lenacapavir + colchicine

CV RISK REDUCTION: avoid combo if renal or hepatic impairment; otherwise, monitor CK, myopathy s/sx; GOUT or FMF: contraindicated if renal or hepatic impairment; otherwise, use alternative or decr. colchicine dose during and x9mo after lenacapavir use as follows: GOUT PROPHYLAXIS: give colchicine 0.3-0.6 mg/day divided qd-bid; ACUTE GOUT: avoid combo if receiving colchicine for prophylaxis; otherwise, give colchicine 1.2 mg x1 only; FMF: decr. max colchicine dose to 1.2 mg/day divided qd-bid: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• eliglustat
Yeztugo (lenacapavir)

+

eliglustat

1 interaction

Contraindicated

lenacapavir + eliglustat

during and x9mo after lenacapavir tx: CYP2D6 EM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, monitor ECG; decr. eliglustat dose to 84 mg qd; CYP2D6 IM: contraindicated if also combined w/ moderate or strong CYP2D6 inhibitor; otherwise, avoid combo; CYP2D6 PM: avoid combo: combo may incr. eliglustat levels, risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• encorafenib
Yeztugo (lenacapavir)

+

encorafenib

1 interaction

Contraindicated

lenacapavir + encorafenib

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: during and x9mo after lenacapavir tx, use alternative or monitor ECG; decr. encorafenib 450 mg dose to 225 mg, decr. 300 mg dose to 150 mg, decr. 225 mg dose to 75 mg, and decr. 150 mg dose to 75 mg; see lenacapavir pkg insert for specific dose adjustments: combo may decr. lenacapavir levels, efficacy; may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism induced; hepatic metabolism inhibited)

• enzalutamide
Yeztugo (lenacapavir)

+

enzalutamide

1 interaction

Contraindicated

lenacapavir + enzalutamide

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start enzalutamide at least 2 days after lenacapavir initiation; on day enzalutamide is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after enzalutamide initiation; if enzalutamide use >6mo, continue supplemental SC and PO doses every 6mo from enzalutamide initiation; consider alternative if already receiving enzalutamide dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• flibanserin
Yeztugo (lenacapavir)

+

flibanserin

1 interaction

Contraindicated

lenacapavir + flibanserin

contraindicated w/in 14 days prior to, during flibanserin tx and x9mo after lenacapavir tx: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (hepatic metabolism inhibited)

• fosphenytoin
Yeztugo (lenacapavir)

+

fosphenytoin

1 interaction

Contraindicated

lenacapavir + fosphenytoin

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start fosphenytoin at least 2 days after lenacapavir initiation; on day fosphenytoin is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after fosphenytoin initiation; if fosphenytoin use >6mo, continue supplemental SC and PO doses every 6mo from fosphenytoin initiation; consider alternative if already receiving fosphenytoin, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced)

• ivosidenib
Yeztugo (lenacapavir)

+

ivosidenib

1 interaction

Contraindicated

lenacapavir + ivosidenib

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: use alternative or monitor ECG during and x9mo after lenacapavir; start ivosidenib at least 2 days after lenacapavir start; on day ivosidenib started, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after ivosidenib start; if ivosidenib >6mo, continue supplemental SC and PO doses every 6mo from ivosidenib start; consider alternative if already receiving ivosidenib, dosing regimen not defined: combo may decr. lenacapavir levels, efficacy; may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism induced; hepatic metabolism inhibited)

• lomitapide
Yeztugo (lenacapavir)

+

lomitapide

1 interaction

Contraindicated

lenacapavir + lomitapide

contraindicated during and x9mo after lenacapavir use: combo may incr. lomitapide levels, risk of hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• lumacaftor/ivacaftor
Yeztugo (lenacapavir)

+

lumacaftor/ ivacaftor

1 interaction

Contraindicated

lenacapavir + lumacaftor/ ivacaftor

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start lumacaftor/ivacaftor at least 2 days after lenacapavir start; on day lumacaftor/ivacaftor is started, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after lumacaftor/ivacaftor start; if lumacaftor/ivacaftor >6mo, continue supplemental SC and PO doses every 6mo from lumacaftor/ivacaftor initiation; consider alternative if already receiving lumacaftor/ivacaftor, dosing regimen undefined: combo may decr. lenacapavir levels, efficacy; may incr. ivacaftor levels, risk of adverse effects during and x9mo after lenacapavir tx (hepatic metabolism induced, P-gp-mediated transport possibly induced; hepatic metabolism inhibited)

• mitotane
Yeztugo (lenacapavir)

+

mitotane

1 interaction

Contraindicated

lenacapavir + mitotane

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start mitotane at least 2 days after lenacapavir initiation; on day mitotane is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after mitotane initiation; if mitotane use >6mo, continue supplemental SC and PO doses every 6mo from mitotane initiation; consider alternative if already receiving mitotane, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• pentobarbital
Yeztugo (lenacapavir)

+

pentobarbital

1 interaction

Contraindicated

lenacapavir + pentobarbital

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start pentobarbital at least 2 days after lenacapavir initiation; on day pentobarbital is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after pentobarbital initiation; if pentobarbital use >6mo, continue supplemental SC and PO doses every 6mo from pentobarbital initiation; consider alternative if already receiving pentobarbital, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced)

• phenytoin
Yeztugo (lenacapavir)

+

phenytoin

1 interaction

Contraindicated

lenacapavir + phenytoin

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start phenytoin at least 2 days after lenacapavir initiation; on day phenytoin is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after phenytoin initiation; if phenytoin use >6mo, continue supplemental SC and PO doses every 6mo from phenytoin initiation; consider alternative if already receiving phenytoin, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced)

• primidone
Yeztugo (lenacapavir)

+

primidone

1 interaction

Contraindicated

lenacapavir + primidone

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start primidone at least 2 days after lenacapavir initiation; on day primidone is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after primidone initiation; if primidone use >6mo, continue supplemental SC and PO doses every 6mo from primidone initiation; consider alternative if already receiving primidone, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport possibly induced)

• rifampin
Yeztugo (lenacapavir)

+

rifampin

1 interaction

Contraindicated

lenacapavir + rifampin

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start rifampin at least 2 days after lenacapavir initiation; on day rifampin is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after rifampin initiation; if rifampin use >6mo, continue supplemental SC and PO doses every 6mo from rifampin initiation; consider alternative if already receiving rifampin, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced)

• St. John's wort
Yeztugo (lenacapavir)

+

St. John's wort

1 interaction

Contraindicated

lenacapavir + St. John's wort

HIV INFECTION: contraindicated; HIV PRE-EXPOSURE PROPHYLAXIS: start St. John's wort at least 2 days after lenacapavir initiation; on day St. John's wort is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after St. John's wort initiation; if St. John's wort use >6mo, continue supplemental SC and PO doses every 6mo from St. John's wort initiation; consider alternative if already receiving St. John's wort, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, P-gp-mediated transport induced)

Avoid/Use Alternative

• adagrasib
Yeztugo (lenacapavir)

+

adagrasib

1 interaction

Avoid/Use Alternative

lenacapavir + adagrasib

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, monitor ECG, electrolytes until adagrasib at steady state (approx. 8 days): combo may incr. adagrasib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• alpelisib
Yeztugo (lenacapavir)

+

alpelisib

1 interaction

Avoid/Use Alternative

lenacapavir + alpelisib

use alternative: combo may incr. alpelisib levels, risk of adverse effects (BCRP-mediated transport possibly inhibited)

• alprazolam
Yeztugo (lenacapavir)

+

alprazolam

1 interaction

Avoid/Use Alternative

lenacapavir + alprazolam

use alternative or monitor respiratory rate; consider decr. alprazolam dose during and x9mo after lenacapavir tx: combo may incr. alprazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• amiodarone
Yeztugo (lenacapavir)

+

amiodarone

1 interaction

Avoid/Use Alternative

lenacapavir + amiodarone

use alternative or monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• aprepitant
Yeztugo (lenacapavir)

+

aprepitant

1 interaction

Avoid/Use Alternative

lenacapavir + aprepitant

avoid combo w/ oral aprepitant during and x9mo after lenacapavir tx; IV aprepitant use OK: combo may incr. aprepitant levels, risk of adverse effects (hepatic metabolism inhibited)

• atazanavir
Yeztugo (lenacapavir)

+

atazanavir

1 interaction

Avoid/Use Alternative

lenacapavir + atazanavir

avoid combo if atazanavir boosted w/ cobicistat or ritonavir: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, UGT inhibited)

• avapritinib
Yeztugo (lenacapavir)

+

avapritinib

1 interaction

Avoid/Use Alternative

lenacapavir + avapritinib

GIST: use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 100 mg qd during and x9mo after lenacapavir tx; ADVANCED SYSTEMIC MASTOCYTOSIS: use alternative or monitor bleeding s/sx; decr. avapritinib start dose to 50 mg qd during and x9mo after lenacapavir tx; INDOLENT SYSTEMIC MASTOCYTOSIS: avoid combo during and x9mo after lenacapavir tx: combo may incr. avapritinib levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• azithromycin
Yeztugo (lenacapavir)

+

azithromycin

1 interaction

Avoid/Use Alternative

lenacapavir + azithromycin

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• belumosudil
Yeztugo (lenacapavir)

+

belumosudil

1 interaction

Avoid/Use Alternative

lenacapavir + belumosudil

avoid combo if also combined w/ strong CYP3A4 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (UGT inhibited, P-gp-mediated transport inhibited)

• bisoprolol
Yeztugo (lenacapavir)

+

bisoprolol

1 interaction

Avoid/Use Alternative

lenacapavir + bisoprolol

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• bosentan
Yeztugo (lenacapavir)

+

bosentan

1 interaction

Avoid/Use Alternative

lenacapavir + bosentan

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: during and x9mo after lenacapavir tx, avoid combo if also combined w/ CYP2C9 inhibitor; otherwise, on day bosentan is initiated, give supplemental lenacapavir 463.5 mg SC x1; if bosentan use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from bosentan initiation; consider alternative if already receiving bosentan, dosing regimen not established: combo may decr. lenacapavir levels, efficacy; may incr. bosentan levels, risk of adverse effects (hepatic metabolism induced; hepatic metabolism inhibited)

• bosutinib
Yeztugo (lenacapavir)

+

bosutinib

1 interaction

Avoid/Use Alternative

lenacapavir + bosutinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. bosutinib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• brigatinib
Yeztugo (lenacapavir)

+

brigatinib

1 interaction

Avoid/Use Alternative

lenacapavir + brigatinib

use alternative or monitor BP, HR; decr. brigatinib dose during and x9mo after lenacapavir tx by approx. 40% as follows: if taking 180 mg, decr. to 120 mg, if taking 120 mg, decr. to 90 mg; if taking 90 mg, decr. to 60 mg: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• buspirone
Yeztugo (lenacapavir)

+

buspirone

1 interaction

Avoid/Use Alternative

lenacapavir + buspirone

consider alternative or restart buspirone dose at 2.5 mg bid during and x9mo after lenacapavir tx: combo may incr. buspirone levels, risk of adverse effects (hepatic metabolism inhibited)

• cannabidiol
Yeztugo (lenacapavir)

+

cannabidiol

1 interaction

Avoid/Use Alternative

lenacapavir + cannabidiol

avoid combo w/ oral lenacapavir if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• capivasertib
Yeztugo (lenacapavir)

+

capivasertib

1 interaction

Avoid/Use Alternative

lenacapavir + capivasertib

avoid combo if also combined w/ strong CYP3A4 and P-gp inhibitors; otherwise, monitor glucose and decr. capivasertib dose to 320 mg bid x4 days followed by 3 days off during and x9mo after lenacapavir tx: combo may incr. level of both drugs, risk of severe hyperglycemia, other adverse effects (hepatic metabolism inhibited, UGT inhibited)

• cariprazine
Yeztugo (lenacapavir)

+

cariprazine

1 interaction

Avoid/Use Alternative

lenacapavir + cariprazine

during and x9mo after lenacapavir: IF STARTING CARIPRAZINE: ADULTS: adjust dose as follows: SCHIZOPHRENIA/BIPOLAR MANIA: start cariprazine 0.75 mg qd, then may incr. to 1.5 mg qd; BIPOLAR DEPRESSION/DEPRESSION ADJUNCT: start cariprazine 0.75 mg qd; PEDS: avoid combo; IF ON STABLE CARIPRAZINE AND STARTING LENACAPAVIR: ADULT/PEDS, ALL USES: adjust cariprazine dose as follows: if on cariprazine 1.5 mg or 3 mg qd, decr. dose to 0.75 mg qd; if on cariprazine 4.5 mg or 6 mg qd, decr. dose to 1.5 mg qd: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metabolism inhibited)

• carvedilol
Yeztugo (lenacapavir)

+

carvedilol

1 interaction

Avoid/Use Alternative

lenacapavir + carvedilol

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• cenobamate
Yeztugo (lenacapavir)

+

cenobamate

1 interaction

Avoid/Use Alternative

lenacapavir + cenobamate

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day cenobamate is initiated, give supplemental lenacapavir 463.5 mg SC x1; if cenobamate use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from cenobamate initiation; consider alternative if already receiving cenobamate, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ceritinib
Yeztugo (lenacapavir)

+

ceritinib

1 interaction

Avoid/Use Alternative

lenacapavir + ceritinib

avoid combo if also combined w/ UGT1A1 and P-gp inhibitors; otherwise, monitor ECG, electrolytes during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• chloramphenicol
Yeztugo (lenacapavir)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

lenacapavir + chloramphenicol

avoid combo if also combined w/ UGT1A1 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited)

• cladribine oral
Yeztugo (lenacapavir)

+

cladribine oral

1 interaction

Avoid/Use Alternative

lenacapavir + cladribine oral

use alternative or monitor CBC w/ oral lenacapavir: combo may incr. cladribine levels, risk of serious infection, myelosuppression, other adverse effects (gut BCRP-mediated transport inhibited)

• clarithromycin
Yeztugo (lenacapavir)

+

clarithromycin

1 interaction

Avoid/Use Alternative

lenacapavir + clarithromycin

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• cobicistat
Yeztugo (lenacapavir)

+

cobicistat

1 interaction

Avoid/Use Alternative

lenacapavir + cobicistat

avoid combo if also combined w/ UGT1A1 inhibitor: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• cobimetinib
Yeztugo (lenacapavir)

+

cobimetinib

1 interaction

Avoid/Use Alternative

lenacapavir + cobimetinib

if lenacapavir short-term (<14 days) use, decr. cobimetinib dose to 20 mg/day; otherwise, use alternative during and x9mo after lenacapavir tx: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metabolism inhibited)

• codeine
Yeztugo (lenacapavir)

+

codeine

1 interaction

Avoid/Use Alternative

lenacapavir + codeine

use alternative or monitor respiratory rate, consider decr. codeine dose during and x9mo after lenacapavir tx: combo may incr. codeine and active metabolite morphine levels, incr. risk of, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, may incr. production of active metabolite morphine)

• conivaptan
Yeztugo (lenacapavir)

+

conivaptan

1 interaction

Avoid/Use Alternative

lenacapavir + conivaptan

consider alternative during and x9mo after lenacapavir tx: combo may incr. conivaptan levels, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metabolism inhibited)

• cyclosporine
Yeztugo (lenacapavir)

+

cyclosporine

1 interaction

Avoid/Use Alternative

lenacapavir + cyclosporine

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor cyclosporine levels, renal fxn during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of serious infection, nephrotoxicity, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• dabigatran
Yeztugo (lenacapavir)

+

dabigatran

1 interaction

Avoid/Use Alternative

lenacapavir + dabigatran

ATRIAL FIBRILLATION: avoid combo if CrCl <30 mL/min; OTHER INDICATIONS: avoid combo if CrCl <50 mL/min; if dabigatran use for DVT/PE prophylaxis post-hip replacement and CrCl >50 mL/min, consider separating admin. at least 2h apart: combo may incr. dabigatran levels, risk of bleeding (including life-threatening), other adverse effects (P-gp-mediated transport inhibited)

• dabrafenib
Yeztugo (lenacapavir)

+

dabrafenib

1 interaction

Avoid/Use Alternative

lenacapavir + dabrafenib

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day dabrafenib is initiated, give supplemental lenacapavir 463.5 mg SC x1; if dabrafenib use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from dabrafenib initiation; consider alternative if already receiving dabrafenib, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• danicopan
Yeztugo (lenacapavir)

+

danicopan

1 interaction

Avoid/Use Alternative

lenacapavir + danicopan

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• daraxonrasib
Yeztugo (lenacapavir)

+

daraxonrasib

1 interaction

Avoid/Use Alternative

lenacapavir + daraxonrasib

avoid combo if also combined with strong CYP3A4 and UGT1A1 inhibitors; otherwise, decr. daraxonrasib dose to 100 mg qd during and x9mo after lenacapavir use: combo may incr. levels of both drugs, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• defactinib
Yeztugo (lenacapavir)

+

defactinib

1 interaction

Avoid/Use Alternative

lenacapavir + defactinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. defactinib levels, risk of adverse effects (hepatic metabolism inhibited)

• dihydrocodeine
Yeztugo (lenacapavir)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

lenacapavir + dihydrocodeine

use alternative or monitor respiratory rate, consider decr. dihydrocodeine dose during and x9mo after lenacapavir tx: combo may incr. dihydrocodeine and active metabolite dihydromorphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, may incr. production of active metabolite dihydromorphine)

• dihydroergotamine
Yeztugo (lenacapavir)

+

dihydroergotamine

1 interaction

Avoid/Use Alternative

lenacapavir + dihydroergotamine

avoid combo during and x9mo after lenacapavir tx: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• diosmin
Yeztugo (lenacapavir)

+

diosmin

1 interaction

Avoid/Use Alternative

lenacapavir + diosmin

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• disopyramide
Yeztugo (lenacapavir)

+

disopyramide

1 interaction

Avoid/Use Alternative

lenacapavir + disopyramide

use alternative or monitor disopyramide levels, ECG during and x9mo after lenacapavir tx: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• domperidone
Yeztugo (lenacapavir)

+

domperidone

1 interaction

Avoid/Use Alternative

lenacapavir + domperidone

avoid combo during and x9mo after lenacapavir tx: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• dordaviprone
Yeztugo (lenacapavir)

+

dordaviprone

1 interaction

Avoid/Use Alternative

lenacapavir + dordaviprone

during and x9mo after lenacapavir tx, use alternative or monitor ECG; for adult and pediatric pts weighing at least 52.5 kg, decr. dordaviprone dose to 500 mg once weekly; dose recommendation not established in pediatric pts weighing less than 52.5 kg: combo may incr. dordaviprone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• doxorubicin
Yeztugo (lenacapavir)

+

doxorubicin

1 interaction

Avoid/Use Alternative

lenacapavir + doxorubicin

avoid combo during and x9mo after lenacapavir tx: combo may incr. doxorubicin levels, risk of serious infection, myelosuppression, cardiotoxicity, other adverse effects (hepatic metabolism inhibited)

• dronedarone
Yeztugo (lenacapavir)

+

dronedarone

1 interaction

Avoid/Use Alternative

lenacapavir + dronedarone

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• efavirenz
Yeztugo (lenacapavir)

+

efavirenz

1 interaction

Avoid/Use Alternative

lenacapavir + efavirenz

avoid combo: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced)

• elacestrant
Yeztugo (lenacapavir)

+

elacestrant

1 interaction

Avoid/Use Alternative

lenacapavir + elacestrant

avoid combo during and x9mo after lenacapavir tx: combo may incr. elacestrant levels, risk of adverse effects (hepatic metabolism inhibited)

• elagolix
Yeztugo (lenacapavir)

+

elagolix

1 interaction

Avoid/Use Alternative

lenacapavir + elagolix

HIV INFECTION: avoid combo if elagolix 300 mg bid regimen; otherwise, caution advised; HIV PRE-EXPOSURE PROPHYLAXIS: on day elagolix 300 mg bid regimen is initiated, give supplemental lenacapavir 463.5 mg SC x1; if elagolix 300 mg bid regimen use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from elagolix initiation; consider alternative if already receiving elagolix 300 mg bid regimen, dosing regimen not established; caution advised if elagolix 200 mg bid regimen or 150 mg qd regimen: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ensartinib
Yeztugo (lenacapavir)

+

ensartinib

1 interaction

Avoid/Use Alternative

lenacapavir + ensartinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (hepatic metabolism possibly inhibited, P-gp-mediated transport possibly inhibited)

• ensitrelvir
Yeztugo (lenacapavir)

+

ensitrelvir

1 interaction

Avoid/Use Alternative

lenacapavir + ensitrelvir

avoid combo if also combined with UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• entrectinib
Yeztugo (lenacapavir)

+

entrectinib

1 interaction

Avoid/Use Alternative

lenacapavir + entrectinib

PEDS PTS w/ ENTRECTINIB START DOSE <200 mg/day: avoid combo; ADULT AND PEDS PTS >2yo: use alternative or monitor ECG, CBC, limit coadmin. to 14 days or less and decr. entrectinib dose as follows: if entrectinib start dose 200 mg qd, decr. to 50 mg qd; if entrectinib start dose 300 mg qd, decr. to 100 mg qd; if entrectinib start dose 400 or 600 mg qd, decr. to 200 mg qd: combo may incr. entrectinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• ergotamine
Yeztugo (lenacapavir)

+

ergotamine

1 interaction

Avoid/Use Alternative

lenacapavir + ergotamine

avoid combo during and x9mo after lenacapavir tx: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• erythromycin
Yeztugo (lenacapavir)

+

erythromycin

1 interaction

Avoid/Use Alternative

lenacapavir + erythromycin

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• etrasimod
Yeztugo (lenacapavir)

+

etrasimod

1 interaction

Avoid/Use Alternative

lenacapavir + etrasimod

during and x9mo after lenacapavir tx; if CYP2C9 poor metabolizer or if also combined w/ moderate or strong CYP2C9 inhibitor; otherwise, caution advised: combo may incr. etrasimod levels, risk of AV block, bradycardia, QT prolongation, cardiac arrhythmias, serious infection, other adverse effects (hepatic metabolism inhibited)

• etravirine
Yeztugo (lenacapavir)

+

etravirine

1 interaction

Avoid/Use Alternative

lenacapavir + etravirine

avoid combo: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• fentanyl
Yeztugo (lenacapavir)

+

fentanyl

1 interaction

Avoid/Use Alternative

lenacapavir + fentanyl

use alternative or monitor respiratory rate, consider decr. fentanyl dose during and x9mo after lenacapavir tx: combo may incr. fentanyl levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• fexinidazole
Yeztugo (lenacapavir)

+

fexinidazole

1 interaction

Avoid/Use Alternative

lenacapavir + fexinidazole

use alternative during and x9mo after lenacapavir tx: combo may decr. lenacapavir levels, efficacy; may decr. fexinidazole active metabolite levels, efficacy (hepatic metabolism induced; hepatic metabolism inhibited, decr. conversion to active metabolites)

• fosaprepitant
Yeztugo (lenacapavir)

+

fosaprepitant

1 interaction

Avoid/Use Alternative

lenacapavir + fosaprepitant

avoid combo during and x9mo after lenacapavir tx: combo may incr. aprepitant levels, risk of adverse effects (hepatic metabolism inhibited)

• gemfibrozil
Yeztugo (lenacapavir)

+

gemfibrozil

1 interaction

Avoid/Use Alternative

lenacapavir + gemfibrozil

avoid combo if also combined w/ strong CYP3A4 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (UGT inhibited)

• gepotidacin
Yeztugo (lenacapavir)

+

gepotidacin

1 interaction

Avoid/Use Alternative

lenacapavir + gepotidacin

UROGENITAL GONORRHEA: use alternative or monitor ECG, electrolytes during and x9mo after lenacapavir tx; URINARY TRACT INFECTION: consider monitoring ECG, electrolytes during and x9mo after lenacapavir tx: combo may incr. gepotidacin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• glecaprevir
Yeztugo (lenacapavir)

+

glecaprevir

1 interaction

Avoid/Use Alternative

lenacapavir + glecaprevir

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. levels of both drugs, risk of adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• hydrocodone
Yeztugo (lenacapavir)

+

hydrocodone

1 interaction

Avoid/Use Alternative

lenacapavir + hydrocodone

use alternative or monitor respiratory rate, ECG, consider decr. (benz)hydrocodone dose during and x9mo after lenacapavir tx: combo may incr. hydrocodone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• iberdomide
Yeztugo (lenacapavir)

+

iberdomide

1 interaction

Avoid/Use Alternative

lenacapavir + iberdomide

during and x9mo after lenacapavir use, use alternative or decr. iberdomide dose to 0.75 mg qd on Days 1 to 21 of a 28-day cycle; if further dose modification needed due to adverse events, decr. iberdomide dose to 1 mg every other day on Days 1 to 21 of a 28-day cycle: combo may incr. iberdomide levels, risk of serious infection, myelosuppression, thromboembolism, other adverse effects (hepatic metabolism inhibited)

• idelalisib
Yeztugo (lenacapavir)

+

idelalisib

1 interaction

Avoid/Use Alternative

lenacapavir + idelalisib

avoid combo if also combined w/ UGT1A1 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited)

• itraconazole
Yeztugo (lenacapavir)

+

itraconazole

1 interaction

Avoid/Use Alternative

lenacapavir + itraconazole

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, consider decr. itraconazole dose during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• ivabradine
Yeztugo (lenacapavir)

+

ivabradine

1 interaction

Avoid/Use Alternative

lenacapavir + ivabradine

avoid combo during and x9mo after lenacapavir tx: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ivacaftor
Yeztugo (lenacapavir)

+

ivacaftor

1 interaction

Avoid/Use Alternative

lenacapavir + ivacaftor

pts <6 mo: avoid combo during and x9mo after lenacapavir tx; pts >6 mo decr. ivacaftor dose during and x9mo after lenacapavir tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• ixabepilone
Yeztugo (lenacapavir)

+

ixabepilone

1 interaction

Avoid/Use Alternative

lenacapavir + ixabepilone

consider alternative or monitor CBC during and x9mo after lenacapavir use: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• ketoconazole
Yeztugo (lenacapavir)

+

ketoconazole

1 interaction

Avoid/Use Alternative

lenacapavir + ketoconazole

avoid combo during and up to 1wk after ketoconazole tx: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, UGT inhibited, P-gp-mediated transport inhibited)

• lapatinib
Yeztugo (lenacapavir)

+

lapatinib

1 interaction

Avoid/Use Alternative

lenacapavir + lapatinib

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG during and x9mo after lenacapavir tx; consider decr. lapatinib dose: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited, BCRP-mediated transport inhibited)

• ledipasvir
Yeztugo (lenacapavir)

+

ledipasvir

1 interaction

Avoid/Use Alternative

lenacapavir + ledipasvir

avoid combo w/ oral lenacapavir if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• lemborexant
Yeztugo (lenacapavir)

+

lemborexant

1 interaction

Avoid/Use Alternative

lenacapavir + lemborexant

avoid combo during and x9mo after lenacapavir tx: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• levoketoconazole
Yeztugo (lenacapavir)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

lenacapavir + levoketoconazole

consider alternative x2wk before and during levoketoconazole tx; otherwise, monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• lonafarnib
Yeztugo (lenacapavir)

+

lonafarnib

1 interaction

Avoid/Use Alternative

lenacapavir + lonafarnib

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, consider alternative or monitor HR, ECG, electrolytes, especially during first week when adding lonafarnib to existing lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• lopinavir/ritonavir
Yeztugo (lenacapavir)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

lenacapavir + lopinavir/ ritonavir

avoid combo: combo may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (hepatic metabolism altered, UGT inhibited, P-gp-mediated transport inhibited)

• lorlatinib
Yeztugo (lenacapavir)

+

lorlatinib

1 interaction

Avoid/Use Alternative

lenacapavir + lorlatinib

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day lorlatinib is initiated, give supplemental lenacapavir 463.5 mg SC x1; if lorlatinib use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from lorlatinib initiation; consider alternative if already receiving lorlatinib, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport induced)

• lovastatin
Yeztugo (lenacapavir)

+

lovastatin

1 interaction

Avoid/Use Alternative

lenacapavir + lovastatin

use alternative or monitor CK, myopathy sx during and x9mo after lenacapavir tx; use lowest lovastatin start dose, adjust lovastatin max dose to 20 mg/day: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• lurbinectedin
Yeztugo (lenacapavir)

+

lurbinectedin

1 interaction

Avoid/Use Alternative

lenacapavir + lurbinectedin

during and x9mo after lenacapavir tx, use alternative or monitor CBC and decr. lurbinectedin dose 50%: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• macitentan
Yeztugo (lenacapavir)

+

macitentan

1 interaction

Avoid/Use Alternative

lenacapavir + macitentan

if also combined w/ strong-mod CYP2C9 inhibitor, avoid combo during and x9mo after lenacapavir tx; otherwise, caution advised during and x9mo after lenacapavir tx: combo may incr. macitentan levels, risk of adverse effects (hepatic metabolism inhibited)

• mavacamten
Yeztugo (lenacapavir)

+

mavacamten

1 interaction

Avoid/Use Alternative

lenacapavir + mavacamten

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: during and x9mo after lenacapavir tx, monitor cardiac fxn, incl. LVEF; see mavacamten pkg insert for specific recommendations; on day mavacamten is initiated, give supplemental lenacapavir 463.5 mg SC x1; if mavacamten use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from mavacamten initiation; consider alternative if already receiving mavacamten, dosing regimen not established: combo may decr. lenacapavir levels, efficacy; may incr. mavacamten levels, risk of heart failure, other adverse effects (hepatic metabolism induced; hepatic metabolism inhibited)

• mavorixafor
Yeztugo (lenacapavir)

+

mavorixafor

1 interaction

Avoid/Use Alternative

lenacapavir + mavorixafor

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• meperidine
Yeztugo (lenacapavir)

+

meperidine

1 interaction

Avoid/Use Alternative

lenacapavir + meperidine

use alternative or monitor respiratory rate, ECG; consider decr. meperidine dose during and x9mo after lenacapavir tx: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• methylergonovine
Yeztugo (lenacapavir)

+

methylergonovine

1 interaction

Avoid/Use Alternative

lenacapavir + methylergonovine

avoid combo during and x9mo after lenacapavir tx: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• midazolam
Yeztugo (lenacapavir)

+

midazolam

1 interaction

Avoid/Use Alternative

lenacapavir + midazolam

avoid combo if midazolam nasal use during and x9mo after lenacapavir tx; otherwise, monitor respiratory rate, consider decr. midazolam dose during and x9mo after lenacapavir tx: combo may incr. midazolam and active metabolite levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• mifepristone
Yeztugo (lenacapavir)

+

mifepristone

1 interaction

Avoid/Use Alternative

lenacapavir + mifepristone

avoid combo if also combined w/ UGT1A1 inhibitor w/in 14 days of daily mifepristone use; otherwise, monitor ECG if daily mifepristone use during and x9mo after lenacapavir tx; caution advised if pregnancy termination use during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• mitapivat
Yeztugo (lenacapavir)

+

mitapivat

1 interaction

Avoid/Use Alternative

lenacapavir + mitapivat

THALASSEMIA: avoid combo during and x9mo after lenacapavir tx; HEMOLYTIC ANEMIA: monitor Hgb; adjust max mitapivat dose to 20 mg bid during and x9mo after lenacapavir tx; HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day mitapivat is initiated, give supplemental lenacapavir 463.5 mg SC x1; if mitapivat use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from mitapivat initiation; consider alternative if already receiving mitapivat, dosing regimen not established: combo may decr. lenacapavir levels, efficacy; may incr. mitapivat levels, risk of adverse effects (hepatic metabolism induced, UGT possibly induced; hepatic metabolism inhibited)

• mobocertinib
Yeztugo (lenacapavir)

+

mobocertinib

1 interaction

Avoid/Use Alternative

lenacapavir + mobocertinib

use alternative or monitor ECG; decr. mobocertinib dose during and x9mo after lenacapavir tx as follows: if taking 160 mg, decr. dose to 80 mg; if taking 120 mg, decr. dose to 40 mg, if taking 80 mg, decr. dose to 40 mg: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• modafinil
Yeztugo (lenacapavir)

+

modafinil

1 interaction

Avoid/Use Alternative

lenacapavir + modafinil

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day modafinil is initiated, give supplemental lenacapavir 463.5 mg SC x1; if modafinil use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from modafinil initiation; consider alternative if already receiving modafinil, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• nafcillin
Yeztugo (lenacapavir)

+

nafcillin

1 interaction

Avoid/Use Alternative

lenacapavir + nafcillin

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day nafcillin is initiated, give supplemental lenacapavir 463.5 mg SC x1; if nafcillin use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from nafcillin initiation; consider alternative if already receiving nafcillin, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• naloxegol
Yeztugo (lenacapavir)

+

naloxegol

1 interaction

Avoid/Use Alternative

lenacapavir + naloxegol

use alternative or decr. naloxegol dose to 12.5 mg/day during and x9mo after lenacapavir tx: combo may incr. naloxegol levels, risk of adverse effects (hepatic metabolism inhibited)

• nefazodone
Yeztugo (lenacapavir)

+

nefazodone

1 interaction

Avoid/Use Alternative

lenacapavir + nefazodone

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• nelfinavir
Yeztugo (lenacapavir)

+

nelfinavir

1 interaction

Avoid/Use Alternative

lenacapavir + nelfinavir

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• neratinib
Yeztugo (lenacapavir)

+

neratinib

1 interaction

Avoid/Use Alternative

lenacapavir + neratinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. neratinib levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• nevirapine
Yeztugo (lenacapavir)

+

nevirapine

1 interaction

Avoid/Use Alternative

lenacapavir + nevirapine

avoid combo: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• nirogacestat
Yeztugo (lenacapavir)

+

nirogacestat

1 interaction

Avoid/Use Alternative

lenacapavir + nirogacestat

avoid combo during and x9mo after lenacapavir tx: combo may incr. nirogacestat levels, risk of hypophosphatemia, other adverse effects (hepatic metabolism inhibited)

• nisoldipine
Yeztugo (lenacapavir)

+

nisoldipine

1 interaction

Avoid/Use Alternative

lenacapavir + nisoldipine

consider alternative or monitor BP during and x9mo after lenacapavir tx: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• olaparib
Yeztugo (lenacapavir)

+

olaparib

1 interaction

Avoid/Use Alternative

lenacapavir + olaparib

use alternative or monitor CBC; decr. olaparib dose to 150 mg bid during and x9mo after lenacapavir tx: combo may incr. olaparib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• oliceridine
Yeztugo (lenacapavir)

+

oliceridine

1 interaction

Avoid/Use Alternative

lenacapavir + oliceridine

use alternative or monitor respiratory rate, ECG; consider decr. oliceridine frequency during and x9mo after lenacapavir tx: combo may incr. oliceridine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• omaveloxolone
Yeztugo (lenacapavir)

+

omaveloxolone

1 interaction

Avoid/Use Alternative

lenacapavir + omaveloxolone

use alternative or decr. omaveloxolone dose to 100 mg/day during and x9mo after lenacapavir tx: combo may incr. omaveloxolone levels, risk of adverse effects during and x9mo after lenacapavir tx; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• orlistat
Yeztugo (lenacapavir)

+

orlistat

1 interaction

Avoid/Use Alternative

lenacapavir + orlistat

consider alternative w/ oral lenacapavir: combo may decr. lenacapavir levels, efficacy (absorption possibly decreased)

• oxcarbazepine
Yeztugo (lenacapavir)

+

oxcarbazepine

1 interaction

Avoid/Use Alternative

lenacapavir + oxcarbazepine

consider alternative anticonvulsant: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport possibly induced)

• oxycodone
Yeztugo (lenacapavir)

+

oxycodone

1 interaction

Avoid/Use Alternative

lenacapavir + oxycodone

use alternative or monitor respiratory rate; consider decr. oxycodone dose during and x9mo after lenacapavir tx: combo may incr. oxycodone levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• pacritinib
Yeztugo (lenacapavir)

+

pacritinib

1 interaction

Avoid/Use Alternative

lenacapavir + pacritinib

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: monitor ECG, CBC, bleeding s/sx during and x9mo after lenacapavir tx; on day pacritinib is initiated, give supplemental lenacapavir 463.5 mg SC x1; if pacritinib use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from pacritinib initiation; consider alternative if already receiving pacritinib, dosing regimen not established: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (including life-threatening), other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• palovarotene
Yeztugo (lenacapavir)

+

palovarotene

1 interaction

Avoid/Use Alternative

lenacapavir + palovarotene

during and x9mo after lenacapavir tx, use alternative or decr. palovarotene dose as follows: wt 10-19.9 kg maint. dose 1 mg daily, flare dose 5 mg daily wk 1-4, then 2.5 mg daily wk 5-12; wt 20-39.9 kg maint. dose 1.5 mg daily, flare dose 6 mg daily wk 1-4, then 3 mg daily wk 5-12; wt 40-59.9 kg maint. dose 2 mg daily, flare dose 7.5 mg daily wk 1-4, then 4 mg daily wk 5-12; wt 60 kg and greater or 14 yo and older maint. dose 2.5 mg daily, flare dose 10 mg daily wk 1-4, then 5 mg daily wk 5-12: combo may incr. palovarotene levels, risk of adverse effects (hepatic metabolism inhibited)

• pazopanib
Yeztugo (lenacapavir)

+

pazopanib

1 interaction

Avoid/Use Alternative

lenacapavir + pazopanib

avoid combo: combo may incr. pazopanib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects during and x9mo after lenacapavir tx (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• pemigatinib
Yeztugo (lenacapavir)

+

pemigatinib

1 interaction

Avoid/Use Alternative

lenacapavir + pemigatinib

use alternative or monitor phosphate and decr. pemigatinib dose during and x9mo after lenacapavir tx as follows: if on pemigatinib 13.5 mg qd, decr. to 9 mg qd; if on pemigatinib 9 mg qd, decr. to 4.5 mg qd: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metabolism inhibited)

• pexidartinib
Yeztugo (lenacapavir)

+

pexidartinib

1 interaction

Avoid/Use Alternative

lenacapavir + pexidartinib

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: during and x9mo after lenacapavir, use alternative or monitor LFTs; see pexidartinib pkg insert for specific dose adjustments; on day pexidartinib is started, give supplemental lenacapavir 463.5 mg SC x1; if pexidartinib use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from pexidartinib start; consider alternative if already receiving pexidartinib, dosing regimen undefined: combo may incr. pexidartinib levels, risk of hepatotoxicity, other adverse effects; may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (hepatic metabolism inhibited; UGT possibly inhibited, hepatic metabolism induced)

• phenobarbital
Yeztugo (lenacapavir)

+

phenobarbital

1 interaction

Avoid/Use Alternative

lenacapavir + phenobarbital

HIV INFECTION: consider alternative anticonvulsant; HIV PRE-EXPOSURE PROPHYLAXIS: start phenobarbital at least 2 days after lenacapavir initiation; on day phenobarbital is initiated, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after phenobarbital initiation; if phenobarbital use >6mo, continue supplemental SC and PO doses every 6mo from phenobarbital initiation; consider alternative if already receiving phenobarbital, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT induced, P-gp-mediated transport possibly induced)

• pibrentasvir
Yeztugo (lenacapavir)

+

pibrentasvir

1 interaction

Avoid/Use Alternative

lenacapavir + pibrentasvir

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. levels of both drugs, risk of adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• pimozide
Yeztugo (lenacapavir)

+

pimozide

1 interaction

Avoid/Use Alternative

lenacapavir + pimozide

avoid combo during and x9mo after lenacapavir tx: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• posaconazole
Yeztugo (lenacapavir)

+

posaconazole

1 interaction

Avoid/Use Alternative

lenacapavir + posaconazole

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• pralsetinib
Yeztugo (lenacapavir)

+

pralsetinib

1 interaction

Avoid/Use Alternative

lenacapavir + pralsetinib

use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows during and x9mo after lenacapavir tx: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• probenecid
Yeztugo (lenacapavir)

+

probenecid

1 interaction

Avoid/Use Alternative

lenacapavir + probenecid

avoid combo if also combined w/ strong CYP3A4 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (UGT inhibited)

• propafenone
Yeztugo (lenacapavir)

+

propafenone

1 interaction

Avoid/Use Alternative

lenacapavir + propafenone

if also combined w/ CYP2D6 inhibitor, avoid combo; otherwise, monitor ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• quinidine (antiarrhythmic)
Yeztugo (lenacapavir)

+

quinidine (antiarrhythmic)

1 interaction

Avoid/Use Alternative

lenacapavir + quinidine (antiarrhythmic)

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor quinidine levels, ECG during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• ranolazine
Yeztugo (lenacapavir)

+

ranolazine

1 interaction

Avoid/Use Alternative

lenacapavir + ranolazine

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG, adjust ranolazine max dose to 1000 mg/day during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• regorafenib
Yeztugo (lenacapavir)

+

regorafenib

1 interaction

Avoid/Use Alternative

lenacapavir + regorafenib

avoid combo if also combined w/ strong CYP3A4 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (UGT inhibited)

• relacorilant
Yeztugo (lenacapavir)

+

relacorilant

1 interaction

Avoid/Use Alternative

lenacapavir + relacorilant

avoid combo if also combined with UGT1A1 and P-gp inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited)

• relugolix
Yeztugo (lenacapavir)

+

relugolix

1 interaction

Avoid/Use Alternative

lenacapavir + relugolix

PROSTATE CANCER: use alternative or monitor ECG, electrolytes and admin. relugolix at least 6h before oral lenacapavir tx; FIBROID-ASSOC. BLEEDING: use alternative or admin. relugolix at least 6h before oral lenacapavir tx: combo may incr. relugolix levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• remibrutinib
Yeztugo (lenacapavir)

+

remibrutinib

1 interaction

Avoid/Use Alternative

lenacapavir + remibrutinib

avoid combo: combo may incr. remibrutinib levels, risk of adverse effects (hepatic metabolism inhibited)

• repotrectinib
Yeztugo (lenacapavir)

+

repotrectinib

1 interaction

Avoid/Use Alternative

lenacapavir + repotrectinib

avoid combo during and x9mo after lenacapavir tx; D/C lenacapavir 3-5 half-lives prior to repotrectinib tx: combo may incr. repotrectinib levels, risk of adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited, P-gp-mediated transport inhibited; hepatic metabolism induced)

• ribociclib
Yeztugo (lenacapavir)

+

ribociclib

1 interaction

Avoid/Use Alternative

lenacapavir + ribociclib

avoid combo if also combined w/ UGT1A1 and P-gp inhibitors; otherwise, monitor ECG, electrolytes, CBC during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• rifabutin
Yeztugo (lenacapavir)

+

rifabutin

1 interaction

Avoid/Use Alternative

lenacapavir + rifabutin

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: monitor CBC, uveitis s/sx during and x9mo after lenacapavir; start rifabutin at least 2 days after lenacapavir start; on day rifabutin started, give supplemental lenacapavir 927 mg SC x1 and 600 mg PO x1, then give 600 mg PO x1 the day after rifabutin start; if rifabutin use >6mo, continue supplemental SC and PO doses every 6mo from rifabutin initiation; consider alternative if already receiving rifabutin, dosing regimen not defined: combo may decr. lenacapavir levels, efficacy; may incr. rifabutin levels, risk of myelosuppression, uveitis, other adverse effects (hepatic metabolism induced, UGT induced, P-gp-mediated transport possibly induced; hepatic metabolism inhibited)

• rifapentine
Yeztugo (lenacapavir)

+

rifapentine

1 interaction

Avoid/Use Alternative

lenacapavir + rifapentine

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: on day rifapentine is initiated, give supplemental lenacapavir 463.5 mg SC x1; if rifapentine use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from rifapentine initiation; consider alternative if already receiving rifapentine, dosing regimen not established: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, UGT possibly induced, P-gp-mediated transport possibly induced)

• rilzabrutinib
Yeztugo (lenacapavir)

+

rilzabrutinib

1 interaction

Avoid/Use Alternative

lenacapavir + rilzabrutinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. rilzabrutinib levels, risk of adverse effects (hepatic metabolism inhibited)

• rivaroxaban
Yeztugo (lenacapavir)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

lenacapavir + rivaroxaban

use alternative if CrCl <80; otherwise, monitor bleeding s/sx during and x9mo after lenacapavir tx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• selpercatinib
Yeztugo (lenacapavir)

+

selpercatinib

1 interaction

Avoid/Use Alternative

lenacapavir + selpercatinib

during and x9mo after lenacapavir tx, use alternative or monitor ECG, electrolytes; decr. selpercatinib dose as follows: if on selpercatinib 40 mg tid, decr. to 40 mg qd; if on selpercatinib 80 mg bid, decr. to 40 mg bid; if on selpercatinib 120 mg bid, decr. to 80 mg bid; if on selpercatinib 160 mg bid, decr. to 120 mg bid: combo may incr. selpercatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• selumetinib
Yeztugo (lenacapavir)

+

selumetinib

1 interaction

Avoid/Use Alternative

lenacapavir + selumetinib

during and x9mo after lenacapavir tx, use alternative or monitor LVEF, CK, myopathy sx; decr. selumetinib dose as follows: if on selumetinib 25 mg/m^2 bid, decr. to 20 mg/m^2 bid; if on selumetinib 20 mg/m^2 bid, decr. to 15 mg/m^2 bid; see selumetinib pkg insert for specific dose adjustments: combo may incr. selumetinib levels, risk of cardiotoxicity, myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• simvastatin
Yeztugo (lenacapavir)

+

simvastatin

1 interaction

Avoid/Use Alternative

lenacapavir + simvastatin

use alternative or monitor CK, myopathy sx during and x9mo after lenacapavir tx; use lowest simvastatin start dose; adjust max simvastatin dose to 10 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• siponimod
Yeztugo (lenacapavir)

+

siponimod

1 interaction

Avoid/Use Alternative

lenacapavir + siponimod

if also combined w/ strong CYP2C9 inhibitor, avoid combo; if also combined w/ moderate CYP2C9 inhibitor, monitor HR, ECG during and x9mo after lenacapavir tx: combo may incr. siponimod levels, risk of PR interval prolongation, AV block, bradycardia, serious infection, other adverse effects (hepatic metabolism inhibited)

• sirolimus albumin-bound
Yeztugo (lenacapavir)

+

sirolimus albumin-bound

1 interaction

Avoid/Use Alternative

lenacapavir + sirolimus albumin-bound

avoid combo: combo may incr. sirolimus albumin-bound levels, risk of serious infection, myelosuppression, bleeding (including life-threatening), other adverse effects during and x9mo after lenacapavir tx (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• sonidegib
Yeztugo (lenacapavir)

+

sonidegib

1 interaction

Avoid/Use Alternative

lenacapavir + sonidegib

if lenacapavir use 14 days or longer, avoid combo during and x9mo after lenacapavir use; if lenacapavir use <14 days, use alternative or monitor CK, myopathy symptoms during and x9mo after lenacapavir use: combo may incr. sonidegib levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• sonrotoclax
Yeztugo (lenacapavir)

+

sonrotoclax

1 interaction

Avoid/Use Alternative

lenacapavir + sonrotoclax

during and x9mo after lenacapavir use, consider alternative or during sonrotoclax ramp-up phase, avoid combo if sonrotoclax dose 1 mg or 2 mg/day; otherwise, decr. sonrotoclax ramp-up dose as follows: if taking 5 mg/day decr. to 1 mg/day, if 10 mg/day decr. to 2 mg/day, if 20 mg/day decr. to 5 mg/day, if 40 mg/day decr. to 10 mg/day, if 80 mg/day decr. to 20 mg/day, if 160 mg/day decr. to 40 mg/day, if 320mg/day decr. to 80 mg/day; if on stable sonrotoclax tx, decr. sonrotoclax dose to 80 mg/day: combo may incr. sonrotoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metabolism inhibited)

• sorafenib
Yeztugo (lenacapavir)

+

sorafenib

1 interaction

Avoid/Use Alternative

lenacapavir + sorafenib

avoid combo if also combined w/ strong CYP3A4 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (UGT inhibited, P-gp-mediated transport possibly inhibited)

• sotorasib
Yeztugo (lenacapavir)

+

sotorasib

1 interaction

Avoid/Use Alternative

lenacapavir + sotorasib

HIV INFECTION: avoid combo; HIV PRE-EXPOSURE PROPHYLAXIS: avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, on day sotorasib is initiated, give supplemental lenacapavir 463.5 mg SC x1; if sotorasib use >6mo, give supplemental lenacapavir 463.5 mg SC x1 every 6mo from sotorasib initiation; consider alternative if already receiving sotorasib, dosing regimen not established: combo may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (P-gp-mediated transport inhibited, hepatic metabolism induced)

• sufentanil
Yeztugo (lenacapavir)

+

sufentanil

1 interaction

Avoid/Use Alternative

lenacapavir + sufentanil

consider alternative or monitor respiratory rate, consider decr. sufentanil dose or frequency during and x9mo after lenacapavir tx: combo may incr. sufentanil levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• tadalafil
Yeztugo (lenacapavir)

+

tadalafil

1 interaction

Avoid/Use Alternative

lenacapavir + tadalafil

PAH: avoid combo during and x9mo after lenacapavir tx; ED: monitor BP during and x9mo after lenacapavir tx: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• taletrectinib
Yeztugo (lenacapavir)

+

taletrectinib

1 interaction

Avoid/Use Alternative

lenacapavir + taletrectinib

avoid combo during and x9mo after lenacapavir tx: combo may incr. taletrectinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• tazemetostat
Yeztugo (lenacapavir)

+

tazemetostat

1 interaction

Avoid/Use Alternative

lenacapavir + tazemetostat

during and x9mo after lenacapavir tx, use alternative or monitor ECG, CBC; decr. tazemetostat dose as follows: if taking 800 mg bid, decr. tazemetostat dose to 400 mg bid; if taking 600 mg bid, decr. tazemetostat dose to 400 mg qam plus 200 mg qpm: combo may incr. tazemetostat levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• tepotinib
Yeztugo (lenacapavir)

+

tepotinib

1 interaction

Avoid/Use Alternative

lenacapavir + tepotinib

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• tipranavir
Yeztugo (lenacapavir)

+

tipranavir

1 interaction

Avoid/Use Alternative

lenacapavir + tipranavir

avoid combo: combo may decr. lenacapavir levels, efficacy (UGT induced, P-gp-mediated transport induced)

• tolvaptan
Yeztugo (lenacapavir)

+

tolvaptan

1 interaction

Avoid/Use Alternative

lenacapavir + tolvaptan

HYPONATREMIA USE: avoid combo during and x9mo after lenacapavir tx; AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DZ USE: decr. tolvaptan total daily dose by 50% during and x9mo after lenacapavir tx as follows: if taking 60 mg/day, decr. to 15 mg qam and 15 mg qpm; if taking 90 mg/day, decr. to 30 mg qam and 15 mg qpm; if taking 120 mg/day, decr. to 45 mg qam and 15 mg qpm: combo may incr. tolvaptan levels, risk of adverse effects (hepatic metabolism inhibited)

• topotecan
Yeztugo (lenacapavir)

+

topotecan

1 interaction

Avoid/Use Alternative

lenacapavir + topotecan

avoid combo w/ oral topotecan: combo may incr. topotecan levels, risk of serious infection, myelosuppression, other adverse effects (gut BCRP-mediated transport inhibited, gut P-gp-mediated transport inhibited)

• tramadol
Yeztugo (lenacapavir)

+

tramadol

1 interaction

Avoid/Use Alternative

lenacapavir + tramadol

use alternative or monitor respiratory rate, ECG, consider decr. tramadol dose during and x9mo after lenacapavir tx: combo may incr. tramadol and active metabolite levels, risk of CNS and respiratory depression, psychomotor impairment, seizures, serotonin syndrome, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, may incr. production of active metabolite)

• tucatinib
Yeztugo (lenacapavir)

+

tucatinib

1 interaction

Avoid/Use Alternative

lenacapavir + tucatinib

avoid combo if also combined w/ UGT1A1 inhibitor; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• turmeric
Yeztugo (lenacapavir)

+

turmeric

1 interaction

Avoid/Use Alternative

lenacapavir + turmeric

avoid combo w/ oral turmeric: combo may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (P-gp-mediated transport altered)

• vardenafil
Yeztugo (lenacapavir)

+

vardenafil

1 interaction

Avoid/Use Alternative

lenacapavir + vardenafil

max vardenafil dose 5 mg/24h during and x9mo after lenacapavir tx; avoid combo w/ ODT form during and x9mo after lenacapavir tx: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• venetoclax
Yeztugo (lenacapavir)

+

venetoclax

1 interaction

Avoid/Use Alternative

lenacapavir + venetoclax

monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50% during and x9mo after lenacapavir tx; AML: decr. venetoclax dose by at least 50% during and x9mo after lenacapavir tx: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• vepdegestrant
Yeztugo (lenacapavir)

+

vepdegestrant

1 interaction

Avoid/Use Alternative

lenacapavir + vepdegestrant

avoid combo if also combined with strong CYP3A4 and UGT1A1 inhibitors; otherwise, monitor ECG during and x9mo after lenacapavir use: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• verapamil
Yeztugo (lenacapavir)

+

verapamil

1 interaction

Avoid/Use Alternative

lenacapavir + verapamil

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised during and x9mo after lenacapavir tx: combo may incr. levels of both drugs, risk of hypotension, bradycardia, AV block, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• vimseltinib
Yeztugo (lenacapavir)

+

vimseltinib

1 interaction

Avoid/Use Alternative

lenacapavir + vimseltinib

avoid combo if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, give vimseltinib at least 4h before lenacapavir: combo may incr. lenacapavir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• voriconazole
Yeztugo (lenacapavir)

+

voriconazole

1 interaction

Avoid/Use Alternative

lenacapavir + voriconazole

avoid combo if also combined w/ UGT1A1 and P-gp inhibitors: combo may incr. lenacapavir levels, risk of adverse effects (hepatic metabolism inhibited)

• voxilaprevir
Yeztugo (lenacapavir)

+

voxilaprevir

1 interaction

Avoid/Use Alternative

lenacapavir + voxilaprevir

avoid combo w/ oral lenacapavir if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• zidesamtinib
Yeztugo (lenacapavir)

+

zidesamtinib

1 interaction

Avoid/Use Alternative

lenacapavir + zidesamtinib

avoid combo during and x9mo after lenacapavir use: combo may incr. zidesamtinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

Monitor/Modify Tx

• abemaciclib
Yeztugo (lenacapavir)

+

abemaciclib

1 interaction

Monitor/Modify Tx

lenacapavir + abemaciclib

during and x9mo after lenacapavir tx, consider decr. abemaciclib 200 mg bid dose to 150 mg bid, abemaciclib 150 mg bid dose to 100 mg bid, abemaciclib 100 mg bid dose to 50 mg bid; monitor CBC: combo may incr. abemaciclib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• acalabrutinib
Yeztugo (lenacapavir)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

lenacapavir + acalabrutinib

decr. acalabrutinib dose to 100 mg qd; monitor CBC during and x9mo after lenacapavir tx: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• afatinib
Yeztugo (lenacapavir)

+

afatinib

1 interaction

Monitor/Modify Tx

lenacapavir + afatinib

decr. afatinib dose by 10 mg/day if not tolerated: combo may incr. afatinib levels, risk of adverse effects (P-gp-mediated transport inhibited)

• alfuzosin
Yeztugo (lenacapavir)

+

alfuzosin

1 interaction

Monitor/Modify Tx

lenacapavir + alfuzosin

monitor BP, ECG during and x9mo after lenacapavir tx: combo may incr. alfuzosin levels, risk of QT prolongation, cardiac arrhythmias, hypotension (including orthostasis, syncope), other adverse effects (hepatic metabolism inhibited)

• apixaban
Yeztugo (lenacapavir)

+

apixaban

1 interaction

Monitor/Modify Tx

lenacapavir + apixaban

monitor bleeding s/sx during and x9mo after lenacapavir tx: combo may incr. apixaban levels, risk of bleeding, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• aripiprazole oral
Yeztugo (lenacapavir)

+

aripiprazole oral

1 interaction

Monitor/Modify Tx

lenacapavir + aripiprazole oral

consider decr. PO aripiprazole dose during and x9mo after lenacapavir tx; if also CYP2D6 PM or if also combined w/ strong CYP2D6 inhibitor, consider decr. PO aripiprazole dose up to 75% during and x9mo after lenacapavir tx; no dose adjustment if depression adjunct tx use: combo may incr. aripiprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• artemether/lumefantrine
Yeztugo (lenacapavir)

+

artemether/ lumefantrine

1 interaction

Monitor/Modify Tx

lenacapavir + artemether/ lumefantrine

monitor ECG during and x9mo after lenacapavir tx: combo may incr. artemether/lumefantrine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• atorvastatin
Yeztugo (lenacapavir)

+

atorvastatin

1 interaction

Monitor/Modify Tx

lenacapavir + atorvastatin

monitor CK, myopathy sx during and x9mo after lenacapavir tx: combo may incr. atorvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• avanafil
Yeztugo (lenacapavir)

+

avanafil

1 interaction

Monitor/Modify Tx

lenacapavir + avanafil

monitor BP; adjust max avanafil dose to 50 mg/24h during and x9mo after lenacapavir tx: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• avatrombopag
Yeztugo (lenacapavir)

+

avatrombopag

1 interaction

Monitor/Modify Tx

lenacapavir + avatrombopag

during and x9mo after lenacapavir tx: CHRONIC IMMUNE THROMBOCYTOPENIA: monitor platelets, thrombosis s/sx; if avatrombopag tablet also combined w/ a moderate or strong CYP2C9 inhibitor, decr. start dose to 20 mg 3x/wk; if avatrombopag sprinkle also combined w/ a moderate or strong CYP2C9 inhibitor, decr. start dose to 10 mg 3x/wk; CHRONIC LIVER DZ: monitor platelets, thrombosis s/sx: combo may incr. avatrombopag levels, risk of thromboembolism, other adverse effects (hepatic metabolism inhibited)

• axitinib
Yeztugo (lenacapavir)

+

axitinib

1 interaction

Monitor/Modify Tx

lenacapavir + axitinib

consider decr. axitinib dose during and x9mo after lenacapavir tx: combo may incr. axitinib levels, risk of adverse effects (hepatic metabolism inhibited)

• brexpiprazole
Yeztugo (lenacapavir)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

lenacapavir + brexpiprazole

if CYP2D6 poor metabolizer or if also combined w/ moderate or strong CYP2D6 inhibitor, decr. brexpiprazole dose 75% during and x9mo after lenacapavir tx: combo may incr. brexpiprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• bromocriptine
Yeztugo (lenacapavir)

+

bromocriptine

1 interaction

Monitor/Modify Tx

lenacapavir + bromocriptine

during and x9mo after lenacapavir use, adjust bromocriptine dose as follows: ACROMEGALY: start bromocriptine 1.25 mg qd, adjust max bromocriptine dose to 25 mg qd; DIABETES: no start dose adjustment needed, adjust max bromocriptine dose to 1.6 mg/day; HYPERPROLACTINEMIA: start bromocriptine 1.25 mg qd, adjust max bromocriptine dose to 3.75 mg qd; PROLACTIN-SECRETING ADENOMAS: start bromocriptine 1.25 mg qd, adjust max bromocriptine dose to 2.5 mg qd; PARKINSON DISEASE: start bromocriptine 1.25 mg qd, adjust max bromocriptine dose to 12.5 mg bid: combo may incr. bromocriptine levels, risk of hypotension (including orthostasis, syncope), other adverse effects (hepatic metabolism inhibited)

• budesonide
Yeztugo (lenacapavir)

+

budesonide

1 interaction

Monitor/Modify Tx

lenacapavir + budesonide

monitor hypercorticism s/sx during and x9mo after lenacapavir tx: combo may incr. budesonide levels, risk of systemic corticosteroid effects, including Cushing syndrome, adrenal suppression, serious infection, other adverse effects (hepatic metabolism inhibited)

• buprenorphine
Yeztugo (lenacapavir)

+

buprenorphine

1 interaction

Monitor/Modify Tx

lenacapavir + buprenorphine

monitor respiratory rate, ECG; consider decr. buprenorphine dose during and x9mo after lenacapavir tx: combo may incr. buprenorphine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• butorphanol
Yeztugo (lenacapavir)

+

butorphanol

1 interaction

Monitor/Modify Tx

lenacapavir + butorphanol

monitor respiratory rate, consider decr. butorphanol dose during and x9mo after lenacapavir tx: combo may incr. butorphanol levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• cabozantinib
Yeztugo (lenacapavir)

+

cabozantinib

1 interaction

Monitor/Modify Tx

lenacapavir + cabozantinib

monitor ECG, BP, bleeding s/sx during and x9mo after lenacapavir tx: combo may incr. cabozantinib levels, risk of QT prolongation, cardiac arrhythmias, HTN, GI or other bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• cilostazol
Yeztugo (lenacapavir)

+

cilostazol

1 interaction

Monitor/Modify Tx

lenacapavir + cilostazol

decr. cilostazol dose to 50 mg bid during and x9mo after lenacapavir tx: combo may incr. cilostazol levels, risk of adverse effects (hepatic metabolism inhibited)

• clonazepam
Yeztugo (lenacapavir)

+

clonazepam

1 interaction

Monitor/Modify Tx

lenacapavir + clonazepam

monitor respiratory rate during and x9mo after lenacapavir tx: combo may incr. clonazepam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• clozapine
Yeztugo (lenacapavir)

+

clozapine

1 interaction

Monitor/Modify Tx

lenacapavir + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose during and x9mo after lenacapavir tx: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (hepatic metabolism inhibited)

• copanlisib
Yeztugo (lenacapavir)

+

copanlisib

1 interaction

Monitor/Modify Tx

lenacapavir + copanlisib

monitor CBC during and x9mo after lenacapavir tx: combo may incr. copanlisib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• crizotinib
Yeztugo (lenacapavir)

+

crizotinib

1 interaction

Monitor/Modify Tx

lenacapavir + crizotinib

monitor ECG, electrolytes, CBC during and x9mo after lenacapavir tx: combo may incr. crizotinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• daridorexant
Yeztugo (lenacapavir)

+

daridorexant

1 interaction

Monitor/Modify Tx

lenacapavir + daridorexant

adjust max daridorexant dose to 25 mg/day during and x9mo after lenacapavir tx: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• dasatinib
Yeztugo (lenacapavir)

+

dasatinib

1 interaction

Monitor/Modify Tx

lenacapavir + dasatinib

monitor ECG, CBC during and x9mo after lenacapavir tx: combo may incr. dasatinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• deflazacort
Yeztugo (lenacapavir)

+

deflazacort

1 interaction

Monitor/Modify Tx

lenacapavir + deflazacort

decr. deflazacort to 1/3 usual dose during and x9mo after lenacapavir tx: combo may incr. deflazacort active metabolite levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression (hepatic metabolism inhibited)

• digoxin
Yeztugo (lenacapavir)

+

digoxin

1 interaction

Monitor/Modify Tx

lenacapavir + digoxin

monitor digoxin levels, HR: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects (P-gp-mediated transport inhibited)

• docetaxel
Yeztugo (lenacapavir)

+

docetaxel

1 interaction

Monitor/Modify Tx

lenacapavir + docetaxel

monitor CBC; consider decr. docetaxel dose during and x9mo after lenacapavir tx: combo may incr. docetaxel levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• dofetilide
Yeztugo (lenacapavir)

+

dofetilide

1 interaction

Monitor/Modify Tx

lenacapavir + dofetilide

monitor ECG during and x9mo after lenacapavir tx: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• edoxaban
Yeztugo (lenacapavir)

+

edoxaban

1 interaction

Monitor/Modify Tx

lenacapavir + edoxaban

monitor bleeding s/sx: combo may incr. edoxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• elexacaftor/tezacaftor/ivacaftor
Yeztugo (lenacapavir)

+

elexacaftor/ tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

lenacapavir + elexacaftor/ tezacaftor/ ivacaftor

decr. elexacaftor/tezacaftor/ivacaftor dose during and x9mo after lenacapavir tx as follows: 2-5 YO: decr. usual morning dose by alternating between one elexacaftor/tezacaftor/ivacaftor packet (Day 1) and one ivacaftor packet (Day 2), no evening doses; 6 YO AND OLDER: decr. usual morning dose by alternating between two elexacaftor/tezacaftor/ivacaftor tablets (Day 1) and one ivacaftor tablet (Day 2), no evening doses: combo may incr. elexacaftor/tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• elinzanetant
Yeztugo (lenacapavir)

+

elinzanetant

1 interaction

Monitor/Modify Tx

lenacapavir + elinzanetant

decr. elinzanetant dose to 60 mg daily during and x9mo after lenacapavir tx: combo may incr. elinzanetant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• enfortumab vedotin
Yeztugo (lenacapavir)

+

enfortumab vedotin

1 interaction

Monitor/Modify Tx

lenacapavir + enfortumab vedotin

if also combined w/ strong CYP3A4 inhibitor, monitor CBC, glucose: combo may incr. enfortumab vedotin levels, risk of myelosuppression, neuropathy, hyperglycemia, other adverse effects (P-gp-mediated transport inhibited)

• eplerenone
Yeztugo (lenacapavir)

+

eplerenone

1 interaction

Monitor/Modify Tx

lenacapavir + eplerenone

ALL INDICATIONS: monitor potassium, renal fxn during and x9mo after lenacapavir tx; POST-MI HFrEF: adjust max eplerenone dose to 25 mg/day during and x9mo after lenacapavir tx; HTN: start eplerenone 25 mg qd, adjust max eplerenone dose to 50 mg/day during and x9mo after lenacapavir tx: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• erdafitinib
Yeztugo (lenacapavir)

+

erdafitinib

1 interaction

Monitor/Modify Tx

lenacapavir + erdafitinib

monitor phosphate during and x9mo after lenacapavir tx: combo may incr. erdafitinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metabolism inhibited)

• estazolam
Yeztugo (lenacapavir)

+

estazolam

1 interaction

Monitor/Modify Tx

lenacapavir + estazolam

monitor respiratory rate; consider decr. estazolam dose during and x9mo after lenacapavir tx: combo may incr. estazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• estradiol (contraceptive)
Yeztugo (lenacapavir)

+

estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

lenacapavir + estradiol (contraceptive)

monitor thrombosis s/sx during and x9mo after lenacapavir tx: combo may incr. estradiol levels, risk of thromboembolism, other adverse effects (hepatic metabolism inhibited)

• ethinyl estradiol (contraceptive)
Yeztugo (lenacapavir)

+

ethinyl estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

lenacapavir + ethinyl estradiol (contraceptive)

monitor thrombosis s/sx during and x9mo after lenacapavir tx, especially if oral ethinyl estradiol dose >35 mcg/day: combo may incr. ethinyl estradiol levels, risk of thromboembolism, other adverse effects (hepatic metabolism inhibited)

• everolimus
Yeztugo (lenacapavir)

+

everolimus

1 interaction

Monitor/Modify Tx

lenacapavir + everolimus

BREAST CA, PNET, RENAL CELL CA, or RENAL ANGIOMYOLIPOMA w/ TSC: decr. everolimus dose to 2.5 mg/day, may then incr. to 5 mg/day if tolerated, monitor CBC during and x9mo after lenacapavir tx; TSC-ASSOC. SEGA or TSC-ASSOC. PARTIAL-ONSET SEIZURES: monitor everolimus levels, CBC during and x9mo after lenacapavir tx and decr. everolimus dose 50%; give every other day if already on lowest available dose; TRANSPLANT: monitor everolimus levels, CBC during and x9mo after lenacapavir tx: combo may incr. everolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• fedratinib
Yeztugo (lenacapavir)

+

fedratinib

1 interaction

Monitor/Modify Tx

lenacapavir + fedratinib

if fedratinib also combined w/ CYP2C19 inhibitor, monitor CBC, LFTs during and x9mo after lenacapavir tx: combo may incr. fedratinib levels, risk of myelosuppression, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• felodipine
Yeztugo (lenacapavir)

+

felodipine

1 interaction

Monitor/Modify Tx

lenacapavir + felodipine

monitor BP, HR during and x9mo after lenacapavir tx: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (hepatic metabolism inhibited)

• finerenone
Yeztugo (lenacapavir)

+

finerenone

1 interaction

Monitor/Modify Tx

lenacapavir + finerenone

monitor potassium during and x9mo after lenacapavir tx: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• fluvastatin
Yeztugo (lenacapavir)

+

fluvastatin

1 interaction

Monitor/Modify Tx

lenacapavir + fluvastatin

monitor CK, myopathy sx: combo may incr. fluvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport inhibited)

• futibatinib
Yeztugo (lenacapavir)

+

futibatinib

1 interaction

Monitor/Modify Tx

lenacapavir + futibatinib

monitor phosphate during and x9mo after lenacapavir tx: combo may incr. futibatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metabolism inhibited)

• gepirone
Yeztugo (lenacapavir)

+

gepirone

1 interaction

Monitor/Modify Tx

lenacapavir + gepirone

monitor ECG, electrolytes; decr. gepirone dose 50% during and x9mo after lenacapavir tx: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• gilteritinib
Yeztugo (lenacapavir)

+

gilteritinib

1 interaction

Monitor/Modify Tx

lenacapavir + gilteritinib

monitor ECG during and x9mo after lenacapavir tx: combo may incr. gilteritinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• glasdegib
Yeztugo (lenacapavir)

+

glasdegib

1 interaction

Monitor/Modify Tx

lenacapavir + glasdegib

monitor CBC, ECG during and x9mo after lenacapavir tx: combo may incr. glasdegib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• guanfacine
Yeztugo (lenacapavir)

+

guanfacine

1 interaction

Monitor/Modify Tx

lenacapavir + guanfacine

decr. guanfacine ER dose 50% during and x9mo after lenacapavir tx; consider decr. dose for immed.-release form: combo may incr. guanfacine levels, risk of adverse effects (hepatic metabolism inhibited)

• hydrocortisone
Yeztugo (lenacapavir)

+

hydrocortisone

1 interaction

Monitor/Modify Tx

lenacapavir + hydrocortisone

consider decr. hydrocortisone dose during and x9mo after lenacapavir tx: combo may incr. hydrocortisone levels, risk of systemic corticosteroid effects, including Cushing syndrome and adrenal suppression, other adverse effects (hepatic metabolism inhibited)

• ibrutinib
Yeztugo (lenacapavir)

+

ibrutinib

1 interaction

Monitor/Modify Tx

lenacapavir + ibrutinib

B-CELL MALIGNANCIES: decr. ibrutinib dose to 280 mg qd during and x9mo after lenacapavir tx; CHRONIC GVHD: consider decr. ibrutinib dose during and x9mo after lenacapavir tx: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• iloperidone
Yeztugo (lenacapavir)

+

iloperidone

1 interaction

Monitor/Modify Tx

lenacapavir + iloperidone

monitor ECG during and x9mo after lenacapavir tx: combo may incr. iloperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• irinotecan
Yeztugo (lenacapavir)

+

irinotecan

1 interaction

Monitor/Modify Tx

lenacapavir + irinotecan

monitor CBC during and x9mo after lenacapavir tx: combo may incr. irinotecan and active metabolite levels, risk of serious infection, myelosuppression, other toxicities (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• lefamulin
Yeztugo (lenacapavir)

+

lefamulin

1 interaction

Monitor/Modify Tx

lenacapavir + lefamulin

ORAL LEFAMULIN: monitor ECG during and x9mo after lenacapavir tx; IV lefamulin use OK: combo may incr. lefamulin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lidocaine
Yeztugo (lenacapavir)

+

lidocaine

1 interaction

Monitor/Modify Tx

lenacapavir + lidocaine

monitor lidocaine levels if lidocaine antiarrhythmic use during and x9mo after lenacapavir tx; otherwise, monitor BP, HR: combo may incr. lidocaine levels, risk of hypotension, bradycardia, other adverse effects; risk may be higher with continuous infusion or higher doses for local anesthesia (hepatic metabolism inhibited)

• lumateperone
Yeztugo (lenacapavir)

+

lumateperone

1 interaction

Monitor/Modify Tx

lenacapavir + lumateperone

monitor ECG during and x9mo after lenacapavir tx; decr. lumateperone dose to 21 mg qd: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lurasidone
Yeztugo (lenacapavir)

+

lurasidone

1 interaction

Monitor/Modify Tx

lenacapavir + lurasidone

monitor ECG during and x9mo after lenacapavir tx; decr. lurasidone start dose to 20 mg or decr. usual lurasidone dose 50%, max 80 mg/day: combo may incr. lurasidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• mefloquine
Yeztugo (lenacapavir)

+

mefloquine

1 interaction

Monitor/Modify Tx

lenacapavir + mefloquine

monitor ECG during and x9mo after lenacapavir tx: combo may incr. mefloquine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• methadone
Yeztugo (lenacapavir)

+

methadone

1 interaction

Monitor/Modify Tx

lenacapavir + methadone

monitor respiratory rate, ECG, consider decr. methadone dose during and x9mo after lenacapavir tx: combo may incr. methadone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• methotrexate
Yeztugo (lenacapavir)

+

methotrexate

1 interaction

Monitor/Modify Tx

lenacapavir + methotrexate

monitor CBC, renal fxn: combo may incr. methotrexate levels, risk of serious infection, myelosuppression, nephrotoxicity, other adverse effects (BCRP-mediated transport inhibited)

• midostaurin
Yeztugo (lenacapavir)

+

midostaurin

1 interaction

Monitor/Modify Tx

lenacapavir + midostaurin

monitor ECG, CBC during and x9mo after lenacapavir tx: combo may incr. midostaurin levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• milsaperidone
Yeztugo (lenacapavir)

+

milsaperidone

1 interaction

Monitor/Modify Tx

lenacapavir + milsaperidone

monitor ECG during and x9mo after lenacapavir use: combo may incr. milsaperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• mitoxantrone
Yeztugo (lenacapavir)

+

mitoxantrone

1 interaction

Monitor/Modify Tx

lenacapavir + mitoxantrone

monitor CBC, cardiac fxn, incl. LVEF: combo may incr. mitoxantrone levels, risk of serious infection, myelosuppression, cardiotoxicity, other adverse effects (BCRP-mediated transport inhibited)

• morphine
Yeztugo (lenacapavir)

+

morphine

1 interaction

Monitor/Modify Tx

lenacapavir + morphine

monitor respiratory rate, consider decr. morphine dose: combo may incr. morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (P-gp-mediated transport inhibited)

• nifedipine
Yeztugo (lenacapavir)

+

nifedipine

1 interaction

Monitor/Modify Tx

lenacapavir + nifedipine

consider lowest nifedipine start dose, monitor BP during and x9mo after lenacapavir tx: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nilotinib
Yeztugo (lenacapavir)

+

nilotinib

1 interaction

Monitor/Modify Tx

lenacapavir + nilotinib

monitor ECG, CBC during and x9mo after lenacapavir tx: combo may incr. nilotinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• nimodipine
Yeztugo (lenacapavir)

+

nimodipine

1 interaction

Monitor/Modify Tx

lenacapavir + nimodipine

monitor BP during and x9mo after lenacapavir tx: combo may incr. nimodipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nortriptyline
Yeztugo (lenacapavir)

+

nortriptyline

1 interaction

Monitor/Modify Tx

lenacapavir + nortriptyline

consider monitoring nortriptyline levels during and x9mo after lenacapavir use: combo may incr. nortriptyline levels, risk of adverse effects (hepatic metabolism inhibited)

• oveporexton
Yeztugo (lenacapavir)

+

oveporexton

1 interaction

Monitor/Modify Tx

lenacapavir + oveporexton

during and x9mo after lenacapavir use, decr. oveporexton dose to 0.5 mg after awakening and 0.5 mg 3-5h later: combo may incr. oveporexton levels, risk of adverse effects (hepatic metabolism inhibited)

• palbociclib
Yeztugo (lenacapavir)

+

palbociclib

1 interaction

Monitor/Modify Tx

lenacapavir + palbociclib

monitor CBC during and x9mo after lenacapavir tx: combo may incr. palbociclib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• pimavanserin
Yeztugo (lenacapavir)

+

pimavanserin

1 interaction

Monitor/Modify Tx

lenacapavir + pimavanserin

consider monitoring ECG during and x9mo after lenacapavir tx: combo may incr. pimavanserin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• pirtobrutinib
Yeztugo (lenacapavir)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

lenacapavir + pirtobrutinib

monitor CBC during and x9mo after lenacapavir tx: combo may incr. pirtobrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• ponatinib
Yeztugo (lenacapavir)

+

ponatinib

1 interaction

Monitor/Modify Tx

lenacapavir + ponatinib

monitor CBC during and x9mo after lenacapavir tx: combo may incr. ponatinib levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• pravastatin
Yeztugo (lenacapavir)

+

pravastatin

1 interaction

Monitor/Modify Tx

lenacapavir + pravastatin

monitor CK, myopathy sx: combo may incr. pravastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport inhibited)

• quetiapine
Yeztugo (lenacapavir)

+

quetiapine

1 interaction

Monitor/Modify Tx

lenacapavir + quetiapine

monitor ECG; consider decr. quetiapine dose during and x9mo after lenacapavir tx: combo may incr. quetiapine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• quinidine (CYP2D6 inhibitor)
Yeztugo (lenacapavir)

+

quinidine (CYP2D6 inhibitor)

1 interaction

Monitor/Modify Tx

lenacapavir + quinidine (CYP2D6 inhibitor)

monitor ECG during and x9mo after lenacapavir tx: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• quinine
Yeztugo (lenacapavir)

+

quinine

1 interaction

Monitor/Modify Tx

lenacapavir + quinine

monitor ECG during and x9mo after lenacapavir tx: combo may incr. quinine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• red yeast rice
Yeztugo (lenacapavir)

+

red yeast rice

1 interaction

Monitor/Modify Tx

lenacapavir + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice, during and x9mo after lenacapavir tx: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, red yeast rice contains varying amounts of lovastatin)

• repaglinide
Yeztugo (lenacapavir)

+

repaglinide

1 interaction

Monitor/Modify Tx

lenacapavir + repaglinide

monitor glucose during and x9mo after lenacapavir tx: combo may incr. repaglinide levels, risk of hypoglycemia, other adverse effects (hepatic metabolism inhibited)

• rimegepant
Yeztugo (lenacapavir)

+

rimegepant

1 interaction

Monitor/Modify Tx

lenacapavir + rimegepant

separate rimegepant doses by at least 48h during and x9mo after lenacapavir tx: combo may incr. rimegepant levels, risk of adverse effects (hepatic metabolism inhibited)

• riociguat
Yeztugo (lenacapavir)

+

riociguat

1 interaction

Monitor/Modify Tx

lenacapavir + riociguat

consider decr. riociguat start dose to 0.5 mg PO tid; monitor BP during and x9mo after lenacapavir tx: combo may incr. riociguat levels, risk of severe hypotension, other adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• rosuvastatin
Yeztugo (lenacapavir)

+

rosuvastatin

1 interaction

Monitor/Modify Tx

lenacapavir + rosuvastatin

monitor CK, myopathy sx: combo may incr. rosuvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (BCRP-mediated transport inhibited)

• ruxolitinib
Yeztugo (lenacapavir)

+

ruxolitinib

1 interaction

Monitor/Modify Tx

lenacapavir + ruxolitinib

monitor CBC during and x9mo after lenacapavir tx: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• ruxolitinib topical
Yeztugo (lenacapavir)

+

ruxolitinib topical

1 interaction

Monitor/Modify Tx

lenacapavir + ruxolitinib topical

monitor CBC during and x9mo after lenacapavir tx: combo may incr. ruxolitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• saxagliptin
Yeztugo (lenacapavir)

+

saxagliptin

1 interaction

Monitor/Modify Tx

lenacapavir + saxagliptin

monitor glucose during and x9mo after lenacapavir tx: combo may incr. saxagliptin levels, risk of hypoglycemia, other adverse effects (hepatic metabolism inhibited)

• sebetralstat
Yeztugo (lenacapavir)

+

sebetralstat

1 interaction

Monitor/Modify Tx

lenacapavir + sebetralstat

during and x9mo after lenacapavir tx, consider monitoring ECG; decr. sebetralstat dose to 300 mg, may give second 300 mg dose at least 3h after first dose if needed: combo may incr. sebetralstat levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• sertraline
Yeztugo (lenacapavir)

+

sertraline

1 interaction

Monitor/Modify Tx

lenacapavir + sertraline

monitor ECG during and x9mo after lenacapavir tx: combo may incr. sertraline levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• sildenafil
Yeztugo (lenacapavir)

+

sildenafil

1 interaction

Monitor/Modify Tx

lenacapavir + sildenafil

during and x9mo after lenacapavir tx, adjust sildenafil dose as follows: PULMONARY HTN: monitor BP; ERECTILE DYSFUNCTION: consider decr. sildenafil start dose to 25 mg: combo may incr. sildenafil levels, risk of hypotension (including syncope), priapism, other adverse effects (hepatic metabolism inhibited)

• sirolimus
Yeztugo (lenacapavir)

+

sirolimus

1 interaction

Monitor/Modify Tx

lenacapavir + sirolimus

monitor sirolimus levels during and x9mo after lenacapavir tx: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• sparsentan
Yeztugo (lenacapavir)

+

sparsentan

1 interaction

Monitor/Modify Tx

lenacapavir + sparsentan

monitor BP, potassium, renal fxn during and x9mo after lenacapavir tx: combo may incr. sparsentan levels, risk of hypotension (including orthostasis, syncope), hyperkalemia, edema, nephrotoxicity, other adverse effects (hepatic metabolism inhibited)

• sunitinib
Yeztugo (lenacapavir)

+

sunitinib

1 interaction

Monitor/Modify Tx

lenacapavir + sunitinib

consider monitoring ECG, electrolytes during and x9mo after lenacapavir tx: combo may incr. sunitinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• suvorexant
Yeztugo (lenacapavir)

+

suvorexant

1 interaction

Monitor/Modify Tx

lenacapavir + suvorexant

decr. suvorexant dose to 5 mg, max 10 mg/day during and x9mo after lenacapavir tx: combo may incr. suvorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• suzetrigine
Yeztugo (lenacapavir)

+

suzetrigine

1 interaction

Monitor/Modify Tx

lenacapavir + suzetrigine

start suzetrigine 100 mg x1 at least 1h before or 2h after food, after 12h give 50 mg q12h x3 doses, then after 12h give 50mg q24h: combo may incr. suzetrigine and active metabolite levels, risk of adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• tacrolimus
Yeztugo (lenacapavir)

+

tacrolimus

1 interaction

Monitor/Modify Tx

lenacapavir + tacrolimus

monitor tacrolimus levels, ECG, renal fxn during and x9mo after lenacapavir tx: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• talazoparib
Yeztugo (lenacapavir)

+

talazoparib

1 interaction

Monitor/Modify Tx

lenacapavir + talazoparib

monitor CBC: combo may incr. talazoparib levels, risk of myelosuppression, other adverse effects (BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• tamsulosin
Yeztugo (lenacapavir)

+

tamsulosin

1 interaction

Monitor/Modify Tx

lenacapavir + tamsulosin

monitor BP during and x9mo after lenacapavir tx, especially w/ tamsulosin dose >0.4 mg: combo may incr. tamsulosin levels, risk of hypotension (including orthostasis, syncope), other adverse effects (hepatic metabolism inhibited)

• temsirolimus
Yeztugo (lenacapavir)

+

temsirolimus

1 interaction

Monitor/Modify Tx

lenacapavir + temsirolimus

monitor CBC; consider decr. temsirolimus dose during and x9mo after lenacapavir tx: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• tenofovir disoproxil
Yeztugo (lenacapavir)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

lenacapavir + tenofovir disoproxil

monitor renal fxn w/ oral lenacapavir: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut BCRP-mediated transport inhibited, gut P-gp-mediated transport inhibited)

• tezacaftor/ivacaftor
Yeztugo (lenacapavir)

+

tezacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

lenacapavir + tezacaftor/ ivacaftor

decr. dose during and x9mo after lenacapavir tx by alternating tezacaftor/ivacaftor tab and ivacaftor tab at morning dose, no evening doses: combo may incr. tezacaftor/ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• tofacitinib
Yeztugo (lenacapavir)

+

tofacitinib

1 interaction

Monitor/Modify Tx

lenacapavir + tofacitinib

ALL USES: monitor CBC; if combined w/ strong CYP2C19 inhibitor, adjust tofacitinib as follows during and x9mo after lenacapavir: ADULT RHEUMATOID or PSORIATIC ARTHRITIS or ANKYLOSING SPONDYLITIS: decr. to 5 mg qd; ULCERATIVE COLITIS: decr. induction to 5 mg bid using tabs or 11 mg qd using XR tab for up to 16 wks, followed by 5 mg qd maintenance using tabs; do not use XR tabs for maintenance; PEDIATRIC PSORIATIC or POLYARTICULAR COURSE JUVENILE IDIOPATHIC ARTHRITIS: decr. usual bid dose to qd: combo may incr. tofacitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• toremifene
Yeztugo (lenacapavir)

+

toremifene

1 interaction

Monitor/Modify Tx

lenacapavir + toremifene

monitor ECG during and x9mo after lenacapavir tx: combo may incr. toremifene levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• trabectedin
Yeztugo (lenacapavir)

+

trabectedin

1 interaction

Monitor/Modify Tx

lenacapavir + trabectedin

monitor CBC, cardiac function (including LVEF), LFTs during and x9mo after lenacapavir tx: combo may incr. trabectedin levels, risk of myelosuppression, cardiotoxicity, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• trazodone
Yeztugo (lenacapavir)

+

trazodone

1 interaction

Monitor/Modify Tx

lenacapavir + trazodone

monitor ECG, BP during and x9mo after lenacapavir tx: combo may incr. trazodone levels, risk of QT prolongation, cardiac arrhythmias, hypotension (including orthostasis, syncope), other adverse effects (hepatic metabolism inhibited)

• triazolam
Yeztugo (lenacapavir)

+

triazolam

1 interaction

Monitor/Modify Tx

lenacapavir + triazolam

monitor respiratory rate during and x9mo after lenacapavir tx; consider decr. triazolam dose: combo may incr. triazolam levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• ubrogepant
Yeztugo (lenacapavir)

+

ubrogepant

1 interaction

Monitor/Modify Tx

lenacapavir + ubrogepant

limit ubrogepant dose to 50 mg during and x9mo after lenacapavir tx, may give second 50 mg dose after 24h if needed: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited, P-gp-mediated transport inhibited)

• vanzacaftor/tezacaftor/deutivacaftor
Yeztugo (lenacapavir)

+

vanzacaftor/ tezacaftor/ deutivacaftor

1 interaction

Monitor/Modify Tx

lenacapavir + vanzacaftor/ tezacaftor/ deutivacaftor

during and x9mo after lenacapavir tx, adjust vanzacaftor/tezacaftor/deutivacaftor dose as follows: 6-11 YO AND WT <40 KG: decr. vanzacaftor/tezacaftor/deutivacaftor dose to two tablets (4 mg/20 mg/50 mg each) qod; 6-11 YO AND WT 40 KG AND ABOVE: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod; 12 YO AND OLDER: decr. vanzacaftor/tezacaftor/deutivacaftor dose to one tablet (10 mg/50 mg/125 mg) qod: combo may incr. vanzacaftor/tezacaftor/deutivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• vemurafenib
Yeztugo (lenacapavir)

+

vemurafenib

1 interaction

Monitor/Modify Tx

lenacapavir + vemurafenib

monitor ECG during and x9mo after lenacapavir tx: combo may incr. vemurafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (hepatic metabolism inhibited; P-gp-mediated transport inhibited, hepatic metabolism induced)

• vinblastine
Yeztugo (lenacapavir)

+

vinblastine

1 interaction

Monitor/Modify Tx

lenacapavir + vinblastine

monitor CBC during and x9mo after lenacapavir tx: combo may incr. vinblastine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• vincristine
Yeztugo (lenacapavir)

+

vincristine

1 interaction

Monitor/Modify Tx

lenacapavir + vincristine

monitor CBC during and x9mo after lenacapavir tx: combo may incr. vincristine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• vinorelbine
Yeztugo (lenacapavir)

+

vinorelbine

1 interaction

Monitor/Modify Tx

lenacapavir + vinorelbine

monitor CBC during and x9mo after lenacapavir tx: combo may incr. vinorelbine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• voclosporin
Yeztugo (lenacapavir)

+

voclosporin

1 interaction

Monitor/Modify Tx

lenacapavir + voclosporin

monitor ECG, renal fxn; decr. voclosporin morning dose to 15.8 mg and evening dose to 7.9 mg during and x9mo after lenacapavir tx: combo may incr. voclosporin levels, risk of QT prolongation, cardiac arrhythmias, serious infection, nephrotoxicity, other adverse effects (hepatic metabolism inhibited)

• warfarin
Yeztugo (lenacapavir)

+

warfarin

1 interaction

Monitor/Modify Tx

lenacapavir + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration, during and x9mo after lenacapavir tx: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• zanubrutinib
Yeztugo (lenacapavir)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

lenacapavir + zanubrutinib

decr. zanubrutinib dose to 80 mg bid; monitor CBC during and x9mo after lenacapavir tx: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• ziftomenib
Yeztugo (lenacapavir)

+

ziftomenib

1 interaction

Monitor/Modify Tx

lenacapavir + ziftomenib

monitor ECG during and x9mo after lenacapavir tx: combo may incr. ziftomenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

Caution Advised

• aliskiren
Yeztugo (lenacapavir)

+

aliskiren

1 interaction

Caution Advised

lenacapavir + aliskiren

caution advised during and x9mo after lenacapavir tx: combo may incr. aliskiren levels, risk of adverse effects (hepatic metabolism inhibited)

• armodafinil
Yeztugo (lenacapavir)

+

armodafinil

1 interaction

Caution Advised

lenacapavir + armodafinil

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• avacopan
Yeztugo (lenacapavir)

+

avacopan

1 interaction

Caution Advised

lenacapavir + avacopan

caution advised during and x9mo after lenacapavir tx: combo may incr. avacopan levels, risk of adverse effects (hepatic metabolism inhibited)

• belzutifan
Yeztugo (lenacapavir)

+

belzutifan

1 interaction

Caution Advised

lenacapavir + belzutifan

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• bexarotene
Yeztugo (lenacapavir)

+

bexarotene

1 interaction

Caution Advised

lenacapavir + bexarotene

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• budesonide rectal
Yeztugo (lenacapavir)

+

budesonide rectal

1 interaction

Caution Advised

lenacapavir + budesonide rectal

caution advised during and x9mo after lenacapavir tx: combo may incr. budesonide levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression, serious infection, other adverse effects (hepatic metabolism inhibited)

• clobazam
Yeztugo (lenacapavir)

+

clobazam

1 interaction

Caution Advised

lenacapavir + clobazam

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• cortisone
Yeztugo (lenacapavir)

+

cortisone

1 interaction

Caution Advised

lenacapavir + cortisone

caution advised during and x9mo after lenacapavir tx: combo may incr. cortisone levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression (hepatic metabolism possibly inhibited)

• cyclophosphamide
Yeztugo (lenacapavir)

+

cyclophosphamide

1 interaction

Caution Advised

lenacapavir + cyclophosphamide

caution advised during and x9mo after lenacapavir tx: combo may decr. cyclophosphamide active metabolite levels, efficacy (hepatic metabolism possibly inhibited, decr. conversion to active metabolite)

• danshen
Yeztugo (lenacapavir)

+

danshen

1 interaction

Caution Advised

lenacapavir + danshen

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, P-gp-mediated transport induced)

• darifenacin
Yeztugo (lenacapavir)

+

darifenacin

1 interaction

Caution Advised

lenacapavir + darifenacin

caution advised during and x9mo after lenacapavir tx: combo may incr. darifenacin levels, risk of adverse effects (hepatic metabolism inhibited)

• darolutamide
Yeztugo (lenacapavir)

+

darolutamide

1 interaction

Caution Advised

lenacapavir + darolutamide

caution advised: combo may incr. darolutamide levels, risk of adverse effects; may decr. lenacapavir levels, efficacy (P-gp-mediated transport inhibited; hepatic metabolism induced)

• dexamethasone
Yeztugo (lenacapavir)

+

dexamethasone

1 interaction

Caution Advised

lenacapavir + dexamethasone

caution advised during and x9mo after lenacapavir tx: combo may incr. dexamethasone levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression, serious infection, other adverse effects; may decr. lenacapavir levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• dicloxacillin
Yeztugo (lenacapavir)

+

dicloxacillin

1 interaction

Caution Advised

lenacapavir + dicloxacillin

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced, P-gp-mediated transport induced)

• echinacea
Yeztugo (lenacapavir)

+

echinacea

1 interaction

Caution Advised

lenacapavir + echinacea

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• elafibranor
Yeztugo (lenacapavir)

+

elafibranor

1 interaction

Caution Advised

lenacapavir + elafibranor

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• eletriptan
Yeztugo (lenacapavir)

+

eletriptan

1 interaction

Caution Advised

lenacapavir + eletriptan

caution advised during and x9mo after lenacapavir tx: combo may incr. eletriptan levels, risk of adverse effects (hepatic metabolism inhibited)

• enasidenib
Yeztugo (lenacapavir)

+

enasidenib

1 interaction

Caution Advised

lenacapavir + enasidenib

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• erlotinib
Yeztugo (lenacapavir)

+

erlotinib

1 interaction

Caution Advised

lenacapavir + erlotinib

caution advised during and x9mo after lenacapavir tx: combo may incr. erlotinib levels, risk of adverse effects (hepatic metabolism inhibited)

• eslicarbazepine acetate
Yeztugo (lenacapavir)

+

eslicarbazepine acetate

1 interaction

Caution Advised

lenacapavir + eslicarbazepine acetate

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• felbamate
Yeztugo (lenacapavir)

+

felbamate

1 interaction

Caution Advised

lenacapavir + felbamate

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• fosamprenavir
Yeztugo (lenacapavir)

+

fosamprenavir

1 interaction

Caution Advised

lenacapavir + fosamprenavir

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• garlic
Yeztugo (lenacapavir)

+

garlic

1 interaction

Caution Advised

lenacapavir + garlic

caution advised w/ supplemental garlic; dietary intake OK: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ginkgo
Yeztugo (lenacapavir)

+

ginkgo

1 interaction

Caution Advised

lenacapavir + ginkgo

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ginseng, Asian
Yeztugo (lenacapavir)

+

ginseng, Asian

1 interaction

Caution Advised

lenacapavir + ginseng, Asian

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• glycerol phenylbutyrate
Yeztugo (lenacapavir)

+

glycerol phenylbutyrate

1 interaction

Caution Advised

lenacapavir + glycerol phenylbutyrate

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• grazoprevir
Yeztugo (lenacapavir)

+

grazoprevir

1 interaction

Caution Advised

lenacapavir + grazoprevir

caution advised during and x9mo after lenacapavir tx: combo may incr. grazoprevir levels, risk of adverse effects (hepatic metabolism inhibited)

• griseofulvin
Yeztugo (lenacapavir)

+

griseofulvin

1 interaction

Caution Advised

lenacapavir + griseofulvin

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ifosfamide
Yeztugo (lenacapavir)

+

ifosfamide

1 interaction

Caution Advised

lenacapavir + ifosfamide

caution advised during and x9mo after lenacapavir tx: combo may decr. ifosfamide active metabolite levels, efficacy (hepatic metabolism inhibited, decr. active metabolite formation)

• imlunestrant
Yeztugo (lenacapavir)

+

imlunestrant

1 interaction

Caution Advised

lenacapavir + imlunestrant

caution advised during and x9mo after lenacapavir tx: combo may incr. imlunestrant levels, risk of adverse effects (hepatic metabolism inhibited)

• isavuconazonium
Yeztugo (lenacapavir)

+

isavuconazonium

1 interaction

Caution Advised

lenacapavir + isavuconazonium

caution advised during and x9mo after lenacapavir tx: combo may incr. isavuconazole levels, risk of adverse effects (hepatic metabolism inhibited)

• istradefylline
Yeztugo (lenacapavir)

+

istradefylline

1 interaction

Caution Advised

lenacapavir + istradefylline

caution advised during and x9mo after lenacapavir tx: combo may incr. istradefylline levels, risk of adverse effects (hepatic metabolism inhibited)

• larotrectinib
Yeztugo (lenacapavir)

+

larotrectinib

1 interaction

Caution Advised

lenacapavir + larotrectinib

caution advised during and x9mo after lenacapavir tx: combo may incr. larotrectinib levels, risk of adverse effects (hepatic metabolism inhibited)

• maraviroc
Yeztugo (lenacapavir)

+

maraviroc

1 interaction

Caution Advised

lenacapavir + maraviroc

caution advised during and x9mo after lenacapavir tx: combo may incr. maraviroc levels, risk of adverse effects (hepatic metabolism inhibited)

• meropenem
Yeztugo (lenacapavir)

+

meropenem

1 interaction

Caution Advised

lenacapavir + meropenem

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced, P-gp-mediated transport possibly induced)

• methylprednisolone
Yeztugo (lenacapavir)

+

methylprednisolone

1 interaction

Caution Advised

lenacapavir + methylprednisolone

caution advised during and x9mo after lenacapavir tx: combo may incr. methylprednisolone levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression (hepatic metabolism inhibited)

• naldemedine
Yeztugo (lenacapavir)

+

naldemedine

1 interaction

Caution Advised

lenacapavir + naldemedine

caution advised during and x9mo after lenacapavir tx: combo may incr. naldemedine levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• odevixibat
Yeztugo (lenacapavir)

+

odevixibat

1 interaction

Caution Advised

lenacapavir + odevixibat

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• olutasidenib
Yeztugo (lenacapavir)

+

olutasidenib

1 interaction

Caution Advised

lenacapavir + olutasidenib

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced)

• ospemifene
Yeztugo (lenacapavir)

+

ospemifene

1 interaction

Caution Advised

lenacapavir + ospemifene

caution advised during and x9mo after lenacapavir tx: combo may incr. ospemifene levels, risk of adverse effects (hepatic metabolism inhibited)

• perampanel
Yeztugo (lenacapavir)

+

perampanel

1 interaction

Caution Advised

lenacapavir + perampanel

caution advised if on perampanel 12 mg/day: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• pioglitazone
Yeztugo (lenacapavir)

+

pioglitazone

1 interaction

Caution Advised

lenacapavir + pioglitazone

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• pivekimab sunirine
Yeztugo (lenacapavir)

+

pivekimab sunirine

1 interaction

Caution Advised

lenacapavir + pivekimab sunirine

caution advised during and x9mo after lenacapavir use: combo may incr. alkylating agent (FGN849) levels, risk of adverse effects (hepatic metabolism inhibited)

• prednisone
Yeztugo (lenacapavir)

+

prednisone

1 interaction

Caution Advised

lenacapavir + prednisone

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ritonavir
Yeztugo (lenacapavir)

+

ritonavir

1 interaction

Caution Advised

lenacapavir + ritonavir

caution advised: combo may incr. or decr. lenacapavir levels, incr. risk of adverse effects or decr. efficacy (hepatic metabolism inhibited, P-gp-mediated transport inhibited; hepatic metabolism induced, UGT induced)

• roflumilast
Yeztugo (lenacapavir)

+

roflumilast

1 interaction

Caution Advised

lenacapavir + roflumilast

caution advised during and x9mo after lenacapavir tx: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast topical
Yeztugo (lenacapavir)

+

roflumilast topical

1 interaction

Caution Advised

lenacapavir + roflumilast topical

caution advised during and x9mo after lenacapavir tx: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• rufinamide
Yeztugo (lenacapavir)

+

rufinamide

1 interaction

Caution Advised

lenacapavir + rufinamide

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• sarilumab
Yeztugo (lenacapavir)

+

sarilumab

1 interaction

Caution Advised

lenacapavir + sarilumab

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism altered; sarilumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)

• seladelpar
Yeztugo (lenacapavir)

+

seladelpar

1 interaction

Caution Advised

lenacapavir + seladelpar

caution advised during and x9mo after lenacapavir tx if CYP2C9 poor metabolizer or if also combined with moderate CYP2C9 inhibitor, OATP1B1 and/or OATP1B3 inhibitor: combo may incr. seladelpar levels, risk of adverse effects (hepatic metabolism inhibited, BCRP-mediated transport inhibited)

• sevabertinib
Yeztugo (lenacapavir)

+

sevabertinib

1 interaction

Caution Advised

lenacapavir + sevabertinib

caution advised during and x9 mo after lenacapavir tx: combo may incr. sevabertinib levels, risk of adverse effects (hepatic metabolism inhibited)

• silodosin
Yeztugo (lenacapavir)

+

silodosin

1 interaction

Caution Advised

lenacapavir + silodosin

caution advised during and x9mo after lenacapavir tx: combo may incr. silodosin levels, risk of adverse effects (hepatic metabolism inhibited)

• sirolimus topical
Yeztugo (lenacapavir)

+

sirolimus topical

1 interaction

Caution Advised

lenacapavir + sirolimus topical

caution advised during and x9mo after lenacapavir tx: combo may incr. sirolimus levels, risk of adverse effects (hepatic metabolism inhibited)

• stiripentol
Yeztugo (lenacapavir)

+

stiripentol

1 interaction

Caution Advised

lenacapavir + stiripentol

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced)

• sulfasalazine
Yeztugo (lenacapavir)

+

sulfasalazine

1 interaction

Caution Advised

lenacapavir + sulfasalazine

caution advised w/ oral lenacapavir: combo may incr. sulfasalazine levels, risk of adverse effects; may decr. IBD tx efficacy (gut BCRP-mediated transport inhibited)

• sunvozertinib
Yeztugo (lenacapavir)

+

sunvozertinib

1 interaction

Caution Advised

lenacapavir + sunvozertinib

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• tecovirimat
Yeztugo (lenacapavir)

+

tecovirimat

1 interaction

Caution Advised

lenacapavir + tecovirimat

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• telotristat ethyl
Yeztugo (lenacapavir)

+

telotristat ethyl

1 interaction

Caution Advised

lenacapavir + telotristat ethyl

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• ticagrelor
Yeztugo (lenacapavir)

+

ticagrelor

1 interaction

Caution Advised

lenacapavir + ticagrelor

caution advised during and x9mo after lenacapavir tx: combo may incr. ticagrelor levels, risk of dyspnea, bleeding, other adverse effects (hepatic metabolism inhibited)

• tocilizumab
Yeztugo (lenacapavir)

+

tocilizumab

1 interaction

Caution Advised

lenacapavir + tocilizumab

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism altered; tocilizumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes)

• topiramate
Yeztugo (lenacapavir)

+

topiramate

1 interaction

Caution Advised

lenacapavir + topiramate

caution advised, especially w/ topiramate doses >200 mg/day: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• tovorafenib
Yeztugo (lenacapavir)

+

tovorafenib

1 interaction

Caution Advised

lenacapavir + tovorafenib

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism induced)

• tretinoin
Yeztugo (lenacapavir)

+

tretinoin

1 interaction

Caution Advised

lenacapavir + tretinoin

caution advised during and x9mo after lenacapavir tx: combo may incr. tretinoin levels, risk of adverse effects (hepatic metabolism inhibited)

• upadacitinib
Yeztugo (lenacapavir)

+

upadacitinib

1 interaction

Caution Advised

lenacapavir + upadacitinib

caution advised during and x9mo after lenacapavir tx: combo may incr. upadacitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• vaborbactam
Yeztugo (lenacapavir)

+

vaborbactam

1 interaction

Caution Advised

lenacapavir + vaborbactam

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced, P-gp-mediated transport possibly induced)

• valproic acid
Yeztugo (lenacapavir)

+

valproic acid

1 interaction

Caution Advised

lenacapavir + valproic acid

caution advised: combo may decr. lenacapavir levels, efficacy (UGT induced)

• vamorolone
Yeztugo (lenacapavir)

+

vamorolone

1 interaction

Caution Advised

lenacapavir + vamorolone

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced)

• vilazodone
Yeztugo (lenacapavir)

+

vilazodone

1 interaction

Caution Advised

lenacapavir + vilazodone

caution advised during and x9mo after lenacapavir tx: combo may incr. vilazodone levels, risk of adverse effects (hepatic metabolism inhibited)

• vorasidenib
Yeztugo (lenacapavir)

+

vorasidenib

1 interaction

Caution Advised

lenacapavir + vorasidenib

caution advised: combo may decr. lenacapavir levels, efficacy (hepatic metabolism possibly induced)