Bictegravir, emtricitabine, and tenofovir alafenamide and Ranolazine interaction
Bictegravir, emtricitabine, and tenofovir alafenamide and Ranolazine: the Bictegravir, emtricitabine, and tenofovir alafenamide prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Bictegravir, emtricitabine, and tenofovir alafenamide (BIXLENVO) label · effective 2026-08-27
Concomitant administration of BIXLENVO with combined P-gp, UGT1A1, and strong CYP3A inhibitors is not recommended.
Combined P-gp, UGT1A1, and Strong CYP3A Inhibitors Combined UGT1A1 and strong CYP3A inhibitors may significantly increase plasma concentrations of BIC.
Combined P-gp, UGT1A1, and strong CYP3A inhibitors may significantly increase plasma concentrations of LEN.
Corticosteroids (systemic): cortisone/hydrocortisone dexamethasone ↑ corticosteroids (systemic) ↓ lenacapavir (dexamethasone) Concomitant administration with systemic corticosteroids whose exposures are significantly increased by CYP3A inhibitors can increase the risk for Cushing's syndrome and adrenal suppression.
Lenacapavir (LEN), a component of BIXLENVO, is a moderate inhibitor of CYP3A and a P-gp inhibitor.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.