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Genvoya Interactions

Genvoya Interactions

The success of antiretroviral therapies (ART) depends on achieving a therapeutic drug concentration that will result to maximum efficacy and fewer toxicities. It’s important for patients to know the impact of drug interactions on a safe and effective treatment plan. Drug interactions are common between antiretroviral agents and co-administered medications. Drug-drug interactions have dangerous consequences, including drug toxicities and virologic failure. They can result to inefficient treatment of the disease, organ system impairment, and death. There are two types of drug interactions:

  • Pharmacokinetic (PK) interactions – may occur during absorption, metabolism, or excretion of the antiretroviral agent and/or the co-administered drug. Examples of medicines that can cause PK interactions include acid reducing agents (proton pump inhibitors, H2 antagonists, or antacids) and drugs that inhibit the CYP3A4 enzyme.
  • Pharmacodynamic interactions – when interacting drugs have additive or reducing effects, in which the overall effect may be either amplified or substantially decreased, to the point of being cancelled out.

If suppression of viral load does not happen, you are probably facing treatment failure. One of the most common causes of treatment failure is poor medication adherence, whether intermittent or continuous. Food and drug interactions is another issue that must be examined. Your antiretroviral regimen can be affected by other medications you are taking and vice versa; even over-the-counter drugs can have devastating effects. You should keep a list of all food and drugs to avoid when taking this regimen. It’s better to ask your healthcare provider before taking additional medications. Since Genvoya is already a complete regimen in one tablet, you should not take other antiretroviral agents unless prescribed by your doctor.

Food interaction

Food also affects how drug behaves. Some anti-HIV meds require a high-fat meal to increase drug exposure. Others must be taken on an empty stomach for faster absorption. Genvoya must be taken with food as it increases the drug’s concentration in your blood. If you have diarrhea, or if you vomit less than hour after taking Genvoya, it will disrupt the drug’s absorption. Consult your healthcare provider regarding missed doses. Take the drug around the same time every day to maintain the optimal level of the medication in your system. Choosing a convenient time of taking the medicine, say, at night during dinner, will help you avoid missing a dose.

Drug interactions for Genvoya

There are hundreds of drugs that may interact with Genvoya. One of the downsides of an antiretroviral regimen with an integrase or protease inhibitor is the requirement of a booster. Cobicistat is added to Genvoya to prevent its drug components from being metabolized, particularly elvitegravir. While cobicistat has no activity against HIV, it can interact with a variety of other drugs. Acid-reducing agents may lower the concentration of elvitegravir; take an antacid at least 2 hours before or after Genvoya intake. Below are examples of drugs that should not be taken together with this ART regimen.

Contraindicated drugs

Drug within class

Brand name


(Alpha 1-Adrenoreceptor




– Uroxatral

May result to hypotension due to increased alfuzosin concentrations




– Carbatrol, Carnexiv, Epitol, Equetro, Tegretrol
­– Luminal
– Dilantin, Phenytek

May cause significant decrease of Genvoya in the plasma, leading to loss of therapeutic effect




– Rifadin, Rifamate, Rimactane


May cause significant decrease of Genvoya components in the plasma, resulting in loss of therapeutic effect




– Latuda
– Orap


– May cause serious or fatal reactions
– May cause life-threatening reactions such as abnormal heart rhythm

(Ergot derivatives)



– D.H.E. 45, Migranal
– Cafergot, Ercaf, Wigraine
– Methergine


May cause serious or fatal events such as acute ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities

(GI Motility Agent)



– Propulsid, QuickSolv

May cause serious and/or life-threatening events such as abnormal heart rhythm

(Herbal Supplement)

St. John’s Wort
(Hypericum perforatum)


–St. John’s Wort

Products with this herb may result in reduced plasma concentration of elvitegravir, cobicistat, and tenofovir alafenamide, resulting in loss of effectiveness and drug resistance

(HMG-CoA Reductase Inhibitors)




–Altoprev, Mevacor
–Vytorin, Zocor

May cause serious adverse reactions such as myopathy (rhabdomyolysis)

(Phosphodiesterase-5 (PDE5) Inhibitor)





May exacerbate sildenafil-associated side effects, such as hypotension, syncope, visual disturbances, and priapism (prolonged penile erection)


Midazolam oral


–Dormicum, Hypnovel


Administration of Genvoya may cause significant increase in the concentration of these benzodiazepines, which may lead to increased sedation and respiratory depression

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