Elvitegravir–cobicistat–emtricitabine–tenofovir

A single-tablet HIV regimen (integrase inhibitor elvitegravir boosted by cobicistat, plus emtricitabine and tenofovir), FDA-approved as a complete HIV-1 treatment.

psilodex.org/m/elvitegravir-cobicistat-emtricitabine-tenofovir · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: ~13 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Elvitegravir–cobicistat–emtricitabine–tenofovir”, v2026.10.05. psilodex.org/m/elvitegravir-cobicistat-emtricitabine-tenofovir

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

HIV-1 infection (complete regimen; adults and children above a weight threshold)

Sources [1][2]

Other safety

Boxed warning: severe acute hepatitis B flares after stopping in people with hepatitis B. The label also warns of new or worsening kidney problems, lactic acidosis and many drug interactions from cobicistat.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Its booster may slow how the body clears psilocybin (not studied with psilocybin). Separately, stopping it with hepatitis B can cause a severe flare.

Detail Cobicistat, the booster in this regimen, inhibits (slows) the liver enzymes CYP3A and CYP2D6. In lab studies, CYP2D6 and CYP3A4 broke down psilocin, the active form of psilocybin (Thomann 2024). So this combination may raise psilocin levels. However, the body removes psilocin mainly by glucuronidation and conversion to 4-HIAA. There are no psilocybin data. Separately, stopping it in a person with hepatitis B can cause a severe hepatitis B flare. Sources [1][2][3]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: elvitegravir ~13 h; cobicistat ~3.5 h; emtricitabine ~10 h; tenofovir alafenamide ~0.5 h (Genvoya); tenofovir 12–18 h (Stribild) (FDA label, checked 2026-10-04) Median terminal plasma half-lives (label pharmacokinetic table). Tenofovir diphosphate persists 150–180 h within PBMCs.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Withdrawal or rebound if stopped abruptly: Stopping suddenly can cause withdrawal or a rebound of symptoms. Sources [1]
Liver injury: The label or source warns of liver injury, from raised liver enzymes to liver failure. Liver disease also affects how the body clears psilocin. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

GENVOYA (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) - Gilead · FDA label (DailyMed) — revised 2025-02 | Withdrawal or rebound if stopped abruptly: Boxed Warning: Post Treatment Acute Exacerbation of Hepatitis B "Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of GENVOYA." | Liver injury: Boxed Warning (same sentence) | 7 "Cobicistat, a component of GENVOYA, is an inhibitor of CYP3A and CYP2D6 and an inhibitor of the following transporters: P-glycoprotein (P-gp), BCRP, OATP1B1 and OATP1B3." | 12.3 "t1/2 values refer to median terminal plasma half-life. Note that the pharmacologically active metabolite, tenofovir diphosphate, has a half-life of 150-180 hours within PBMCs. 12.9 3.5 10 0.51"
STRIBILD (elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate) - Gilead · FDA label (DailyMed) — revised 2025-02 | "Cobicistat, a component of STRIBILD, is an inhibitor of CYP3A and CYP2D6 and an inhibitor of the following transporters: P-glycoprotein (P-gp), BCRP, OATP1B1, and OATP1B3." | "t1/2 values refer to median terminal plasma half-life. 12.9 3.5 10 12-18"
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Abstract: "recombinant CYP2D6 and CYP3A4 enzymes metabolized nearly 100% and 40% of psilocin, respectively." "MAO-A transformed psilocin into minimal amounts of 4-HIAA and 4-HTP." "In conclusion, MAO-A, CYP2D6, and CYP3A4 are involved in psilocin's metabolism." Introduction: "Around 33% of a psilocybin dose is renally excreted as 4-HIAA."

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

Report an error in this record →