Are there contraindications to concurrent use of Lexapro (escitalopram) and Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 30, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

There are no significant contraindications to taking Lexapro (escitalopram) and Biktarvy together, and they can generally be used concurrently without major drug interactions. Lexapro is an antidepressant that works by increasing serotonin levels in the brain, while Biktarvy is a complete HIV treatment regimen containing bictegravir, emtricitabine, and tenofovir alafenamide. According to the 2018 recommendations of the international antiviral society-USA panel 1, Biktarvy has a relatively low risk of resistance with virologic failure and few drug interactions, which supports its use with other medications like Lexapro. However, it's essential to inform your healthcare provider about all medications you're taking, as mild interactions are possible since both medications are processed by the liver. Some patients might experience increased side effects such as nausea, headache, or dizziness when taking both medications. Your doctor may need to monitor you more closely, especially when first starting either medication, as suggested by the 2016 recommendations for switching antiretroviral regimens 1. If you notice any unusual symptoms or side effects, contact your healthcare provider promptly. Regular follow-up appointments are crucial to ensure both medications are working effectively and not causing adverse effects.

Key considerations when taking Lexapro and Biktarvy together include:

  • Monitoring for potential side effects such as nausea, headache, or dizziness
  • Informing your healthcare provider about all medications you're taking
  • Regular follow-up appointments to ensure the medications are working effectively and not causing adverse effects
  • Being aware of the potential for mild drug interactions due to liver processing.

From the Research

Contraindications to Being on Lexapro and Biktarvy

There are no direct studies on the contraindications of being on Lexapro (escitalopram) and Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide) simultaneously. However, we can look at the individual components and their potential interactions:

  • Lexapro is an SSRI antidepressant, and its interactions with other medications are generally related to its effects on the cytochrome P450 enzyme system.
  • Biktarvy is an antiretroviral medication used to treat HIV-1 infection.

Potential Interactions

Some potential interactions to consider:

  • Cytochrome P450 interactions: Biktarvy's components are not significant inducers or inhibitors of the cytochrome P450 enzymes, but escitalopram is metabolized by CYP2C19 and CYP3A4. However, there is no direct evidence of a significant interaction between Lexapro and Biktarvy components 2, 3, 4, 5, 6.
  • Serotonin syndrome: The use of SSRIs like Lexapro with certain medications, including some antiretrovirals, may increase the risk of serotonin syndrome. However, there is no specific evidence to suggest a significant risk with Biktarvy 2, 3, 4, 5, 6.

Conclusion Not Provided as Per Request

As per the request, no conclusion will be drawn, and the information provided is based solely on the available evidence. It is essential to consult a healthcare professional for personalized advice on potential interactions between Lexapro and Biktarvy.

Key Points to Consider

Key points to consider when evaluating the potential contraindications of being on Lexapro and Biktarvy:

  • Monitor for potential interactions, such as cytochrome P450 interactions or serotonin syndrome.
  • Consult a healthcare professional for personalized advice on potential interactions between Lexapro and Biktarvy.
  • The available evidence does not provide direct information on the contraindications of using Lexapro and Biktarvy simultaneously 2, 3, 4, 5, 6.

Related Questions

Can an HIV patient be switched from Odefsey (emtricitabine, rilpivirine, and tenofovir disoproxil fumarate) to Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide)?
What is the most appropriate management for a patient with a history of primary syphilis, currently on antiretroviral therapy (ART) with bictegravir (Integrase Strand Transfer Inhibitor)/emtricitabine (Nucleoside Reverse Transcriptase Inhibitor)/tenofovir alafenamide (Nucleotide Reverse Transcriptase Inhibitor), who has stable rapid plasma reagin (RPR) titers with a slight increase to 1:8, and no symptoms?
What is the most appropriate management for a patient with a history of primary syphilis, currently on bictegravir (Integrase Strand Transfer Inhibitor)/emtricitabine (Nucleoside Reverse Transcriptase Inhibitor)/tenofovir alafenamide (Nucleotide Reverse Transcriptase Inhibitor), with stable Rapid Plasma Reagin (RPR) titers and no symptoms?
What are the considerations for using Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide) in patients with liver failure?
What are the recommended initial regimens for new HIV medication?
What are the considerations and management plan for transplanting Hepatitis B (HBV) positive antibody (Ab) donor lungs into a Hepatitis B vaccinated patient?
What is the treatment for vertebral artery dissection (VAD)?
What is vertebral artery dissection (VAD)?
Are there contraindications to concurrent use of Escitalopram (Lexapro), Adalimumab (Humira), and Bictegravir/Emtricitabine/Tenofovir alafenamide (Biktarvy)?
What is the workup for frequent premature ventricular contractions (PVCs)?
Are there contraindications to concurrent use of Escitalopram (Lexapro) and Adalimumab (Humira)?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.