Formulary
Cobicistat: Indications, Dosing, Side Effects and Interactions
Cobicistat clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Cobicistat: Indications, Dosing, Side Effects and Interactions
Cobicistat clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Pharmacokinetic enhancer used to increase the effect of atazanavir or darunavir**
- **Adult** (By Mouth): 150 mg once daily.
**Pharmacokinetic enhancer used to increase the effect of atazanavir for cobicistat**
- **Child 12-17 years (body-weight 35 kg and above)** (By mouth): 150 mg once daily.
**Pharmacokinetic enhancer used to increase the effect of darunavir for cobicistat**
- **Child 12-17 years (body-weight 40 kg and above)** (By mouth): 150 mg once daily.
Interactions
**Severe interactions:**
- John's wort ( Hypericum perforatum ), rifampicin, carbamazepine, phenobarbital, and phenytoin may result in significantly decreased cobicistat and elvitegravir plasma concentrations, which may...
- Antimycobacterials Rifabutin (150 mg every other day)/ Elvitegravir (150 mg once daily)/ Cobicistat (150 mg once daily) Coadministration of rifabutin, a potent CYP3A inducer, may significantly...
- ANTICONVULSANTS Carbamazepine (200 mg twice daily)/ Elvitegravir (150 mg once daily)/ Cobicistat (150 mg once daily) Coadministration of carbamazepine, a potent CYP3A inducer, may significantly...
- Coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of salmeterol, which is associated with the potential for...
- Coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of this medicinal product, which is associated with the...
- Due to the presence of cobicistat, coadministration with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead may result in increased plasma concentrations of this medicinal product,...
- Studies conducted with other medicinal products Based on drugdrug interaction studies conducted with Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead or the components of...
**Other interactions (126):**
- Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead should not be coadministered with other antiretroviral medicinal products.
- Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Gilead should not be administered concomitantly with medicinal products containing tenofovir alafenamide, tenofovir disoproxil, lamivudine...
- Elvitegravir Elvitegravir is primarily metabolised by CYP3A, and medicinal products that induce or inhibit CYP3A may affect the exposure of elvitegravir.
- Elvitegravir may have the potential to induce CYP2C9 and/or inducible uridine diphosphate glucuronosyltransferase (UGT) enzymes; as such it may decrease the plasma concentration of substrates of...
- Cobicistat Cobicistat is a strong mechanismbased inhibitor of CYP3A and is also a CYP3A substrate.
- Cobicistat is also a weak CYP2D6 inhibitor and is metabolised, to a minor extent, by CYP2D6.
Pregnancy
Not to be initiated during pregnancy. M For use with atazanavir, see atazanavir with cobicistat . For use with darunavir, see darunavir with cobicistat or darunavir with cobicistat, emtricitabine and tenofovir alafenamide . For use with elvitegravir, see elvitegravir with cobicistat, emtricitabine and tenofovir disoproxil or elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide .
Hepatic impairment
Manufacturer advises avoid in severe impairment-no information available.
Renal impairment
No dose adjustment required; inhibits tubular secretion of creatinine; when any co-administered drug requires dose adjustment based on renal function, avoid initiating cobicistat if creatinine clearance less than 70 mL/minute. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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