#cobicistat

[drpedi07]

Cobicistat Drug

Medical information for Cobicistat on Pediatric Oncall including Mechanism, Indication, Contraindications, Dosing, Adverse Effect, Interaction, Hepatic Dose.

[pharmasatyadeva]

[siglerprescriptiondrugcards]

Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide

Brand Name: Genvoya

Common Dosage Forms:

Tablets: Each tablet contains 150 mg of elvitegravir, 150 mg of cobicistat, 200 mg of emtricitabine, and 10 mg of tenofovir alafenamide.

FDA Indications/Dosages:

Indicated as a complete regimen for the treatment of HIV-1 infection in adult and pediatric patients weighing at least 25 kg, who have no antiretroviral treatment history or to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen for at least 6 months with no history of treatment failure and no known substitutions associated with resistance to the individual components of this drug: One tablet daily taken with food.

Monitor: CrCL, urine glucose and protein, BMD, LFT

Pharmacology/Pharmacokinetics: Genvoya is a fixed dose combination of antiviral drugs elvitegravir, emtricitabine, and tenofovir alafenamide along with CYP3A inhibitor cobicistat. Elvitegravir inhibits the strand transfer activity of HIV-1 DNA integrase which prevents the integration of HIV-1 DNA into host genomic DNA. This inhibition blocks the formation of the HIV-1 provirus and propagation of the viral infection. Emtricitabine undergoes phosphorylation by cellular enzymes to form emtricitabine 5′-triphosphate, The metabolite inhibits the activity of HIV-1 RT by completing with the natural substrate deoxycytidine 5′-triphosphate. Incorporation of emtricitabine 5′-triphosphate into the viral DNA results in chain termination. Tenofovir alafenamide is phosphoramidate prodrug of tenofovir. Tenofovir is metabolized to the active tenofovir diphosphate where it inhibits the activity of HIV-1 RT by competing with deoxyadenosine 5′-triphosphate for incorporation into DNA. It ultimately causes chain termination. Cobicistat is a selective inhibitor of CYP3A which prolongs the half-life of elvitegravir. Peak plasma levels in the fasted state are different for each ingredient and range from 1-4 hours. Tenofovir and emtricitabine are primarily excreted as unchanged drug in the urine. Elvitegravir and cobicistat are metabolized primarily via the CYP3A isoenzyme.

Drug Interactions: Antacids, CARBAMAZEPINE, RIFAMPIN, PHENOBARBITAL, and dexamethasone may decrease elvitegravir may decrease elvitegravir concentration. May increase concentrations concentrations of antiarrhythmics, PIMOZIDE, ALFUZOSIN, digoxin, clarithromycin, clonazepam, ethosuximide, antidepressants, colchicine, antifungals, quetiapine, beta-blockers, calcium channel blockers, fluticasone, bosentan, atorvastatin, norgestimate, buprenorphine, immunosuppressants, salmeterol, PDE-inhibitors, and TRIAZOLAM. May decrease concentrations of ethinyl estradiol and naloxone. Drugs that reduce kidney function or compete with tubular secretion may increase concentrations of emtricitabine and tenofovir. ST. JOHN’S WORT may decrease concentrations. Do not use with LOVASTATIN, SIMVASTATIN, or any ergot derivatives due to potential for severe adverse effects.

Contraindications/Precautions: Coadministration is contraindicated with drugs that are highly dependent on CYP3A. Contraindicated with any of the drugs in the Drug Interactions section printed in all UPPER CASE letters. Severe acute exacerbations of hepatitis B may occur therefore patients should be tested for hepatitis before initiating treatment. Not recommended in patients with CrCL below 30 mL/min. Monitor renal function throughout therapy. Avoid use with other antiviral medications. May decrease bone mineral density therefore monitoring is suggested. Cases of lactic acidosis and severe hepatomegaly have occurred in patients taking tenofovir with other antiretrovirals. Pregnancy Category B.

Adverse Effects: The most common adverse effects are diarrhea, nausea, rash, fatigue, headache, dizziness, insomnia, and abnormal dreams. Rare but potentially severe adverse effects include lactic acidosis, severe hepatomegaly, Hepatitis B exacerbation, renal impairment, and decreased bone mineral density.

Patient Consultation:

Take with a meal.

If you miss a dose, take it as soon as you remember. If it is closer to the time of your next dose, skip the missed dose and carry on with your normal dosing schedule. Do not double doses.

Call your healthcare provider if you experience any symptoms of lactic acidosis (very weak, unusual muscle pain, breathing trouble, stomach pain with nausea or vomiting, fast or irregular heartbeat, dizziness, coldness in extremities).

Call your healthcare provider is you experience any symptoms of liver dysfunction (yellow skin or eyes, dark urine, light-colored stools, anorexia, stomach pain, or nausea).

This medication does not prevent you from transmitting HIV-1 to other people.

[fundacionluchandovenceras]

TYBOST COBICISTAT Potenciador farmacocinetico (Inhibidor de CYP3A) . . . . . #arv #retrovirrales #antiretrovirrales #tybost #cobicistat #salud #saludresponsable #saludmentalyemocional #medicamentos #saludresponde #saludables #saludybienestar #conciencia #medicamento #medicina #medicines #medicinas https://www.instagram.com/p/CBjeKi_HNQc/?igshid=1pabysnyl2u48

[fundacionluchandovenceras]

SYMTUZA DRV/COBI/FTC/TAF Darunavir / cobicistat / emtricitabina / fumarato de Alafenamida de Tenofovir. Combinación Farmaceutica. . . . . . #symtuza #darunavir #cobicistat #emtricitabina #alafenamidadetenofovir #alafenamida #tenofovir #arv #retrovirrales #antiretrovirrales #salud #saludresponsable #saludybienestar #concienciasocial https://www.instagram.com/p/CBMvI8tjx_b/?igshid=147q8tv2vmncj

[fundacionluchandovenceras]

REZOLTA DARUNAVIR COBICISTAT #rezolta #darunavir #cobicistat #arv #retrovirrales #antiretrovirrales #medic #medicine #medicinas #medicamento #medicamentos #salud #saludresponsable #targ #concienciasocial #conciencia https://www.instagram.com/p/CA4JFaSnOzC/?igshid=9dap4fz6lnte

[fundacionluchandovenceras]

STRIBILD ELVITEGRAVIR / COBICISTAT / EMTRICITABINA / FUMARATO DE DISOPROXILO DE TENOFOVIR EVG/COBI/FTC/TDF, QUAD #stribild #cobicistat #emtricitabina #fumarato #disoproxilo #tenofovir #arv #retrovirrales #antiretrovirrales #medicine #medic #medicinas #medicina #medicamentos #salud #saludresponsable #saludybienestar #concienciasocial #concienciaplena #concienciauniversal https://www.instagram.com/p/CA3NauRnB9u/?igshid=1v6a76pdufotb

[fundacionluchandovenceras]

EVOTAZ ATAZANAVIR/COBICISTAT ATV/COBI, Sulfato de Atazanavir/Cobicistat #evotaz #atazanavir #cobicistat #sulfato #arv #retrovirrales #antiretrovirrales #salud #medic #medicine #medicinas #medicina #concienciaplena #cuidadopersonal #cuidatusalud #divercidad https://www.instagram.com/p/CAx0vj_DKpM/?igshid=acuvo4fkg2is