Cobicistat
Cobicistat Uses, Dosage, Side Effects, Food Interaction and all others data.
Cobicistat, marketed under the name Tybost (formerly GS-9350), indicated for treating infection with human immunodeficiency virus (HIV). Although it does not have any anti-HIV activity, cobicistat acts as a pharmacokinetic enhancer by inhibiting cytochrome P450 3A isoforms (CYP3A) and therefore increases the systemic exposure of coadministered agents that are metabolized by CYP3A enzymes. More specifically, cobicistat is indicated to increase systemic exposure of atazanavir or darunavir (once daily dosing regimen) in combination with other antiretroviral agents in the treatment of HIV-1 infection. Increasing systemic exposure of anti-retrovirals (ARVs) without increasing dosage allows for better treatment outcomes and a decreased side effect profile.
| Trade Name | Cobicistat |
| Availability | Prescription only |
| Generic | Cobicistat |
| Cobicistat Other Names | Cobicistat |
| Related Drugs | Biktarvy, Truvada, tenofovir, ritonavir, Complera, Atripla, Stribild |
| Weight | 150mg, 150mg + 800mg + 200mg + 10mg, 150mg + 150mg + 200mg + 10mg, 150mg + 150mg + 200mg + 300mg, |
| Type | Oral Tablet, Oral |
| Formula | C40H53N7O5S2 |
| Weight | Average: 776.03 Monoisotopic: 775.354960183 |
| Protein binding | 97-98% bound to human plasma proteins. |
| Groups | Approved |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Cobicistat is a CYP3A inhibitor used to increase the systemic exposure of atazanavir or darunavir in combination with other antiretroviral agents in the treatment of HIV-1 infection.
Cobicistat is a CYP3A inhibitor indicated to increase systemic exposure of atazanavir or darunavir (once daily dosing regimen) in combination with other antiretroviral agents in the treatment of HIV-1 infection. It is not interchangeable with ritonavir to increase systemic exposure of darunavir 600 mg twice daily, fosamprenavir, saquinavir, or tipranavir due to lack of exposure data. The use of cobicistat is not recommended with darunavir 600 mg twice daily, fosamprenavir, saquinavir or tipranavir. Complex or unknown mechanisms of drug interactions preclude extrapolation of ritonavir drug interactions to certain cobicistat interactions. Cobicistat and ritonavir when administered with either atazanavir or darunavir may result in different drug interactions when used with concomitant medications.
Cobicistat is also used to associated treatment for these conditions: Human Immunodeficiency Virus (HIV) Infections, Human Immunodeficiency Virus Type 1 (HIV-1) Infection
How Cobicistat works
Cobicistat is a mechanism-based inhibitor of cytochrome P450 3A (CYP3A) isoforms. Inhibition of CYP3A-mediated metabolism by cobicistat increases the systemic exposure of CYP3A substrates atazanavir and darunavir and therefore enables increased anti-viral activity at a lower dosage. Cobicistat does not have any anti-HIV activity on its own.
Toxicity
The most common adverse reactions reported during clinical trials were jaundice (13%), ocular icterus (15%), and nausea (12%).
Food Interaction
- Avoid St. John's Wort. St. John's Wort is contraindicated as it induces the CYP3A metabolism of cobicistat and may reduce its serum concentration.
- Take at the same time every day.
- Take with food.
Cobicistat Drug Interaction
Moderate: nirmatrelvir / ritonavir, emtricitabine / tenofovirUnknown: aspirin, charcoal, lodoxamide ophthalmic, lubiprostone, lorazepam, botulism immune globulin, beclomethasone nasal, methohexital, calcium / vitamin d, sulfamethoxazole / trimethoprim, ubiquinone, copper gluconate, glycerin, magnesium hydroxide, darunavir, bioflavonoids, cyanocobalamin, cholecalciferol
Cobicistat Disease Interaction
Elimination Route
Median peak plasma concentrations were observed at 3.5 hours post-dose.
Half Life
The terminal plasma half-life of cobicistat is approximately 3 to 4 hours.
Elimination Route
With single dose administration of [14C] cobicistat after multiple dosing of cobicistat for six days, the mean percent of the administered dose excreted in feces and urine was 86.2% and 8.2%, respectively.
Innovators Monograph
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