Cobicistat and darunavir and Ketek

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using cobicistat together with telithromycin may increase the blood levels and effects of both medications. Increased blood levels of telithromycin can cause an irregular heart rhythm that may be serious. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration of a macrolide or ketolide antibiotic (clarithromycin, erythromycin, telithromycin) with cobicistat is expected to increase the plasma concentrations of both drugs. The mechanism may involve both competitive and noncompetitive inhibition of CYP450 3A4, since these drugs are all substrates as well as inhibitors of the isoenzyme. No pharmacokinetic data are currently available. Clinically, high plasma levels of macrolide or ketolide antibiotics may increase the risk of QT interval prolongation and torsade de pointes arrhythmia.

MANAGEMENT: Caution and close clinical monitoring are recommended if clarithromycin, erythromycin, or telithromycin are used in combination with cobicistat. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitations, irregular heartbeat, shortness of breath, or syncope. Some authorities recommend avoiding the concomitant use of fixed combination antiretroviral products containing cobicistat with these antibiotics. For clarithromycin, a dosage reduction by 50% has been recommended in patients with CrCl between 30 and 60 mL/min. Data are not available in patients with CrCl less than 30 mL/min. However, in patients receiving atazanavir or ritonavir concomitantly with clarithromycin, it has been suggested that the dose of clarithromycin be reduced by 75% in patients with a CrCl of less than 30 mL/min. A similar dosage reduction may be appropriate when clarithromycin is used with cobicistat.

Cobicistat and darunavir

Generic Name: cobicistat / darunavir

Brand name: Prezcobix

Synonyms: Darunavir and Cobicistat

What is Cobicistat and darunavir?

Ketek

Generic Name: telithromycin

Brand name: Ketek

Synonyms: n.a.

What is Ketek?