Darunavir and Cobicistat and Vfend

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 voriconazole may increase the blood levels and effects of both medications. Increased blood levels of voriconazole 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 an azole antifungal agent with cobicistat and elvitegravir may result in increased plasma concentrations of all three 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. When ketoconazole 200 mg twice daily was given with elvitegravir 150 mg once daily plus ritonavir (100 mg/day pharmacokinetic booster dose), elvitegravir mean peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) increased by approximately 17%, 48% and 67%, respectively. The pharmacokinetics of ketoconazole were not reported. Clinically, high plasma levels of an azole antifungal agent may increase the risk of QT interval prolongation and torsade de pointes arrhythmia.

MANAGEMENT: Caution is advised if azole antifungal agents are used in combination with cobicistat and elvitegravir. Dosage adjustments may be required. According to the product information for cobicistat, the maximum daily dosage of ketoconazole or itraconazole should not exceed 200 mg/day. An assessment of benefit-to-risk ratio is recommended to justify the use of voriconazole with cobicistat and elvitegravir.

Darunavir and Cobicistat

Generic Name: cobicistat / darunavir

Brand name: Prezcobix

Synonyms: Cobicistat and darunavir

What is Darunavir and Cobicistat?

Vfend

Generic Name: voriconazole

Brand name: Vfend, Vfend

Synonyms: Vfend Injection

What is Vfend?