Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate and Dextromethorphan Hydrobromide and Quinidine Sulfate

• Generic Name: cobicistat / darunavir / emtricitabine / tenofovir alafenamide
• Dosage Forms: n.a.
• Other Brand Names: Symtuza

Darunavir, cobicistat, emtricitabine, and tenofovir alafenamide fumarate is a four-drug combination of darunavir (DRV), an HIV-1 protease inhibitor, cobicistat (COBI), a CYP3A inhibitor, and emtricitabine (FTC) and tenofovir alafenamide (TAF), both HIV-1 NRTIs, and is indicated as a complete regimen for the treatment of HIV-1 infection in adults who have no prior antiretroviral treatment history or who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen for at least 6 months and have no known substitutions associated with resistance to darunavir or tenofovir.

• Generic Name: dextromethorphan / quinidine
• Dosage Forms: n.a.
• Other Brand Names: Nuedexta

The fixed combination of dextromethorphan hydrobromide and quinidine sulfate (dextromethorphan/quinidine; Nuedexta) is used in the treatment of PBA.

PBA occurs secondary to various otherwise unrelated neurologic conditions (e.g., amyotrophic lateral sclerosis [ALS], multiple sclerosis [MS], dementia of the Alzheimer's type [Alzheimer's disease] or other dementia, parkinsonian syndrome, stroke, traumatic brain injury) and is characterized by involuntary, sudden, uncontrollable, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state.

Studies supporting efficacy in PBA were conducted in patients with underlying ALS or MS.

Safety and efficacy in the treatment of other common types of emotional lability (e.g., those occurring in patients with Alzheimer's disease and other dementias) not established.