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Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate and Ziagen (Abacavir Tablets)

Determining the interaction of Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate and Ziagen (Abacavir Tablets) and the possibility of their joint administration.

Check result:
Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate <> Ziagen (Abacavir Tablets)
Relevance: 06.07.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Cobicistat is a medication used to boost the effects of some medications that treat HIV infection. However, using cobicistat together with other HIV medications, such as abacavir, may alter the blood levels and effects of both medications. Using abacavir with cobicistat may reduce or increase blood levels of cobicistat. Reduced blood levels of cobicistat may make cobicistat less effective and may cause overall HIV treatment to be less effective. Cobicistat may increase blood levels of abacavir which may increase the risk of side effects. Talk to your doctor or pharmacist if you have any questions on how to use these medications properly. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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.

Professional:

GENERALLY AVOID: Cobicistat may increase the plasma concentrations of antiretroviral agents. The plasma concentrations of cobicistat may also be increased or reduced in the presence of antiretroviral agents. The proposed mechanism is cobicistat inhibition of the CYP450 3A4 isoenzyme, of which antiretroviral agents may be substrates, and the inhibition or induction of CYP450 3A4 by concomitant antiretroviral medications. Cobicistat is a mechanism-based inhibitor and substrate of CYP450 3A4 with no antiretroviral activity of its own. Rather, it is indicated in its capacity as a pharmacokinetic booster of CYP450 3A4 to increase the systemic exposure of some antiretroviral medications such as atazanavir, darunavir, and elvitegravir, which are substrates of this isoenzyme. Concomitant use of other antiretroviral agents with cobicistat may also increase the plasma levels and risk of side effects associated with these medicines. In contrast, concomitant use of cobicistat-boosted atazanavir or darunavir with CYP450 3A4 inducers nevirapine, etravirine, or efavirenz may reduce the plasma concentrations of cobicistat, darunavir, and atazanavir, leading to a potential loss of therapeutic effect and development of resistance to darunavir and atazanavir. Pharmacokinetic data are not available.

MANAGEMENT: Cobicistat is not intended for use with more than one antiretroviral medication that requires pharmacokinetic enhancement, such as two protease inhibitors or elvitegravir in combination with a protease inhibitor. In addition, cobicistat should not be used concomitantly with ritonavir due to their similar effects on CYP450 3A4. According to some authorities, use of the antiretroviral combinations of atazanavir-cobicistat or darunavir-cobicistat concomitantly with the CYP450 3A4 inducers efavirenz, etravirine, or nevirapine is also not recommended. Since dosing recommendations have only been established for a number of antiretroviral medications, product labeling and current antiretroviral treatment guidelines should be consulted.

References
  • "Product Information. Tybost (cobicistat)." Gilead Sciences, Foster City, CA.
  • "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences, Foster City, CA.
  • "Product Information. Viramune (nevirapine)." Boehringer-Ingelheim, Ridgefield, CT.
  • "Product Information. Sustiva (efavirenz)." DuPont Pharmaceuticals, Wilmington, DE.
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • "Product Information. Prezista (darunavir)." Ortho Biotech Inc, Bridgewater, NJ.
  • "Product Information. Intelence (etravirine)." Ortho Biotech Inc, Bridgewater, NJ.
  • "Product Information. Evotaz (atazanavir-cobicistat)." Bristol-Myers Squibb, Princeton, NJ.
  • "Product Information. Prezcobix (cobicistat-darunavir)." Janssen Pharmaceuticals, Titusville, NJ.
  • Cerner Multum, Inc. "Australian Product Information." O 0
Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate

Generic Name: cobicistat / darunavir / emtricitabine / tenofovir alafenamide

Brand name: Symtuza

Synonyms: Cobicistat, darunavir, emtricitabine, and tenofovir, Darunavir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide

Ziagen (Abacavir Tablets)

Generic Name: abacavir

Brand name: Ziagen

Synonyms: Ziagen

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.