Cobicistat

Chemical formula: C₄₀H₅₃N₇O₅S₂  Molecular mass: 776.03 g/mol  PubChem compound: 25151504

Therapeutic indications

Cobicistat is indicated for:

Human immunodeficiency virus-1 infection

Population group: only adolescents (12 years - 18 years old) , adults (18 years old or older)

Cobicistat is a CYP3A inhibitor indicated to increase systemic exposure of atazanavir or darunavir in combination with other antiretroviral agents in the treatment of HIV-1 infection in adults and in pediatric patients weighing at least 35 kg coadministered with atazanavir or 40 kg coadministered with darunavir.

Limitations of Use:

  • Cobicistat 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 TYBOST interactions. Cobicistat and ritonavir when administered with either atazanavir or darunavir may result in different drug interactions when used with concomitant medications.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

Contraindications

Cobicistat is contraindicated in the following cases:

Pregnancy

Pregnancy

Lactation

Lactation

Efavirenz coadministered with darunavir

Efavirenz

Etravirine

Etravirine

Nevirapine

Nevirapine

Alfuzosin

Alfuzosin

Ranolazine

Ranolazine

Dronedarone

Dronedarone

Rivaroxaban

Rivaroxaban

Carbamazepine, phenobarbital, phenytoin

at least one of
Carbamazepine
Phenobarbital
Phenytoin

Rifampicin

Rifampicin

Ticagrelor

Ticagrelor

Clopidogrel

Clopidogrel

Lurasidone

Lurasidone

Pimozide

Pimozide

Ergot derivatives

at least one of
Ergot alkaloids
Ergotamine
Methergine

Cisapride

Cisapride

Boceprevir, simeprevir

at least one of
Boceprevir
Simeprevir

St. John’s wort

Hypericum perforatum (St John's Wort)

Salmeterol

Salmeterol

Lovastatin, simvastatin

at least one of
Lovastatin
Simvastatin

Lomitapide

Lomitapide

Sildenafil for the treatment of pulmonary arterial hypertension

Sildenafil and additionally Pulmonary hypertensive arterial disease

Avanafil

Avanafil

Triazolam, orally administered midazolam

at least one of
Midazolam
Triazolam

Colchicine

Colchicine

Indinavir

Indinavir

Drospirenone/ethinylestradiol

Drospirenone and ethinylestradiol

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