cobicistat (GS-9350, COBI)

Indications

• treatment of HIV1 in combination with HIV medications that require boosting
• component of elvitegravir/emtricitabine/cobicistat/tenofovir (Quad)

Contraindications

• not recommended if creatinine clearance < 70 mL/min

Dosage

• 150 mg, once a day PO QD

Adverse effects

• diarrhea, nausea
• dyslipidemia: hypercholesterolemia, hypertriglyceridemia
• increases in serum creatine kinase
• increases in serum creatinine
  • decreases tubular secretion, not GFR
  • expect increase in serum creatinine
    • average increase = 0.14 mg/dL
    • investigate for other causes if increase > 0.4 mg/dL
• hematuria

• drug adverse effects of antiretroviral agents

Drug interactions

• inhibits CYP3A4 & other cyt P450s

• drug interaction(s) of antibiotics with warfarin

Mechanism of action

• inhibits metabolism of other antiretroviral agents used in combination
• inhibits CYP3A4 & other cyt P450s

More general terms

• antiretroviral booster

Component of

• cobicistat/darunavir/emtricitabine/tenofovir
• cobicistat/darunavir
• atazanavir/cobicistat (Evotaz)
• cobicistat/elvitegravir/emtricitabine/tenofovir (Quad, Stribild, Genvoya)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=25151504