COBICISTAT

Other

Brand names: Tybost

Oral

Mechanism of Action

12.1 Mechanism of Action Cobicistat is a mechanism-based inhibitor of cytochrome P450 3A (CYP3A). Inhibition of CYP3A-mediated metabolism by cobicistat increases the systemic exposure of CYP3A substrates atazanavir and darunavir.

Indications

fosamprenavir

saquinavir

or tipranavir due to lack of exposure data. The use of TYBOST is not recommended with darunavir 600 mg twice daily

fosamprenavir

saquinavir

or tipranavir. ( 1.2

Contraindications

• phenobarbital
• phenytoin Anti-gout: colchicine Antimycobacterial: rifampin Antineoplastics: irinotecan These contraindications apply only to TYBOST coadministered with atazanavir Antipsychotics: lurasidone
• pimozide Ergot Derivatives: dihydroergotamine
• ergotamine
• methylergonovine Herbal Products: St. John's wort ( Hypericum perforatum ) Hormonal Contraceptives: drospirenone/ ethinyl estradiol Lipid-modifying Agents: lomitapide

FDA Warnings

5 WARNINGS AND PRECAUTIONS Assess creatinine clearance (CLcr) before initiating treatment
Monitor serum phosphorus in patients with or at risk for renal impairment
Measure serum phosphorus in patients with or at risk for renal impairment when used with TDF
3 Risk of Serious Adverse Reactions or Loss of Virologic Response Due to Drug Interactions Initiation of TYBOST, a CYP3A inhibitor, in patients receiving medications metabolized by CYP3A, or initiation of medications metabolized by CYP3A in patients already receiving TYBOST, may increase plasma concentrations of medications metabolized by CYP3A and reduce plasma concentrations of active metabolite(s) formed by CYP3A

Known Side Effects

1 documented side effects by frequency

Anxiety

1-10%

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Formulations

Dosage Forms

Tablet

Route

Oral