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Health Guide

Cobicistat (Oral route)

Pronunciation:

koe-BIK-i-stat

Brand Names:

  • Tybost

Dosage Forms:

  • Tablet

Classifications:

Therapeutic—

Anti-Infective Agent

Uses of This Medicine:

Cobicistat is used to increase the effects of atazanavir or darunavir for the treatment of human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS).

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of cobicistat in the pediatric population. Safety and efficacy have not been established.

Older adults—

Although appropriate studies on the relationship of age to the effects of cobicistat have not been performed in the geriatric population, no geriatric-specific problems have been documented to date.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Alfuzosin
  • Carbamazepine
  • Cisapride
  • Colchicine
  • Conivaptan
  • Crizotinib
  • Dihydroergotamine
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Eletriptan
  • Eliglustat
  • Eplerenone
  • Ergonovine
  • Ergotamine
  • Fosphenytoin
  • Isavuconazonium Sulfate
  • Ivabradine
  • Lomitapide
  • Lovastatin
  • Lurasidone
  • Maraviroc
  • Methylergonovine
  • Midazolam
  • Naloxegol
  • Pazopanib
  • Phenobarbital
  • Phenytoin
  • Pimozide
  • Primidone
  • Ranolazine
  • Rifampin
  • Riociguat
  • Romidepsin
  • Sildenafil
  • Silodosin
  • Simvastatin
  • St John's Wort
  • Tolvaptan
  • Triazolam
  • Venetoclax

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ado-Trastuzumab Emtansine
  • Afatinib
  • Alprazolam
  • Amiodarone
  • Amprenavir
  • Apixaban
  • Aprepitant
  • Aripiprazole
  • Avanafil
  • Bedaquiline
  • Betrixaban
  • Boceprevir
  • Bosentan
  • Bosutinib
  • Brigatinib
  • Bromocriptine
  • Budesonide
  • Cabazitaxel
  • Cabozantinib
  • Calcifediol
  • Cariprazine
  • Ceritinib
  • Cilostazol
  • Clarithromycin
  • Cobimetinib
  • Cyclophosphamide
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Dasatinib
  • Deflazacort
  • Delamanid
  • Delavirdine
  • Dexamethasone
  • Diazepam
  • Digoxin
  • Disopyramide
  • Docetaxel
  • Domperidone
  • Donepezil
  • Erlotinib
  • Erythromycin
  • Eslicarbazepine Acetate
  • Eszopiclone
  • Etravirine
  • Everolimus
  • Fentanyl
  • Flecainide
  • Fluoxetine
  • Fluticasone
  • Fosamprenavir
  • Fosaprepitant
  • Haloperidol
  • Hydrocortisone
  • Ibrutinib
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Irinotecan
  • Irinotecan Liposome
  • Itraconazole
  • Ivacaftor
  • Ketoconazole
  • Lapatinib
  • Levomilnacipran
  • Lidocaine
  • Lopinavir
  • Macitentan
  • Manidipine
  • Methadone
  • Mexiletine
  • Midostaurin
  • Mifepristone
  • Morphine
  • Morphine Sulfate Liposome
  • Netupitant
  • Nevirapine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Olaparib
  • Orlistat
  • Oxcarbazepine
  • Oxycodone
  • Palbociclib
  • Panobinostat
  • Pimavanserin
  • Piperaquine
  • Pixantrone
  • Ponatinib
  • Propafenone
  • Quetiapine
  • Quinidine
  • Reboxetine
  • Regorafenib
  • Retapamulin
  • Ribociclib
  • Rifabutin
  • Rifapentine
  • Ritonavir
  • Rivaroxaban
  • Rosuvastatin
  • Ruxolitinib
  • Salmeterol
  • Saquinavir
  • Simeprevir
  • Sirolimus
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Tamoxifen
  • Tamsulosin
  • Telithromycin
  • Temsirolimus
  • Thiotepa
  • Ticagrelor
  • Tipranavir
  • Topotecan
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trazodone
  • Valbenazine
  • Vardenafil
  • Vemurafenib
  • Vilanterol
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Vorapaxar
  • Voriconazole
  • Warfarin
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aripiprazole Lauroxil
  • Atazanavir
  • Darunavir
  • Indinavir
  • Nelfinavir

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Kidney disease—Use with caution. May make this condition worse.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. You should talk to your doctor if you have any questions.

This medicine should be taken with food.

Do not change the dose or stop using this medicine without checking first with your doctor. When your supply of this medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of this medicine.

If you are also taking an antacid containing aluminum or magnesium, take it at least 2 hours before or after cobicistat with atazanavir. Ask your doctor or pharmacist before taking any other medicines for your stomach or heartburn.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For enhancement of atazanavir or darunavir:
      • Adults—150 milligrams (mg) once a day, taken with atazanavir 300 mg once a day or darunavir 800 mg once a day.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of cobicistat with atazanavir or darunavir by less than 12 hours, take the missed dose of cobicistat with atazanavir or darunavir right away. However, if you miss a dose of cobicistat with atazanavir or darunavir by more than 12 hours, wait and take the next dose at your usual time. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Do not use this medicine if the seal on the bottle is broken or missing. Keep the bottle tightly closed. Keep the medicine in the original bottle that you were given at the pharmacy.

Precautions While Using This Medicine:

Your doctor will want to check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for any unwanted effects.

Do not use this medicine together with atazanavir or darunavir if you are also using any of the following: alfuzosin (Uroxatral®), carbamazepine (Tegretol®), cisapride (Propulsid®), colchicine (Colcrys®), dronedarone (Multaq®), indinavir (Crixivan®), irinotecan (Camptosar®), lovastatin (Altoprev®, Mevacor®), lurasidone (Latuda®), midazolam (Versed®), nevirapine (Viramune®), phenobarbital (Luminal®), phenytoin (Dilantin®), pimozide (Orap®), ranolazine (Ranexa®), rifampin (Rifadin®), sildenafil (Revatio®), simvastatin (Simcor®, Zocor®), St. John's wort, triazolam (Halcion®), or ergot medicines (eg, dihydroergotamine, ergotamine, methylergonovine, Cafergot®, Migranal®). Doing so may cause serious unwanted effects.

Using this medicine together with tenofovir DF may cause kidney problems (including Fanconi syndrome). Tell your doctor right away if you have bloody urine, decreased frequency or amount of urine, increased thirst, loss of appetite, lower back or side pain, nausea, vomiting, swelling of the face, fingers, or lower legs, troubled breathing, unusual tiredness or weakness, or weight gain.

This medicine does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contaminated blood. Make sure you understand and practice safe sex, even if your partner also has HIV. Avoid sharing needles with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
Abdominal or stomach pain
bloody urine
chills
clay-colored stools
dark urine
decreased frequency or amount of urine
dizziness
fast heartbeat
fever
headache
hives or welts, itching, or rash
hoarseness
increased thirst
irritation
joint pain, stiffness, or swelling
loss of appetite
lower back or side pain
nausea and vomiting
pain in the groin or genitals
redness of the skin
sharp back pain just below the ribs
swelling of the eyelids, face, lips, hands, lower legs, or feet
tightness in the chest
troubled breathing or swallowing
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
weight gain
yellow eyes or skin
Less common or rare
Dark-colored urine
muscle cramps or spasms
muscle pain or stiffness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common or rare
Diarrhea
discouragement
feeling sad or empty
irritability
loss of interest or pleasure
trouble concentrating
trouble sleeping
upper abdominal or stomach pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 8/4/2017
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