cobicistat + darunavir ethanolate at a glance
Medicine class
HIV protease inhibitor with a pharmacokinetic enhancer
Usual role
Part of combination antiretroviral treatment for HIV-1
Food
Take with food
Interaction risk
Check all prescribed, non-prescription and herbal products with the HIV team
What is cobicistat + darunavir ethanolate used for?
Licensed use represented by the selected product:
Treatment of HIV-1 alongside other antiretrovirals in eligible adults and children aged 6 years or older who weigh at least 25 kg. Suitability depends partly on HIV genotype and previous treatment history.
How does cobicistat + darunavir ethanolate work?
Darunavir blocks HIV-1 protease, preventing production of mature infectious virus particles. Cobicistat slows darunavir breakdown through CYP3A inhibition and maintains its exposure; cobicistat does not treat HIV itself.
cobicistat + darunavir ethanolate preparations and strengths
Tablet
Route: Oral
Strengths: 800 mg + 150 mg
How to take cobicistat + darunavir ethanolate
Follow the HIV specialist’s directions.
Take with food.
Swallow the tablet whole whenever possible.
If swallowing it whole is difficult, the selected tablet may be divided with a tablet cutter; consume both pieces immediately.
Tell the HIV team if swallowing difficulties, vomiting or repeated missed tablets affect treatment.
cobicistat + darunavir ethanolate side effects
Common or expected effects
- Diarrhoea or nausea
- Headache
- Rash or itching
- Vomiting, abdominal discomfort, indigestion or wind
- Tiredness or muscle pain
- Raised liver enzymes, cholesterol, triglycerides or serum creatinine
Get urgent medical advice
- Severe skin reaction with blistering, peeling, mouth sores, fever or general illness
- Serious allergic reaction, including facial swelling or breathing difficulty
- Symptoms of liver inflammation, such as jaundice, dark urine or worsening nausea and fatigue
- Severe persistent abdominal pain, which may indicate pancreatitis
- New inflammatory symptoms after effective HIV treatment begins, which may reflect immune reconstitution
cobicistat + darunavir ethanolate in pregnancy
Darunavir exposure is substantially reduced when boosted with cobicistat during later pregnancy, risking treatment failure and HIV transmission to the baby. It should not be started during pregnancy. Anyone who becomes pregnant while taking it should contact their HIV team promptly and should not stop treatment independently.
cobicistat + darunavir ethanolate while breastfeeding
The product information advises against breastfeeding because infant exposure and adverse effects cannot be excluded. HIV can also pass through breast milk, so discuss feeding plans early with the specialist perinatal HIV team.
cobicistat + darunavir ethanolate interactions
Clinically important interactions are common. The HIV team should check all products before they are started, stopped or changed.
Rifampicin, carbamazepine, phenytoin, phenobarbital or St John’s wort
These can markedly reduce treatment exposure and cause loss of HIV control; co-administration is contraindicated.
Simvastatin or lovastatin
Concentrations and muscle-toxicity risk may rise substantially; co-administration is contraindicated.
Fluticasone, budesonide and other CYP3A-metabolised corticosteroids
Systemic steroid exposure may increase, causing adrenal suppression or Cushing’s syndrome; alternatives and monitoring may be needed.
Common questions about cobicistat + darunavir ethanolate
Answers are fully visible for fast scanning and source review.
What is cobicistat + darunavir ethanolate used for?
It is used with other antiretrovirals to treat HIV-1 in eligible adults and children.
Does it cure HIV?
No. It suppresses HIV replication as part of combination treatment but does not remove HIV from the body.
Why is cobicistat included?
Cobicistat slows CYP3A-mediated breakdown of darunavir, increasing its exposure. It has no direct antiviral activity.
Must it be taken with food?
Yes. Food substantially improves darunavir exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.