cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate at a glance
Medicine class
Protease inhibitor with a pharmacokinetic enhancer and two reverse-transcriptase inhibitors
Licensed use
Treatment of HIV-1 infection
Licensed population
Adults and adolescents aged 12 years or older who weigh at least 40 kg
Food
Take with food; the type of food is not important
Interaction warning
Many prescribed, over-the-counter and herbal products interact; check them with the HIV team
What is cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate used for?
Licensed as a complete treatment for:
HIV-1 infection in adults.
HIV-1 infection in adolescents aged 12 years or older who weigh at least 40 kg. Genotypic resistance testing should guide use.
How does cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate work?
Darunavir blocks HIV protease, preventing new virus particles from maturing. Emtricitabine and tenofovir alafenamide block reverse transcriptase and interrupt viral DNA formation. Cobicistat slows CYP3A metabolism, increasing darunavir exposure; it has no direct antiviral activity.
cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate preparations and strengths
Tablet
Route: Oral
Strengths: 800 mg + 150 mg + 200 mg + 10 mg
How to take cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate
Take exactly as prescribed and with food. Swallow the film-coated tablet with a drink and do not crush it. Do not stop without speaking to the HIV team, particularly if you also have hepatitis B, because hepatitis may worsen after stopping.
The type of food does not affect exposure.
Check before starting any prescribed, non-prescription or herbal product.
cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate side effects
Common or expected effects
- Headache
- Diarrhoea
- Rash or itching
- Nausea, vomiting, abdominal discomfort or indigestion
- Dizziness or abnormal dreams
- Tiredness or weakness
- Muscle or joint pain
- Raised creatinine, liver enzymes, blood fats or glucose
Get urgent medical advice
- Severe allergic reaction or serious skin reaction, including blistering or peeling
- Liver inflammation or dysfunction, which may cause jaundice, dark urine or right-sided upper abdominal pain
- Kidney impairment or proximal renal tubulopathy
- Acute pancreatitis, typically causing severe persistent abdominal pain
- Immune reconstitution inflammatory syndrome, where an infection or autoimmune disorder becomes apparent after immune recovery
cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate in pregnancy
This combination should not be started during pregnancy because pregnancy substantially lowers darunavir and cobicistat exposure, risking loss of HIV control and transmission to the baby. Anyone who becomes pregnant while taking it should promptly contact their HIV and maternity teams.
cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate while breastfeeding
The product information says not to breastfeed while receiving this combination because of possible adverse effects in the infant and HIV transmission through breast milk. UK information describes formula feeding as the safest option, while specialist teams can discuss and closely support individual feeding choices.
cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate interactions
Cobicistat and darunavir strongly affect CYP3A and several transporters, creating clinically important interactions. This list is not exhaustive.
Carbamazepine, phenobarbital, phenytoin or rifampicin
Can lower antiretroviral exposure and cause loss of HIV control; the combination is contraindicated.
St John’s wort
Can substantially reduce antiretroviral exposure; the combination is contraindicated.
Simvastatin, lovastatin or lomitapide
Concentrations may rise markedly, increasing serious toxicity including muscle injury; the combination is contraindicated.
Common questions about cobicistat + darunavir ethanolate + emtricitabine + tenofovir alafenamide fumarate
Answers are fully visible for fast scanning and source review.
What is Symtuza used for?
Symtuza treats HIV-1 infection in eligible adults and adolescents. It reduces viral replication but does not cure HIV.
Is Symtuza a complete HIV treatment?
Yes. It is licensed as a complete regimen.
Why must Symtuza be taken with food?
Food improves exposure to darunavir and cobicistat. The type of meal or snack is not important.
Can Symtuza tablets be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.