Drug Interactions between cobicistat and Erleada

Consumer information for this interaction is not currently available.

CONTRAINDICATED: Coadministration of cobicistat with a drug that is both a substrate as well as a potent inducer of CYP450 3A4 may result in significantly decreased plasma concentrations of cobicistat and significantly increased concentrations of the other drug. Cobicistat is a substrate and a potent inhibitor of CYP450 3A4. In a study of 12 healthy volunteers, coadministration of the potent CYP450 3A4 inducer carbamazepine (200 mg twice daily) with cobicistat-elvitegravir (150 mg-150 mg once a day) reduced the cobicistat systemic exposure (AUC) and peak plasma concentration (Cmax) by 84% and 72%, respectively, and the elvitegravir AUC and Cmax by 69% and 45%, respectively. In addition, the AUC and Cmax of carbamazepine increased by 43% and 40%, respectively, due to inhibition of the CYP450 3A4-mediated metabolism by cobicistat.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic drug levels along with the risk of serious and/or life-threatening adverse effects associated with elevated plasma levels, the concomitant use of antiretroviral regimens containing cobicistat with potent CYP450 3A4 inducers that are also sensitive CYP450 3A4 substrates is considered contraindicated.