Skip to main content

Drug Interactions between cobicistat and Savaysa

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Major

cobicistat edoxaban

Applies to: cobicistat and Savaysa (edoxaban)

ADJUST DOSE: Coadministration with inhibitors of P-glycoprotein (P-gp) such as cobicistat may increase the plasma concentrations of edoxaban, which is a substrate of the efflux transporter. In a single-center, two-arm, single-sequence, open-label study, the AUC and Cmax of another P-gp substrate, dabigatran, both increased by 127% when administered simultaneously with cobicistat (p-value less than 0.001 for AUC and Cmax). In addition, thrombin time (TT) at 24 hours post-dose increased by 51% when dabigatran and cobicistat were given simultaneously compared to dabigatran alone (p-value less than 0.001).

MANAGEMENT: When used for the treatment of deep vein thrombosis and pulmonary embolism, the manufacturer recommends that edoxaban dosage be reduced to 30 mg once daily in patients receiving concomitant treatment with certain P-gp inhibitors including azithromycin, clarithromycin, erythromycin, oral itraconazole, oral ketoconazole, quinidine, and verapamil. This dosage recommendation is based on data from a clinical study, the Hokusai VTE study, and is limited to use with the specific P-gp inhibitors mentioned. Other P-gp inhibitors were not permitted in the study, and patients on antiretroviral therapy (ritonavir, nelfinavir, indinavir, saquinavir) as well as cyclosporine were excluded from the study. Following discontinuation of the P-gp inhibitor, edoxaban dosage should be returned to the regular dosage of 60 mg once daily. No dosage adjustment is recommended for edoxaban when used in the treatment of nonvalvular atrial fibrillation.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2012) "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences
  3. Mendell J, Zahir H, Matsushima N, et al. (2013) "Drug-Drug Interaction Studies of Cardiovascular Drugs Involving P-Glycoprotein, an Efflux Transporter, on the Pharmacokinetics of Edoxaban, an Oral Factor Xa Inhibitor." Am J Cardiovasc Drugs
  4. (2014) "Product Information. Tybost (cobicistat)." Gilead Sciences
  5. (2014) "Product Information. Prezcobix (cobicistat-darunavir)." Janssen Pharmaceuticals
  6. (2015) "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc.
  7. (2015) "Product Information. Evotaz (atazanavir-cobicistat)." Bristol-Myers Squibb
  8. (2015) "Product Information. Genvoya (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences
  9. Parasrampuria DA, Mendell J, Shi M, Matsushima N, Zahir H, Truitt K (2016) "Edoxaban drug–drug interactions with ketoconazole, erythromycin, and cyclosporine." Br J Clin Pharmacol, epub
  10. (2018) "Product Information. Symtuza (cobicistat/darunavir/emtricitabine/tenofovir)." Janssen Pharmaceuticals
  11. Kumar P, Gordon LA, et al. (2017) "Differential influence of the antiretroviral pharmacokinetic enhancers ritonavir and cobicistat on intestinal p-glycoprotein transport and the pharmacokinetic/pharmacodynamics disposition of dabigatran." Antimicrob Agents Chemother, 61, p. 1-12
View all 11 references

Switch to consumer interaction data

Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer