Cobicistat (koe-BIK-i-stat)

Increases the effects of atazanavir or darunavir to help treat HIV infection. This medicine does not cure HIV or AIDS, but it may help slow the progress of the disease.

Brand Name(s):

Tybost

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed. Take all other medicines your doctor has prescribed as part of your combination treatment. You need to take cobicistat at the same time you take atazanavir or darunavir.
• Do not stop using this medicine without checking first with your doctor. If you stop the medicine even for a short time, the virus may become harder to treat. Contact your doctor or pharmacist when your supply is running low so you do not run out.
• It is best to take this medicine with food or milk.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep the medicine in the original bottle. Keep it tightly closed. Do not use this medicine if the seal on the bottle is broken or missing.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with alfuzosin, carbamazepine, colchicine, dihydroergotamine, drospirenone/ethinyl estradiol, ergotamine, dronedarone, indinavir, irinotecan, lomitapide, lovastatin, lurasidone, methylergonovine, nevirapine, oral midazolam, phenobarbital, phenytoin, pimozide, ranolazine, rifampin, sildenafil for pulmonary hypertension, simvastatin, St John's wort, or triazolam.
• There are many other drugs that can interact with this medicine. Make sure your doctor knows about all other medicines you are using, especially any of the following:
  • Atorvastatin, avanafil, boceprevir, bosentan, buprenorphine, buprenorphine/naloxone, clonazepam, clopidogrel, colchicine, cyclosporine, dasatinib, efavirenz, eslicarbazepine, etravirine, everolimus, famotidine, fentanyl, maraviroc, methadone, nevirapine, nilotinib, omeprazole, oxcarbazepine, perphenazine, prasugrel, quetiapine, rifabutin, risperidone, rosuvastatin, salmeterol, simeprevir, sirolimus, tacrolimus, tadalafil, thioridazine, ticagrelor, tramadol, vardenafil, vinblastine, vincristine
  • Birth control pills (including drospirenone/ethinyl estradiol)
  • Blood pressure medicine (including beta-blockers, calcium channel blockers)
  • Blood thinner (including apixaban, betrixaban, dabigatran, edoxaban, rivaroxaban, warfarin)
  • Medicine for depression or mental health problems (including amitriptyline, desipramine, imipramine, nortriptyline, TCAs)
  • Medicine for heart rhythm problems (including amiodarone, disopyramide, flecainide, mexiletine, propafenone, quinidine)
  • Medicine to treat an infection (including clarithromycin, erythromycin, itraconazole, ketoconazole, telithromycin, voriconazole)
  • Steroid medicine (including betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone)
• Take antacids at least 2 hours before or after you take this medicine.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Certain birth control pills may not work as well to prevent pregnancy when used with this medicine. Use another form of birth control (including condoms or spermicide) along with your pills.
• Tell your doctor if you have kidney disease or liver disease.
• Do not breastfeed. You can spread HIV or AIDS to your baby through your breast milk.
• This medicine may cause kidney problems, including Fanconi syndrome, when used together with tenofovir.
• Your immune system may get stronger when you start using HIV medicines. This could cause a hidden infection in your body to become active. Tell your doctor right away if you notice any changes in your health.
• Always practice safe sex, even if your partner also has HIV. If you stop taking this medicine or do not take it as prescribed, you may spread HIV to others. Do not reuse or share needles, or other items, that may have blood or body fluids on them.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate, blood in your urine, lower back or side pain
• Yellow skin or eyes

If you notice these less serious side effects, talk with your doctor:

• Skin rash

If you notice other side effects that you think are caused by this medicine, tell your doctor

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