Darunavir, cobicistat, emtricitabine and tenofovir alafenamide

• Cobicistat, Emtricitabine, Tenofovir Alafenamide, and Darunavir,
• Darunavir, Emtricitabine, Tenofovir Alafenamide, and Cobicistat
• Emtricitabine, Tenofovir Alafenamide, Darunavir, and Cobicistat
• Symtuza
• Tenofovir Alafenamide, Darunavir, Cobicistat, and Emtricitabine

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Symtuza: 800-150-200-10 MG

• Symtuza

• Antiretroviral, Protease Inhibitor (Anti-HIV)
• Antiretroviral, Reverse Transcriptase Inhibitor, Nucleoside (Anti-HIV)
• Antiretroviral, Reverse Transcriptase Inhibitor, Nucleotide (Anti-HIV)
• Cytochrome P-450 Inhibitor

Concurrent use of alfuzosin, ranolazine, dronedarone, carbamazepine, phenobarbital, phenytoin, colchicine (in patients with renal/and or hepatic impairment), rifampin, lurasidone, pimozide ergot derivatives (eg, dihydroergotamine, ergotamine, methylergonovine), cisapride, St John's wort, elbasvir/grazoprevir, lovastatin, simvastatin, sildenafil (for treatment of pulmonary arterial hypertension), midazolam (oral), and triazolam

Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HIV-1 and hepatitis B virus (HBV) and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of darunavir/cobicistat/emtricitabine/tenofovir alafenamide. Closely monitor hepatic function with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue darunavir/cobicistat/emtricitabine/tenofovir alafenamide. If appropriate, anti-hepatitis B therapy may be warranted

The Health and Human Services (HHS) Perinatal HIV guidelines do not recommend darunavir or cobicistat for initial therapy in antiretroviral-naive pregnant females. Due to decreased exposure of both cobicistat and darunavir during pregnancy, alternative regimens should be used when treatment is initiated in pregnant females.

In general, females who become pregnant on a stable antiretroviral therapy (ART) regimen may continue that regimen if viral suppression is effective, appropriate drug exposure can be achieved, contraindications for use in pregnancy are not present, and the regimen is well tolerated (HHS [perinatal] 2017).

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