항생제
Elvitegravir/ Cobicistat/ Emtricitabine/ Tenofovir alafenamide

Elvitegravir/ Cobicistat/ Emtricitabine/ Tenofovir alafenamide

Spectrum Of Activity

General Information

Regimen for patients with HIV-1 infection.

Black Box Warning: Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months. If appropriate, anti-hepatitis B therapy may be warranted.

Monitor viral load prior to initiation or modification of treatment.

Monitor CD4 cell counts prior to initiation or with modification of ARV treatment and every 3-6 months; thereafter during at least the first 2 years of treatment.

Monitor hepatitis B screening.

Perform hepatitis C antibody testing prior to initiation or modification of ARV treatment.

Monitor ALT,AST, and total bilirubin, CBC with a differential, fasting blood glucose and lipid profile.

Monitor estimated creatinine clearance, serum creatinine, urine glucose, and urine protein prior to initiation and throughout treatment.

Common

  • Nausea

Serious

  • Hypervolemia
  • Hyperkalemia
  • Lactic acidosis
  • Hepatitis B exacerbation
  • Hepatomegaly with steatosis
  • Immune reconstitution syndrome
  • Osteomyelitis
  • Fanconi syndrome
  • Renal impairment
  • Pneumonia

Multiple drug-drug interactions

Contraindications:

  • CYP3A4 inhibitors
  • Anticonvulsant drugs
  • Alfuzosin
  • Rifampin
  • Cisapride
  • St. John's wort
  • Ergot derivatives
  • Lomitapide
  • Lovastatin
  • Simvastatin
  • Lurasidone
  • Pimozide
  • Sildenafil
  • Triazolam

Antimicrobial class: Antiviral agent, INSTI, CYP450 inhibitor, NRTI

Pregnancy category: Not recommended in pregnancy

Average serum half life: Cobicistat: 3.5 hours Elvitegravir: 12.9 hours Emtricitabine: 10 hours Tenofovir diphosphate: 150-180 hours

Precaution: Increased risk with impaired renal function and use of nephrotoxic agents including NSAIDs; monitoring recommended before and during therapy.

Discontinue use in patients who develop clinically significant decreases in renal function or evidence of Fanconi syndrome.

Suspend treatment if pronounced hepatotoxicity or lactic acidosis develops, even if transaminases do not markedly increase.