HIV infection; Adjunct
Perform HIV genotypic testing prior to initiation in patients with antiretroviral treatment experience; darunavir/cobicistat may be used in protease inhibitor-naïve patients when HIV genotypic testing is not feasible.
Monitor viral load, CD4 cell counts, and hepatitis B screening at baseline and with modification of ARV treatment.
Perform hepatitis C antibody testing prior to initiation or modification of ARV treatment.
Monitor ALT, AST, total bilirubin, and urinalysis at baseline and with modification of ARV treatment.
Obtain fasting blood glucose or HbA1C, fasting lipid profile, and CBC with a differential.
Obtain basic chemistry including serum sodium, potassium, bicarbonate, chloride, BUN, creatinine, and creatinine-based estimated glomerular filtration rate.
Monitor creatinine clearance, and renal function.
Monitor for sulfonamide allergy after initiating treatment.
Common
Serious
Contraindications:
Multiple drug-drug interactions
Antimicrobial class: Antiretroviral, Protease inhibitor
Pregnancy category: Do not initiate
Average serum half life: 7 hours (Darunavir), 4 hours (Cobicistat)
Precautions: Discontinue if drug rash with eosinophilia and systemic symptoms or severe skin reactions are suspected.
Hepatitis and liver dysfunction; monitoring recommended and interruption or discontinuation may be necessary.
Initiation or adjustment of hypoglycemic agents may be warranted.
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