Cobicistat is one of a number of medicines that you will need to take regularly for HIV.
Take one tablet each day.
Swallow the tablet with a drink of water after a meal.
Clinical Author's Note (Michael Stewart) 18/07/2018: new data shows that women who are pregnant and are taking cobicistat in combination with darunavir (Rezolsta® or Symtuza®) have lower blood levels of the medicines compared to other patients. This means there may be a risk of the treatment not working properly and of HIV being passed on to the unborn child. Women who are pregnant or may become pregnant should not take cobicistat/darunavir combinations and should speak to their doctor about alternative treatments. For more information please refer to the MHRA advice for healthcare professionals.
|Type of medicine||A pharmacokinetic enhancer|
|Used for||Increasing the effect of atazanavir or darunavir, which are medicines used for HIV infection in adults|
|Also called||Tybost® |
There are also combination tablets which contain cobicistat: Evotaz® (cobicistat with atazanavir); Genvoya® (cobicistat with emtricitabine, tenofovir and elvitegravir); Rezolsta® (cobicistat with darunavir); Stribild® (cobicistat with emtricitabine, tenofovir and elvitegravir); Symtuza® (cobicistat with darunavir, emtricitabine and tenofovir)
Cobicistat is prescribed for human immunodeficiency virus (HIV) infection. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. You will be prescribed three or more antiretroviral medicines at the same time, as taking a combination of different medicines is more effective than taking one alone, and also it reduces the risk that the HIV virus will become resistant to any individual medicine. Antiretroviral medicines slow the progress of HIV infection, but do not cure it.
Cobicistat will be prescribed for you by a doctor who is a specialist. You will also have been prescribed either atazanavir or darunavir for the HIV infection. Cobicistat is given to boost the effect of these medicines. Atazanavir and darunavir are both protease inhibitor antiretroviral medicines. Cobicistat helps to improve the effectiveness of these medicines by slowing down their breakdown in the body. This increases the amount of time atazanavir or darunavir is present in your body.
Some brands of cobicistat contain other antiretroviral medicines also (see the list in the table above). Taking one of these brands helps to reduce the number of tablets you need to take each day. Not all of the information in this leaflet applies to the combination brands - please refer to the manufacturer's printed information leaflet from inside the pack for full details about these brands. You will also find more information about each of the individual medicines on our website (see atazanavir, darunavir, emtricitabine, tenofovir).
Before taking cobicistat
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking cobicistat it is important that your doctor knows:
- If you are pregnant, trying for a baby, or breastfeeding.
- If you have any problems with the way your liver works, or if you have problems with the way your kidneys work.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take cobicistat tablets
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about cobicistat, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Take cobicistat exactly as your doctor tells you to. Take one tablet a day, at the same time as either atazanavir or darunavir.
- Swallow the tablet whole with a drink of water. Take the tablet after a meal or a snack.
- If you forget to take a dose, take it as soon as you remember, providing it is within 12 hours of the time you should have taken it. Remember to take the tablet with something to eat. However, if when you remember, it is more than 12 hours late, do not take the dose you missed but instead take your next dose when it is due. Do not take two doses together to make up for the forgotten dose.
Getting the most from your treatment
- Keep your regular appointments with your doctor so that your progress can be monitored. You are likely to need regular blood tests to check how well your medicines are working.
- It is important that you continue to take your antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
- If you develop an infection soon after you start the treatment, let your doctor know. As a result of taking antiretroviral medicines, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
- Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
- If you are trying for a baby or you become pregnant whilst taking cobicistat, let your doctor know straightaway. Your doctor may recommend a different treatment combination that could be more effective during pregnancy.
- It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself then you should speak with your doctor straightaway.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking cobicistat and antiretroviral medicines.
- If you buy any medicines, supplements or herbal remedies 'over the counter', check with a pharmacist that they are suitable to take with cobicistat and your other medicines. This is because cobicistat can interfere with some medicines and stop them from working properly.
Can cobicistat tablets cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with cobicistat. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common cobicistat side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea)||Stick to simple meals - avoid fatty or spicy food|
|Yellowing of your skin or the whites of the eyes (jaundice)||Speak with your doctor as soon as possible|
|Common cobicistat side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Headache||Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Feeling dizzy, tired or sleepy||Do not drive and do not use tools or machines while affected|
|Being sick (vomiting), diarrhoea, stomach pain, indigestion, wind||Stick to simple meals - avoid fatty or spicy food|
|Increased appetite, changes in the way things taste, dry mouth, rash, difficulty sleeping, abnormal dreams||If any of these become troublesome, speak with your doctor|
|Changes to some blood tests||Your doctor will check for these|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store cobicistat
- Keep all medicines out of the reach and sight of children.
- Store the tablets in the original container in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Tybost® 150 mg film-coated tablets; Gilead Sciences Ltd, The electronic Medicines Compendium. Dated April 2019.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.