Cobicistat
Cobicistat is a CYP3A inhibitor used as a pharmacokinetic booster in HIV treatment. It works by inhibiting the CYP3A enzyme that metabolizes certain antiretroviral drugs, thereby increasing their blood levels and allowing for simpler once-daily dosing regimens. While not an antiretroviral itself, it is a key component of several HIV combination therapies.
Cobicistat boosts the effectiveness of HIV medications by inhibiting their metabolism, allowing for more convenient dosing.
Key facts at a glance
- ATC
- V03AX03
- RxNorm
- 1306284
- Generic
- Cobicistat
- Class
- atc-v03
- Brands
- Stribild, Tybost, Prezcobix, Evotaz, Genvoya, Symtuza
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 150mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 150mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 150mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks; cobicistat exposure may be reduced during pregnancy requiring close monitoring
regular viral load monitoring and fetal growth assessments
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesterconsider increased monitoring
monitor viral load frequently as cobicistat levels may be decreased during pregnancy
monthly viral load monitoring, fetal ultrasound for growth
Use with caution and monitor for adverse effects.
pregnancy
third trimesterincreased monitoring required
maintain therapy but monitor closely for viral breakthrough; consider therapeutic drug monitoring if available
frequent viral load monitoring, CD4 count, fetal wellbeing assessments
Use with caution and monitor for adverse effects.
lactation
breastfeedingavoid
HIV-positive mothers should not breastfeed regardless of antiretroviral therapy due to risk of HIV transmission
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
geriatric
elderlyno specific dose adjustment required
use with caution due to increased likelihood of concomitant medications and comorbidities; monitor renal function closely
regular renal function monitoring, drug interaction review
Use with caution and monitor for adverse effects.
pediatric_age
children under 12 yearsnot recommended
cobicistat-containing products are not approved for children under certain age and weight thresholds; pediatric formulations with cobicistat are not widely available
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
mild to moderateno dose adjustment of cobicistat required
cobicistat is not renally eliminated but increases serum creatinine due to tubular secretion inhibition; this does not indicate renal injury but must be distinguished from true renal dysfunction
baseline and periodic renal function monitoring; distinguish between cobicistat-induced creatinine elevation and actual renal impairment
Use with caution and monitor for adverse effects.
renal_impairment
severeno cobicistat dose adjustment; partner drugs may require modification
cobicistat itself does not require dose adjustment but partner antiretrovirals (particularly tenofovir) may need dose adjustment or avoidance; evaluate total regimen
frequent renal function monitoring, urine protein assessment
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateno dose adjustment recommended
use with caution in mild to moderate hepatic impairment; limited data available
monitor liver function tests
Use with caution and monitor for adverse effects.
hepatic_impairment
severeavoid
not recommended for use in severe hepatic impairment (Child-Pugh Class C); pharmacokinetics not studied
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
FDA approval year
Initial FDA approval date for cobicistat
Drug class
Pharmacological classification of cobicistat
Mechanism of action
Primary pharmacological mechanism
Common formulations
Combination products containing cobicistat
Cobicistat is indicated as a pharmacokinetic enhancer for HIV-1 infected patients in combination with other antiretroviral agents. It is specifically used to boost protease inhibitors such as darunavir and atazanavir, as well as the integrase inhibitor elvitegravir, as part of combination antiretroviral therapy.
Cobicistat selectively inhibits CYP3A enzymes in the liver and intestinal wall. CYP3A is responsible for metabolizing many antiretroviral drugs. By blocking this metabolic pathway, cobicistat increases blood concentrations of boosted drugs, enhancing their antiviral effect and allowing for once-daily dosing without requiring multiple doses throughout the day.
Cobicistat is not an antiretroviral agent and must be used with other HIV medications. It has multiple drug interactions and should not be used with certain medications metabolized by CYP3A. Kidney function monitoring is recommended during treatment. It is not recommended for use during pregnancy and should only be used in adults and children meeting specific criteria. Cobicistat may cause serum creatinine elevations without affecting actual renal function.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
WellAlly may earn a referral fee from linked resources at no extra cost to you. Editorial content is never influenced by commercial relationships.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy