This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Cobicistat oral

Updated 2 Feb 2023 | Pharmacokinetic enhancers


Oral formulations of cobicistat.

Drugs List

  • cobicistat 150mg tablets
  • TYBOST 150mg film coated tablets
  • Therapeutic Indications


    Antiretroviral combination therapy-HIV infected adults and children over 12

    Cobicistat is indicated as a pharmacokinetic enhancer of atazanavir or darunavir as part of antiretroviral combination therapy in human immunodeficiency virus-1 (HIV-1) infected adults and adolescents aged 12 years and older.


    Cobicistat is used in combination with atazanavir 300mg once daily or darunavir 800mg once daily, therefore the atazanavir or darunavir Summary of Product Characteristics should be consulted.


    150mg once daily.


    Children aged 12-18 years old weighing 35kg and over:
    150mg once daily.

    Patients with Renal Impairment

    No dose adjustment required.

    Cobicistat should not be initiated in patients with creatinine clearance less than 70ml/minute if any co-administered agent requires dose adjustment based on creatinine clearance. Cobicistat has been shown to decrease estimated creatinine clearance due to inhibition of tubular secretion of creatinine.

    Dialysis patients
    Cobicistat has not been studied in patients receiving dialysis, and, therefore no recommendation can be made.

    Additional Dosage Information

    Missed dose
    If the patient misses a dose of cobicistat within 12 hours of the time it is usually taken, they should take cobicistat with food as soon as possible and resume normal dosing schedule in combination with atazanavir or darunavir. If a patient misses a dose of cobicistat by more than 12 hours, they should not take the missed dose and simply resume the usual dosing schedule.


    Children under 12 years
    Children weighing less than 35kg
    Severe hepatic impairment

    Precautions and Warnings

    Renal dialysis

    Switch to more suitable alternative before planned pregnancy
    Treatment does not prevent risk of transmission of HIV
    HIV therapy: Must be used in combination with other antiretrovirals
    Treatment should be initiated by doctor experienced in HIV management
    Contains sunset yellow (E110) - may cause allergic reaction
    Advise patient to take with or after food
    Advise patient to seek advice at first indications of pregnancy
    Advise patient not to take St John's wort concurrently
    Advise patient grapefruit products may increase plasma level
    Female: Barrier or non-hormonal contraception advised during treatment

    Pregnancy and Lactation


    Cobicistat is contraindicated during pregnancy.

    The manufacturer does not recommend cobicistat treatment to be initiated during pregnancy and women who become pregnant during therapy with this product should be switched to an alternative regimen.

    Treatment with cobicistat in combination with elvitegravir or darunavir during second and third trimester of pregnancy has shown to substantially lower elvitegravir or darunavir exposure respectively, which may result in virological failure and increase the risk of transmission of HIV from the mother to infant.

    Animal studies do not indicate direct or indirect harmful effects of cobicistat with respect to reproductive toxicity.


    Cobicistat is contraindicated in breastfeeding.

    It is unknown whether cobicistat/metabolites are excreted in human milk. Available pharmacodynamic/toxicological data in animals have shown excretion of cobicistat/metabolites in milk.
    A risk to the newborns/infants cannot be excluded. Therefore, cobicistat should not be used during breastfeeding.

    In order to avoid transmission of HIV to the infant it is recommended that HIV infected women do not breastfeed their infants under any circumstances.

    Side Effects

    Abdominal distension
    Abdominal pain
    Dream abnormalities
    Dry mouth
    Increased appetite
    Scleral icterus
    Sleep disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: June 2019

    Reference Sources

    Summary of Product Characteristics: Tybost 150mg film-coated tablet. Gilead Science Ltd. Revised May 2020.

    NICE Evidence Services Available at: Last accessed: 22 October 2021

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.