Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil

Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil is a combination antiretroviral medication used for the treatment of HIV/AIDS. It combines four medications in one: elvitegravir, a HIV integrase inhibitor; cobicistat, a pharmacokinetic enhancer that increases the effectiveness of elvitegravir; emtricitabine, a nucleoside reverse transcriptase inhibitor (NRTI); and tenofovir disoproxil, another NRTI. This combination is used as part of antiretroviral therapy (ART) for people with HIV to help control the virus and increase the immune system's ability to fight infections.

Composition and Mechanism of Action

Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil combines four drugs with different mechanisms of action to provide a potent reduction in HIV viral load.

• Elvitegravir works by inhibiting the HIV integrase enzyme, which is necessary for the virus to replicate.
• Cobicistat acts as a booster by inhibiting the enzyme that metabolizes elvitegravir, thereby increasing its concentration and effectiveness without having any direct antiviral effects.
• Emtricitabine and tenofovir disoproxil are both NRTIs that interfere with the reverse transcriptase enzyme, preventing the virus from making copies of itself.

Indications

This medication is indicated for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 25 kg who have no antiretroviral treatment history or to replace the current antiretroviral regimen in those who have been virologically suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen for at least 3 months with no history of treatment failure and no known substitutions associated with resistance to the individual components of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil.

Administration

Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil is taken orally, once daily, with food. The presence of food enhances the absorption of the drugs, making the treatment more effective.

Side Effects

Common side effects include nausea, diarrhea, fatigue, headache, and dizziness. Serious side effects may include kidney problems, lactic acidosis, liver problems, and a decrease in bone mineral density. It is important for patients to be closely monitored by their healthcare provider while on this medication.

Drug Interactions

Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil can interact with other medications, which can either decrease its effectiveness or increase the risk of side effects. These include certain antacids, anticonvulsants, antimycobacterials, and herbal supplements such as St. John's Wort. Patients should inform their healthcare provider of all medications and supplements they are taking.

Conclusion

Elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil is a significant advancement in the treatment of HIV/AIDS, offering patients a once-daily, single-tablet regimen that can improve adherence to therapy and quality of life. However, like all medications, it comes with potential side effects and interactions that need to be managed by a healthcare provider.