Critical
Cobicistat × Rifampicin
Pharmacokinetic enhancer (booster) for antiretroviral therapy×Antituberculous antibiotic
Mechanism
Strong CYP3A4 inducer. Cobicistat falls 80% – ART failure.
Symptoms
Rising viral load, resistance risk.
Management
Combination contraindicated. TB in HIV patient – dolutegravir-based ARV (double dose with rifampicin).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- EMA: Tybost (cobicistat) Summary of Product Characteristics (2024)– EMA EPAR Tybost