https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13509
No pharmaceutical opinion available for this interaction.
Rifampicin can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Cobicistat.
Possible decrease of the pharmacokinetic boosting effect.
Therefore, resulting in loss of therapeutic effect of associated IP.
Risk of a possible development of resistance to antiretroviral class.
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Increased risk of hepatotoxicity.
Choose an alternative.
Rifabutin with protease inhibitor boosted with ritonavir preferably (see rifabutin with PIs) or choose an antibiotic that does not interact with PIs.
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Co-administration of rifampicin 600 mg QD with protease inhibitors such as lopinavir/ritonavir, darunavir/ritonavir, atazanavir/ritonavir and atazanavir alone causes a decrease in AUC and Cmin of approximately 75% to 80%.
Ref #3116 : To increase the chance of achieving therapeutic serum levels and reduce the development of resistance and treatment failures some experts, as well as the CDC, recommend a 150mg QD dose. See rifabutin + PIs.