https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=15488

Atazanavir / cobicistat

Rifampin

Contraindicated.

No pharmaceutical opinion available for this interaction.

Mechanism

Rifampin can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Atazanavir / cobicistat.

Atazanavir / cobicistat

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Risk of a possible development of resistance to antiretroviral class.

Recommendations

–

Alternative solution(s)

–

Rifampin

Pharmacodynamic effects

–

Recommendations

Contraindicated. Use alternative.

Alternative solution(s)

Rifabutin with protease inhibitor boosted with ritonavir preferably (see rifabutin with PIs) or choose an antibiotic that does not interact with PIs.

Monitor

–

Tests

–

Pharmacokinetic parameters

–

Comment

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.

Reference
  • 3230
    Atazanavir/cobicistat (Evotaz), Bristol-Myers Squibb, Québec, Canada, 8 septembre 2017.
  • 3116
    Center for Disease Control and prevention. Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis. Disponible: http://www.cdc.gov/tb/publications/guidelines/tb_hiv_drugs/recommendations03.htm Publié le 22 sept 2014. Consulté le 11 janvier 2018.