Elvitegravir / Cobicistat

Rosuvastatin

Clinically significant interaction is unlikely.

No pharmaceutical opinion available for this interaction.

Mechanism

Elvitegravir / Cobicistat may inhibit hepatic transports OATP1B1/B3 and BCRP and increase plasma concentration of Rosuvastatin.

Elvitegravir / Cobicistat

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Rosuvastatin

Pharmacodynamic effects

Probably without any clinical consequence.

Recommendations

No a priori dosage adjustment is recommended.

Alternative solution(s)

Monitor

Tests

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
AUC
Cmin
Cmax
Elvitegravir / Cobicistat
3360
10
-
150/150 mg
QD
+ 2%
- 2%
- 6%
Rosuvastatin
3360
10
-
10 mg
x 1
+ 38%
+ 43%
+ 89%
Comment

Ref #3360, 2570 and 3281 : The increase in AUC ranged from 48-142% and the increase in AUC ranged from 13-67% depending on the subject under study. According to the monograph this increase appears to be transient and no adjustment of the dose of rosuvastatin is recommended. Likely driven by inhibition of intestinal efflux by BCRP or hepatic uptake by OATPs by EVG/c. No serious adverse events or grade 2, 3 or 4 AEs or grade 3 or 4 laboratory abnormalities occurred.

Reference
  • 2570
    Elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3281
    Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide(Genvoya), Gilead, Ontario, Canada, 17 septembre 2018.
  • 3360
    Custodio J, Wang H, Hao J, Lepist EI, Ray AS et al. Pharmacokinetics of cobicistat boosted-elvitegravir administered in combination with rosuvastatin. Clin Pharmacol, 2014, 54(6): 649-56.
  • 1490
    Rosuvastatin (Crestor), AstraZeneca, Ontario, Canada, 21 avril 2015.