No pharmaceutical opinion available for this interaction.
Elvitegravir / Cobicistat may inhibit hepatic transports OATP1B1/B3 and BCRP and increase plasma concentration of Rosuvastatin.
Elvitegravir 3A4 and then UGT1A1/3; Cobicistat 3A4 (major) and 2D6 (minor)
Elvitegravir : 2C9 (moderate)
Cobicistat : 3A4 and 2D6 (potent), P-gp, MATE 1, BCRP, OATP1B1 and OATP1B3
OATP1B1, OATP1B3 and BCRP
Probably without any clinical consequence.
No a priori dosage adjustment is recommended.
Monitor for adverse effects.
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.
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.
The study used as a reference a concentration of rosuvastatin alone with the equivalence limits of 70-143% for AUC and 70-175% for Cmax.
The modest increase observed is considered clinically insignificant. Elvitegravir/cobicistat can be taken with rosuvastatin.