(emtricitabine · DailyMed)
Genvoya
elvitegravir/cobicistat/emtricitabine/tenofovir…
What it does
Cobicistat is a medication that helps boost the effectiveness of certain other drugs used to treat viral infections, particularly HIV.
Commonly used for: human immunodeficiency virus (HIV), viral infections
Read more in plain English ↓Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.
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Source: Pharmacy and Poisons Board · fetched 2026-03-01 02:00:34 · updated 2026-10-18 02:02:30
Drug Interactions
237Severe (34)
Acalabrutinib - increases exposure
Cobicistat is predicted to increase the exposure to acalabrutinib. Avoid.
Antifungals,azoles - affects exposure
Cobicistat is predicted to affect the exposure to antifungals, azoles (voriconazole). Avoid.
Antihistamines,non-Sedating - increases exposure
Cobicistat is predicted to increase the exposure to antihistamines, non-sedating (mizolastine). Avoid.
Antipsychotics, Second Generation - increases exposure
Cobicistat is predicted to increase the exposure to antipsychotics, second generation (lurasidone, quetiapine). Avoid.
Benzodiazepines - increases exposure
Cobicistat moderately increases the exposure to benzodiazepines (alprazolam). Avoid.
Moderate (49)
Alfentanil - increases exposure
Cobicistat is predicted to increase the exposure to opioids (alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and adjust dose.
Alfuzosin - increases exposure
Cobicistat is predicted to moderately increase the exposure to alpha blockers (alfuzosin, tamsulosin). Use with caution or avoid.
Alphablockers - increases exposure
Cobicistat is predicted to moderately increase the exposure to alpha blockers (alfuzosin, tamsulosin). Use with caution or avoid.
Amlodipine - increases exposure
Cobicistat is predicted to increase the exposure to calcium channel blockers (amlodipine, felodipine, lacidipine, nicardipine, nifedipine, nimodipine). Monitor and adjust dose.
Antiarrhythmics - increases exposure
Cobicistat is predicted to increase the exposure to antiarrhythmics (propafenone). Monitor and adjust dose.
Unknown (154)
Abemaciclib - increases exposure
Cobicistat is predicted to increase the exposure to abemaciclib. Avoid or adjust abemaciclib dose, p. 1056.
Alitretinoin - increases exposure
Cobicistat is predicted to increase the exposure to retinoids (alitretinoin). Adjust alitretinoin dose, p. 1382.
Almotriptan - increases exposure
Cobicistat increases the exposure to triptans (almotriptan).
Alprazolam - increases exposure
Cobicistatmoderatelyincreasestheexposuretoalprazolam. Avoid.oStudy
Amiodarone - increases concentration
Cobicistat potentially increases the concentration of antiarrhythmics (amiodarone, disopyramide, flecainide, lidocaine).
Data from BNF 85 (British National Formulary). This is not a substitute for professional medical advice. Matched via: exact
About cobicistat
Cobicistat is a medication that helps boost the effectiveness of certain other drugs used to treat viral infections, particularly HIV.
What it treats
- human immunodeficiency virus (HIV)
- viral infections
How it works
Cobicistat works by increasing the levels of other medications in the body, making them more effective in fighting infections.
Who it's for
Cobicistat is for people who are being treated for HIV and need additional support from other medications.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About elvitegravir
Elvitegravir is a medicine used to help manage HIV infection.
What it treats
- HIV infection
- Human Immunodeficiency Virus (HIV)
How it works
Elvitegravir works by blocking the virus from multiplying in the body, helping to control the infection.
Who it's for
This medicine is for adults and children who are living with HIV.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About emtricitabine
Emtricitabine is an antiviral medication used to treat HIV infection.
What it treats
- HIV infection (human immunodeficiency virus)
How it works
It helps to control the virus and improve the immune system.
Who it's for
This medication is for adults and children living with HIV.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About tenofovir…
Tenofovir is an antiviral medication used to treat certain viral infections.
What it treats
- HIV infection (human immunodeficiency virus)
- chronic hepatitis B infection
How it works
It helps to reduce the amount of virus in the body, allowing the immune system to work better.
Who it's for
It is for adults and children who are infected with HIV or hepatitis B.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Emtricitabine
BNF-referencedEmtricitabine is an antiretroviral medication used primarily in the treatment of HIV-1 infection. It is a synthetic nucleoside analog of cytidine that functions as a reverse transcriptase inhibitor. By preventing the conversion of viral RNA into DNA, emtricitabine effectively reduces viral load in the body. It is typically administered once daily and is available in capsule and oral solution forms.
Indications
- HIV infection
Dosage
Children: Child 4 months–17 years (body-weight up to 33 kg): 6 mg/kg once daily. Child 4 months–17 years (body-weight 33 kg and above): 240 mg once daily.
Adults: 200 mg once daily by mouth using capsules or 240 mg once daily by mouth using oral solution.
Mechanism of action
Emtricitabine is a cytidine analog that, when phosphorylated to emtricitabine 5'-triphosphate, competes with deoxycytidine 5'-triphosphate for HIV-1 reverse transcriptase. It incorporates itself into the viral DNA during replication, leading to chain termination. This prevents the incorporation of additional nucleotides and inhibits the transcription of viral RNA into DNA, thereby preventing viral replication.
Pharmacodynamics
Emtricitabine acts by competing with natural substrates of HIV-1 reverse transcriptase, leading to the termination of viral DNA synthesis. It has a long duration of action, allowing for once-daily dosing. Clinicians should monitor for potential side effects, including lactic acidosis and hepatomegaly with steatosis, which can occur with nucleoside analogs.
Pharmacokinetics
Emtricitabine is absorbed well following oral administration, with peak plasma concentrations occurring approximately 1 to 2 hours post-dose. It has a long half-life, allowing for its once-daily administration. Emtricitabine is primarily excreted through the kidneys, and dosage adjustments may be necessary in patients with renal impairment. It is metabolized minimally by the liver.
Contra-indications
- Severe hepatic impairment
- Severe renal impairment (creatinine clearance <30 mL/min)
Adverse effects
- Decreased appetite
- Asthenia
- Constipation
- Diarrhoea
- Dizziness
- Electrolyte imbalance
- Flatulence
- Gastrointestinal discomfort
- Headache
- Abnormal dreams
- Dyspepsia
- Hyperbilirubinaemia
- Hyperglycaemia
- Hypersensitivity reactions
- Hypertriglyceridaemia
- Neutropenia
- Pain
- Rash
- Pustular skin reactions
- Sleep disorders
- Angioedema (uncommon)
Interactions
- Cobicistat and elvitegravir may impact emtricitabine efficacy
- Potential for increased risk of treatment failure in pregnancy when used with elvitegravir
- Monitor for changes in drug levels when co-administered with other antiretrovirals
Precautions
- Caution in patients with hepatic impairment due to increased risk of side effects
- Monitor renal function regularly, particularly in those with existing renal impairment
- Patients should be advised on the risks of lactic acidosis and hepatomegaly with steatosis
Pregnancy
Not recommended for initiation during pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1. Women who become pregnant during therapy should be switched to an alternative regimen.
Breast-feeding
Emtricitabine is excreted in human breast milk, caution is advised when administering to breastfeeding mothers.
Storage
Store in the original container, protected from moisture, and keep out of reach of children.
Formulations
- 200 mg capsules
- 240 mg oral solution
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Cobicistat
BNF-referencedCobicistat is a pharmacokinetic enhancer that is used to boost the effectiveness of certain antiretroviral medications, specifically atazanavir and darunavir. It is not an antiviral drug itself and does not possess any direct activity against HIV. By inhibiting the cytochrome P450 3A (CYP3A) isoforms, cobicistat increases the systemic concentration of co-administered CYP3A substrates, allowing for effective viral suppression at lower doses of these drugs.
Indications
- HIV infection resistant to other protease inhibitors
- Pharmacokinetic enhancement of atazanavir
- Pharmacokinetic enhancement of darunavir
Dosage
Children: Refer to BNF for Children for appropriate paediatric dosing.
Adults: 150 mg once daily by mouth.
Mechanism of action
Cobicistat acts as a mechanism-based inhibitor of cytochrome P450 3A (CYP3A) isoforms. This inhibition reduces the metabolism of CYP3A substrates, such as atazanavir and darunavir, leading to increased systemic exposure and enhanced antiviral effects at lower dosages. It is important to note that cobicistat does not exhibit any intrinsic anti-HIV activity.
Pharmacodynamics
The pharmacodynamic profile of cobicistat is primarily characterized by its ability to enhance the plasma concentrations of certain antiretroviral drugs through CYP3A inhibition. This results in improved efficacy of these drugs while minimizing potential side effects associated with higher doses. Cobicistat's lack of direct antiviral action means it is always used in conjunction with other antiretroviral agents.
Pharmacokinetics
Cobicistat is well absorbed after oral administration, with peak plasma concentrations typically occurring within 1 to 4 hours. It has a high protein binding rate, primarily to albumin and alpha-1 acid glycoprotein. The drug undergoes hepatic metabolism predominantly via CYP3A. The elimination half-life of cobicistat is approximately 3 to 4 hours, and it is excreted mainly in the feces. Monitoring of liver function is recommended due to the potential for hepatotoxicity.
Adverse effects
- Abdominal pain
- Anaemia
- Appetite decreased
- Asthenia
- Depression
- Diarrhoea
- Flatulence
- Headache
- Insomnia
- Nausea
- Rash
Interactions
- cobicistat + acalabrutinib: Severe (increases exposure)
- cobicistat + dronedarone: Severe (increases exposure)
- cobicistat + second-generation antipsychotics: Severe (increases exposure)
- cobicistat + lurasidone: Severe (increases exposure)
- cobicistat + quetiapine: Severe (increases exposure)
- cobicistat + cariprazine: Severe (increases exposure)
- cobicistat + lercanidipine: Severe (increases exposure)
- cobicistat + the active metabolite of clopidogrel: Severe (decreases concentration)
- cobicistat + antiarrhythmics: Severe (increases exposure)
- cobicistat + antifungals, azoles: Severe (affects exposure)
Precautions
- Caution in patients with abnormal liver function tests or signs of liver injury.
- Caution in patients with renal impairment, particularly with eGFR less than 80 mL/minute/1.73 m2.
- Manufacturer advises monitoring liver function before treatment and periodically during treatment.
Pregnancy
Manufacturer advises use only if the potential benefit outweighs the risk, due to toxicity observed in animal studies.
Breast-feeding
Cobicistat is not recommended during breastfeeding due to the potential for adverse effects in nursing infants.
Storage
Store below 30°C. Protect from moisture and light.
Formulations
- Tablets: 150 mg
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: Elvitegravir
BNF-referencedElvitegravir is an antiretroviral medication used for the treatment of HIV infection. It functions as an HIV-1 integrase strand transfer inhibitor, preventing the integration of viral DNA into the host's genome, which is essential for viral replication. Elvitegravir is typically administered in combination with low-dose ritonavir to enhance its effectiveness and pharmacokinetics.
Indications
- HIV infection
- HIV-1 infection without resistance to other inhibitors
Dosage
Children: For paediatric dosing, please refer to the BNF for Children for appropriate dosing guidelines.
Adults: The recommended dosage for adults is 50 mg once daily, taken with food.
Mechanism of action
Elvitegravir is an HIV-1 integrase strand transfer inhibitor (INSTI). It inhibits the integrase enzyme, which is crucial for the integration of HIV-1 DNA into the host's genomic DNA. This inhibition prevents the formation of the HIV-1 provirus, thereby blocking the propagation of the viral infection.
Pharmacodynamics
Elvitegravir's pharmacodynamic profile is characterized by its ability to inhibit the HIV integrase enzyme, leading to a reduction in viral load and improved immune function in HIV-infected patients. The medication helps achieve viral suppression and contributes to the overall management of HIV.
Pharmacokinetics
Elvitegravir is well-absorbed following oral administration, and its bioavailability is enhanced when taken with food. The drug is primarily metabolized by the liver via cytochrome P450 enzymes, particularly CYP3A. The elimination half-life of elvitegravir is approximately 9-12 hours, allowing for once-daily dosing in most cases.
Contra-indications
- Severe hepatic impairment
- Hypersensitivity to elvitegravir or any excipients
- Co-administration with certain medications such as rifampicin, mitotane, or St. John's wort
Adverse effects
- Diarrhoea
- Fatigue
- Headache
- Nausea
- Rash
- Vomiting
- Dizziness
- Insomnia
- Increased weight
- Suicidal ideation
- Depression
- Hyperglycaemia
- Osteonecrosis
Interactions
- Dabrafenib: Severe (decreases concentration)
- Mitotane: Severe (decreases concentration)
- St. John's wort: Severe (decreases concentration)
- Bosentan: Severe (decreases concentration)
- Rifampicin: Severe (decreases concentration)
- Elvitegravir and coumarins: Unknown (decreases anticoagulant effect)
- Elvitegravir and grazoprevir: Unknown (increases exposure)
Precautions
- Caution in patients with a history of psychiatric disorders
- Monitor for signs of hepatic impairment
- Use with caution in elderly patients due to limited information
Pregnancy
Manufacturer advises to avoid use unless essential due to limited data available on safety.
Breast-feeding
Manufacturer advises caution and to avoid breastfeeding while taking this medication.
Storage
Store in original container, protect from moisture, and keep out of reach of children.
Formulations
- Elvitegravir with cobicistat
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: tenofovir
BNF-referencedTenofovir is an antiviral medication used primarily for the treatment of HIV infection and chronic hepatitis B. It belongs to the class of nucleotide reverse transcriptase inhibitors (NRTIs) and is effective in inhibiting viral replication by interfering with the viral reverse transcriptase enzyme. Tenofovir is known for its lower toxicity profile compared to other antiviral agents.
Indications
- HIV infection
- Chronic hepatitis B
Dosage
Children: Refer to BNF for Children for specific pediatric dosing information.
Adults: Refer to BNF for specific dosing information.
Mechanism of action
Once tenofovir is activated by bi-phosphorylation, it functions as an antiviral acyclic nucleoside phosphonate. It inhibits viral reverse transcriptase, exhibiting an inhibitory constant of approximately 0.022 micromolar. Tenofovir competes with deoxyadenosine 5'-triphosphate to generate new viral DNA, leading to chain termination and inhibition of viral replication. Its safety profile is maintained due to its low affinity for cellular DNA polymerases, including mitochondrial DNA polymerase gamma.
Pharmacodynamics
Tenofovir has demonstrated high efficacy in treatment-naive HIV patients, showing comparable effectiveness to efavirenz while exhibiting lower toxicity than some other antiretrovirals, such as stavudine. In patients with hepatitis B, tenofovir treatment has been associated with undetectable viral DNA levels after one year.
Pharmacokinetics
Tenofovir is absorbed after oral administration and is primarily eliminated by the kidneys. It has a half-life that allows for once-daily dosing and achieves therapeutic concentrations in plasma and tissues. The metabolism of tenofovir involves conversion to its active form, which is then incorporated into viral DNA, leading to its antiviral effects.
Contra-indications
- Hypersensitivity to tenofovir or any excipients in the formulation
- Severe renal impairment (CrCl < 30 mL/min) without appropriate dosage adjustment
Adverse effects
- Nausea
- Diarrhea
- Headache
- Fatigue
- Renal impairment
- Bone density loss
- Lactic acidosis
Interactions
- Antiepileptics (carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone) with tenofovir alafenamide: Severe (decreases exposure)
- Tipranavir with tenofovir alafenamide: Severe (decreases exposure)
- Rifamycins with tenofovir alafenamide: Severe (decreases exposure)
- St John’s Wort with tenofovir alafenamide: Severe (decreases exposure)
- Fostemsavir with tenofovir disoproxil: Moderate (increases exposure)
- Fostemsavir with tenofovir alafenamide: Moderate (increases exposure)
- Ciclosporin with tenofovir alafenamide: Unknown (increases exposure)
- Ciclosporin with tenofovir disoproxil: Unknown (increases exposure)
- Eltrombopag with tenofovir alafenamide: Unknown (increases exposure)
- Eltrombopag with tenofovir disoproxil: Unknown (increases exposure)
Precautions
- Monitor renal function regularly during treatment
- Use with caution in patients with a history of renal disease
- Consider bone density monitoring in patients on long-term therapy
Pregnancy
Tenofovir is categorized as a pregnancy category B drug. Animal studies have not shown any harm, but human data is limited. Weigh risks and benefits when prescribing during pregnancy.
Breast-feeding
Tenofovir is excreted in breast milk, but the amount is considered low. The benefits of breastfeeding should be considered against the potential risk of HIV transmission.
Storage
Store at room temperature (20-25°C) in a tightly closed container. Keep away from light and moisture.
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Molecular reference: Cobicistat
PubChem CID 25151504Molecular formula: C40H53N7O5S2
Mechanism of action
Cobicistat is a mechanism-based inhibitor of cytochrome P450 3A (CYP3A) isoforms. Inhibition of CYP3A-mediated metabolism by cobicistat increases the systemic exposure of CYP3A substrates atazanavir and darunavir and therefore enables increased anti-viral activity at a lower dosage. Cobicistat does not have any anti-HIV activity on its own.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Elvitegravir
PubChem CID 5277135Molecular formula: C23H23ClFNO5
Mechanism of action
Elvitegravir is an HIV-1 integrase strand transfer inhibitor (INSTI). Integrase is an HIV-1 encoded enzyme that is required for viral replication. Inhibition of integrase prevents the integration of HIV-1 DNA into host genomic DNA, blocking the formation of the HIV-1 provirus and propagation of the viral infection. Elvitegravir does not inhibit human topoisomerases I or II.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: Emtricitabine
PubChem CID 60877Molecular formula: C8H10FN3O3S
Mechanism of action
Emtricitabine is a cytidine analog which, when phosphorylated to emtricitabine 5'-triphosphate, competes with deoxycytidine 5'-triphosphate for HIV-1 reverse transcriptase. As HIV-1 reverse transcriptase incorporates emtricitabine into forming DNA strands, new nucleotides are unable to be incorporated, leading to viral DNA chain termination. Inhibition of reverse transcriptase prevents transcription of viral RNA into DNA, therefore the virus is unable to incorporate its DNA into host DNA and replicate using host cell machinery. This reduces viral load. Emtricitabine, a synthetic nucleoside analog of cytosine, is phosphorylated by cellular enzymes to form emtricitabine 5'-triphosphate. Emtricitabine 5'-triphosphate inhibits the activity of the HIV-1 reverse transcriptase by competing with the natural substrate deoxycytidine 5'-triphosphate and by being incorporated into nascent viral DNA which results in chain termination. Emtricitabine 5'-triphosphate is a weak inhibitor of mammalian DNA polymerase alpha, beta, epsilon and mitochondrial DNA polymerase gamma.
Pharmacodynamics
Emtricitabine is a cytidine analog that competes with the natural substrate of HIV-1 reverse transcriptase to be incorporated into newly formed DNA, terminating its transcription. It is administered once daily so it has a long duration of action. Patients should be counselled regarding the risk of lactic acidosis and hepatomegaly with steatosis.
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
Molecular reference: tenofovir
PubChem CID 464205Molecular formula: C9H14N5O4P
Mechanism of action
Once tenofovir is activated by a bi-phosphorylation it acts as an antiviral acyclic nucleoside phosphonate. It is a potent inhibitor of the viral reverse transcriptase with an inhibitory constant of approximately 0.022 micromolar. Once activated, tenofovir acts with different mechanisms including the inhibition of viral polymerase causing chain termination and the inhibition of viral synthesis. All these activities are attained by its competition with deoxyadenosine 5'-triphosphate in the generation of new viral DNA. Once tenofovir is incorporated in the chain, it induces a chain termination which in order inhibits viral replication. The safety of tenofovir relies on its low affinity towards the cellular DNA polymerase including the mitochondrial DNA polymerase gamma.
Pharmacodynamics
Tenofovir has been shown to be highly effective in patients that have never had an antiretroviral therapy and it seemed to have lower toxicity than other antivirals such as [stavudine]. In phase 3 clinical trials, tenofovir presented a similar efficacy than [efavirenz] in treatment-naive HIV patients. In hepatitis B infected patients, after one year of tenofovir treatment, the viral DNA levels were undetectable.
Biological pathways
Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.
- ADCO_EMTEVIR 200/300MG TABLET
- AVIRODAY-EM 600MG/200MG/300MG TABLET
- DARUNAVIR+COBICISTAT 800/150MG TABLET
- DOLUTEGRAVIR_+EMTRICITABINE_&TENOFOVIIR_ALAFENAMIDE 50/200/25MG TABLET
- DOLUTEGRAVIR_EMTRICITABIE&_TENOFIVIR_ALAFENAMIDE 50/200/25MG TABLET
- EFAVIRENZ/EMTRICITABINE/TDF 600MG , 200MG , 300MG TABLET
- DOLUTEGRAVIR SODIUM, EMTRICITABINE AND TENOFOVIR ALAFENAMIDE · Hetero Labs
- Descovy · Patheon
- Descovy · Patheon
- Dobataf - 3 · Aurobindo Pharma
- Dobataf - EM · Apl Healthcare
- Dolutegravir, Emtricitabine and Tenofovir Alafenamide
- DOBATAF-3 · Apl Healthcare
- Dolutegravir, Emtricitabine and Tenofovir Alafenamide Tablets 50 mg / 200 mg / 25 mg · Hetero Labs
- EMTRICITABINE + TENOFOVIR DISOPROXIL FUMARATE · Laurus Labs
- EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE 200MG/300MG TABLETS · Lupin
- EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE FILM COATED TABLETS 200 MG/300 MG · Mylan Laboratories
- Emtricitabine and Tenofovir Alafenamide Tablets 200 mg/25 mg · Mylan Laboratories
- DOBATAF-3 TABLETS Each contains Emtricitabine/Tenofovir Alafenamide 200mg/25mg) · Aurobindo Pharma
- DOBATAF-EM TABLETS (Each film-coated tablet contains Emtricitabine/Tenofovir Alafenamide /200mg/25mg) · Apl Healthcare
- EMFANEF TABLETS · Mylan Laboratories
- EMTRICITABINE / TENOFOVIR ALAFENAMIDE TABLETS (Each tablet contains 200 / 25mg) · Lupin
- EMTRICITABINE AND TENOFOVIR ALAFENAMIDE TABLETS · Cipla
- EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE TABLETS · Hetero Labs
- AURO– EMTRICITABINE/ TENOFOVIR DISOPROXIL FUMARATE · Aurobindo Pharma
- EMFANEF · Mylan Laboratories Limited
- ERESTZ · Mylan Laboratories
- ERESTZ · Mylan Laboratories
- KOCITAF · Mylan Laboratories
- KOCITAF · Mylan Laboratories