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Tybost
Tybost (generic name: cobicistat) is a pharmacokinetic enhancer used in combination with certain HIV medications to increase their effectiveness. It acts by inhibiting enzymes in the liver that break down certain HIV drugs, allowing these medications to stay in the body longer at higher concentrations. Tybost itself does not have antiviral activity but is used to boost the levels of other antiretroviral drugs like atazanavir and darunavir to help manage HIV infection.
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Frequently Asked Questions
Does Tybost have antiviral activity?
No, Tybost does not directly treat HIV. It works as a booster to increase the levels of other HIV medications, such as atazanavir or darunavir, to make them more effective.
Can I take Tybost alone?
No, Tybost is always used in combination with other HIV medications. It has no antiviral activity on its own.
How should I take Tybost?
Tybost should be taken once daily with food, as this helps increase its absorption and effectiveness.
Does Tybost interact with other medications?
Yes, Tybost interacts with many medications by affecting how they are metabolized. Always inform your healthcare provider of all medications, supplements, and herbal products you are taking.
Can Tybost cause kidney problems?
Tybost can increase serum creatinine levels, which may be confused with kidney damage, but this does not typically affect actual kidney function. Your healthcare provider will monitor your kidney function regularly to ensure it remains healthy.
Comprehensive Drug Guide
How Does Tybost Work?
Tybost works by inhibiting CYP3A enzymes in the liver, which are responsible for metabolizing certain HIV medications like atazanavir and darunavir. By inhibiting these enzymes, Tybost increases the blood levels of these drugs, allowing them to remain active in the body for longer periods and making the HIV treatment more effective.
Common Dosages
- 150 mg tablet taken once daily with food.
Typical Dosing
- The recommended dose is one 150 mg tablet taken once daily with food.
- Tybost is always used in combination with other HIV medications, such as atazanavir or darunavir, and should not be used on its own.
Typical Dosing
FDA Approved Indications
- Atazanavir or Darunavir in the treatment of HIV-1 infection.
Who Shouldn't Take Tybost?
- Severe liver impairment (Child-Pugh Class C).
- Concurrent use of certain medications that are highly dependent on CYP3A for clearance and for which elevated concentrations could lead to serious or life-threatening effects (e.g., certain sedatives, antiarrhythmics, or ergot derivatives).
- Known hypersensitivity to cobicistat or any other component of the product.
Advice From The Pharmacist
- Take Tybost exactly as prescribed, with food, to ensure proper absorption.
- Do not use Tybost alone; it must be taken in combination with other antiretroviral medications like atazanavir or darunavir.
- Inform your healthcare provider of any other medications you are taking, as Tybost can interact with many other drugs by affecting how they are metabolized.
- Store Tybost at room temperature, away from excessive heat and moisture.
Side Effects of Tybost
Common Side Effects
- Nausea
- Diarrhea
- Fatigue
- Abnormal liver function tests
Uncommon/Severe Side Effects
- Kidney problems, such as increased serum creatinine without affecting actual kidney function.
- Liver toxicity (signs include yellowing of the skin or eyes, dark urine, or abdominal pain).
- Drug interactions: Cobicistat can interact with many medications, potentially leading to serious side effects.
Risks and Warnings of Tybost
- Kidney Function Monitoring: Tybost can cause increases in serum creatinine without affecting actual kidney function. Regular monitoring of kidney function is recommended, especially in patients with pre-existing kidney issues or those taking other medications that affect the kidneys.
- Liver Impairment: Tybost should be used cautiously in patients with mild to moderate liver impairment and is contraindicated in those with severe liver impairment.
- Drug Interactions: Tybost inhibits several enzymes (CYP3A, CYP2D6), and this can cause significant drug interactions with medications metabolized by these enzymes. Always review your medications with your healthcare provider to avoid dangerous interactions.
Interactions with Tybost
Common Drug Interactions
- CYP3A4 inhibitors/inducers: Avoid strong inducers or inhibitors of CYP3A4, such as rifampin, phenytoin, and carbamazepine, as they can reduce the effectiveness of Tybost or increase the risk of side effects.
- Sedatives: Certain sedatives like midazolam or triazolam should not be used with Tybost, as increased concentrations can lead to respiratory depression.
- Anticoagulants: Cobicistat can affect the metabolism of blood thinners like warfarin, leading to changes in blood clotting. Regular monitoring is needed.
Alternatives to Tybost
- Ritonavir: Another pharmacokinetic enhancer used in combination with HIV medications like darunavir. It has a similar function but is more likely to cause side effects such as gastrointestinal upset.
- Prezcobix: A combination of darunavir and cobicistat in one pill, reducing the pill burden for patients taking darunavir.
