{"id":34805,"date":"2018-08-24T11:18:18","date_gmt":"2018-08-24T11:18:18","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=34805"},"modified":"2018-08-24T15:44:54","modified_gmt":"2018-08-24T15:44:54","slug":"interactions-between-oral-anticoagulants-and-genvoya-stribild-and-cobicistat-fda-label-updates","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/34805","title":{"rendered":"Interactions between oral anticoagulants and Genvoya, Stribild and cobicistat: FDA label updates"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/span><\/strong><\/p>\n

On 15 August 2018, the FDA listserv announced label changes to several HIV combinations based on drug interactions with oral anticoagulants.<\/span><\/strong><\/p>\n

A summary of the changes is bulleted below, but please check updated package inserts for full details.<\/span><\/p>\n

Genvoya and Stribild<\/span><\/h2>\n

Genvoya and Stribild <\/span><\/b>are both expected to increase the exposures of apixaban, rivaroxaban, betrixaban, dabigatran and edoxaban. The specific recommendations are as follows:<\/span><\/p>\n

    \n
  • Apixaban: Due to potentially increased bleeding risk, dosing recommendations for coadministration with Genvoya or Stribild depends on the apixaban dose. Refer to apixaban dosing instructions for coadministration with strong CYP3A and P-gp inhibitors in apixaban prescribing information.<\/span><\/li>\n
  • Rivaroxaban:\u00a0 Coadministration of rivaroxaban with Genvoya or Stribild is not recommended because it may lead to an increased bleeding risk.<\/span><\/li>\n
  • Betrixaban, dabigatran, edoxaban: Due to potentially increased bleeding risk, dosing recommendation for coadministration of betrixaban, dabigatran or edoxaban with a P-gp inhibitor such as Genvoya or Stribild depends on the direct oral anticoagulant indication and renal function. Refer to the direct oral anticoagulant dosing instructions for coadministration with P-gp inhibitors in the direct oral anticoagulant prescribing information. \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/li>\n<\/ul>\n

    Tybost coadministered with atazanavir or darunavir<\/span><\/h2>\n
      \n
    • Apixaban: Due to potentially increased bleeding risk, dosing recommendations for coadministration of apixaban with Tybost depends on the apixaban dose. Refer to apixaban dosing instructions for coadministration with strong CYP3A and P-gp inhibitors in apixaban prescribing information.<\/span><\/li>\n
    • Rivaroxaban: Coadministration of rivaroxaban with Tybost is not recommended because it may lead to an increased bleeding risk.<\/span><\/li>\n<\/ul>\n

      Tybost coadministered with atazanavir<\/span><\/h2>\n
        \n
      • Betrixaban, dabigatran and edoxaban: Due to potentially increased bleeding risk, dosing recommendations for coadministration of betrixaban, dabigatran, or edoxaban with a P-gp inhibitor such as Tybost coadministered with atazanavir depends on DOAC indication and renal function. Refer to DOAC dosing instructions for coadministration with P-gp inhibitors in DOAC prescribing information.<\/span><\/li>\n<\/ul>\n

        Tybost coadministered with darunavir<\/span><\/h2>\n
          \n
        • Betrixaban, dabigatran and edoxaban: No dose adjustment.<\/span><\/li>\n<\/ul>\n

          Reference<\/p>\n

          FDA list serve (13 August 2018).<\/p>\n","protected":false},"excerpt":{"rendered":"

          Simon Collins, HIV i-Base On 15 August 2018, the FDA listserv announced label changes to several HIV combinations based on drug interactions with oral anticoagulants. A summary of the changes is bulleted below, but please check updated package inserts for …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,34],"tags":[],"class_list":["post-34805","post","type-post","status-publish","format-standard","hentry","category-antiretrovirals","category-pk-and-drug-interactions"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/34805","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=34805"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/34805\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=34805"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=34805"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=34805"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}