Cobicistat

PD Dialyzability: Unlikely

Pharmacokinetic Parameters [1] [2] [3]

	Cobicistat
Molecular Weight (Da)	776
Plasma Protein Binding (%)	97 - 98
Volume of Distribution (L/Kg)	77
Hepatic Metabolism	CYP3A (Major), CYP2D6 (Minor)
Excreted Unchanged (%)	8
Half-Life; Normal Renal Function (hours)	3 - 4
Half-Life; ESRD (hours)	Unknown

CAPD/CCPD Dosing:

No dosing recommendation for PD population was found in literature. However, due to major hepatic metabolism and extensive protein binding, it is unlikely that dosing adjustment is required [1] [2]. Cobicistat inhibits tubular secretion of creatinine, but does not affect actual glomerular function [2] [4]. Note that cobicistat may not be available as a single entity product in Canada and the need for dose adjustment for other drugs in the combination product must be considered.

Literature Summary:

None identified.

References

[1]	(1, 2) Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. Drugbank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(Database issue):D668-672.

[2]	(1, 2, 3) Gilead Sciences Canada, Inc. Product Monograph Tybost. Mississauga: Gilead Sciences Canada, Inc; 2016.

[3]	Tseng A. Selected properties of cobicistat. Immunodeficiency Clinic [Internet]. 2014 Dec [cited 2018 Jan 17]. 1-5. Available from www.hivclinic.ca.

[4]	Lucas GM, Ross MJ, Stock PG, Shlipak MG, Wyatt CM, Gupta SK, et al. Clinical practice guideline for the management of chronic kidney disease in patients infected with HIV: 2014 update by the HIV medicine association of the infectious diseases society of America. Clin Infect Dis. 2014;59(9):e96–138.