Elvitegravir Approved as an Independent Medication
September 26, 2014
Elvitegravir is an HIV integrase inhibitor that requires pharmacokinetic enhancement with cobicistat or ritonavir. Since 2012 it has been available in a coformulation with cobicistat, tenofovir, and emtricitabine (Stribild) for treatment-naïve adults. This month the FDA approved elvitegravir as an independent medication, for use in in combination with a ritonavir-boosted protease inhibitor (and other ARVs) in treatment-experienced adults. Its brand name is Vitekta.
It is dosed once daily, with the specific dosage determined by the coadministered ritonavir-boosted PI:
- Elvitegravir 85 mg QD with: atazanavir 300 mg QD + ritonavir 100 mg QD or lopinavir/ritonavir 400/100 mg BID
- Elvitegravir 150 mg QD with: darunavir 600 mg BID + ritonavir 100 mg BID, fosamprenavir 700 mg BID + ritonavir 100 mg BID, or tipranavir 500 mg BID + ritonavir 200 mg BID
Elvitegravir should not be used with cobicistat, except in the coformulation with cobicistat/tenofovir/emtricitabine (Stribild); thus it is not recommended with cobicistat-boosted PIs. It also is not recommended with PIs other than those indicated above
It should be taken with food.
Further information is available in the prescribing information at Drugs @FDA.
Susa Coffey is medical editor of the NCRC. She is a Professor of Medicine at UCSF in the Division of HIV, Infectious Diseases and Global Medicine and a longtime clinician and educator in the HIV at San Francisco General Hospital clinic (“Ward 86”). She also is medical editor of HIV InSite.