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Background and importance Recently, change from cobicistat to ritonavir is being promoted at a tertiary hospital for economic reasons. Therefore, there is a growing need to study what this switch may involve. Aim and objectives Our objective was to describe the differences between the interactions profile of cobicistat and ritonavir with concomitant home treatment in HIV positive (HIV+) patients, consulting three databases (DDBB). Material and methods A prospective study (January–May 2019) was carried out in HIV+ patients being treated with cobicistat boosted antiretrovirals, who came to the outpatient pharmacy of a third level hospital and whose treatments were changed to a ritonavir boosted regimen. Concomitant home treatment was registered by consulting the primary care online programme Horus. Interactions between cobicistat and ritonavir and domiciliary treatment were explored in three DDBB: Liverpool, Drugs.com and Micromedex. Severity level was assigned as follows: 4 (severe), 3 (moderate), 2 (minor) and 1 (no interaction). If the drug was not registered in the database, it was codified as 0. Differences in punctuations between cobicistat and ritonavir were registered. Results A total of 174 patients were included: 75% were men, with a median age of 55 (48–59) years, receiving 3 prescribed medicines (range 0–17). Interactions between cobicistat and ritonavir and the 170 prescribed drugs were analysed. Calcifediol (n=81), atorvastatin (n=45) and omeprazole (n=34) were the drugs prescribed the most. Cobicistat and ritonavir had a different interaction severity level in 19% of the drugs, according to Micromedex, 18% if checked in Drugs.com and 15% in Liverpool. The most important severity level changes are summarised in table 1. Conclusion and relevance There were some significant differences between the interactions profile of cobicistat and ritonavir. Caution must be considered and drug databases checked when changing from a cobicistat boosted regimen to a ritonavir boosted one, in order to resolve potential drug interactions. References and/or acknowledgements No conflict of interest. |
