GENVOYA
Combination product
Pronunciation: el-vi-TEG-ra-veer and koe-BIK-i-stat and em-tri-SIT-a-been and ten-OF-oe-veer al-a-FEN-a-mide (jen-VOY-a)
Combination of Elvitegravir, Cobicistat, Emtricitabine and Tenofovir alafenamide.
Each component keeps its own pharmacology page; the combination itself adds no new mechanism.
Components (4)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| HIV-1 infection (complete regimen) | Adults and pediatric patients weighing ≥25 kg | 1 tablet (EVG 150/COBI 150/FTC 200/TAF 10 mg) QD with food | 1 tablet QD with food | 1 tablet QD |
Renal No adjustment if CrCl ≥30 mL/min or ESRD on chronic hemodialysis (dose after dialysis); NOT recommended if CrCl 15 to <30 mL/min or ESRD not on hemodialysis
Hepatic No adjustment for mild/moderate (Child-Pugh A/B); not recommended in severe (Child-Pugh C)
Instructions
- Take one tablet orally once daily with food
- Test for hepatitis B before initiating; assess serum creatinine, CrCl, urine glucose and protein before and during treatment
- On hemodialysis days, administer after completion of dialysis
- Not recommended during pregnancy — an alternative regimen is recommended
Available strengths
- tab 150/150/200/10 mg
Contraindications
- Coadministration with drugs highly dependent on CYP3A for clearance where elevated levels cause serious/life-threatening events (e.g., alfuzosin, ergot derivatives, lovastatin/simvastatin, lomitapide, pimozide, lurasidone, oral midazolam, triazolam, sildenafil for PAH), or with strong CYP3A inducers (e.g., rifampin, carbamazepine, phenobarbital, phenytoin, St. John's wort) that reduce efficacy
Cautions
- Significant drug interactions (loss of efficacy/resistance or increased concomitant drug toxicity)
- Immune reconstitution syndrome
- New onset or worsening renal impairment (Fanconi syndrome, PRT); cobicistat raises serum creatinine without affecting GFR
- Lactic acidosis/severe hepatomegaly with steatosis
Adverse reactions
- Nausea
- Diarrhea
- Headache
- Fatigue
Pregnancy Not recommended during pregnancy (substantially lower cobicistat/elvitegravir exposures in 2nd/3rd trimesters)
Lactation Breastfeeding not recommended (potential HIV-1 transmission)
Cost
| Strength | #/mo | generic $/mo | brand $/mo | CostPlus | |
|---|---|---|---|---|---|
| 150/150/200/10 mg | tab | 30 qd | — | $4,300.60 | not offered |
Part D rank #520.