Has your doctor prescribed this medicine to treat HIV infection? It has two names, Darunavir and Cobicistat. You may know it by the brand name PREZCOBIX. You may have questions or even a little apprehension about this medicine. That's normal. Today, we'll talk about this medicine in a friendly and simple way, how it works, how to take it, and what to watch out for.
What really happens with this medicine?
Simply put, this is a type of medicine that works against the HIV virus. In medical terms, we call this an ``Antiretroviral'' medicine. This is actually a combination of two types of medicine in one pill. That is, Darunavir is an anti-viral medicine, and Cobicistat is a medicine that increases the effectiveness of that medicine (booster).
The important thing is that this is not a cure for HIV infection. However, it does control the amount of HIV in your body (viral load). This means that it reduces the virus's ability to damage your immune system, helping you live a healthy, normal life. Also, when used correctly, this medicine can significantly reduce, if not eliminate, the risk of passing HIV to someone else.
Things to tell your doctor before starting medication
It is essential for your doctor to know the full details of your health condition so that he can choose the most suitable and safest treatment for you. Therefore, if you have any of the following, do not hide anything and tell your doctor.
- If you have diabetes (`Diabetes Mellitus`).
- If you have a blood clotting disorder such as hemophilia.
- If you have any kidney disease.
- If you have any liver disease.
- If you have had an allergic reaction to Darunavir, Cobicistat, sulfa drugs, or any other medicine, food, or dye.
- If you are pregnant or trying to get pregnant.
- If you are a mother who is breastfeeding a child.
How should I use this medicine?
The biggest secret to the success of this treatment is to never miss a dose of medication and to take it at the scheduled time. Here's how to take the medication:
1. Take with food: This medicine should definitely be taken with a meal . Do not take it on an empty stomach.
2. Drink with a glass of water: Swallow the tablet whole with a glass of water.
3. Take it on time: Get in the habit of taking your medicine at the same time every day, as prescribed by your doctor.
4. Don't stop taking your medication: Even if you feel better, don't stop taking your medication without your doctor's advice. If you skip the medication, the HIV virus can become resistant not only to this medication but also to other medications. We call that ``Drug Resistance''. If that happens, it becomes very difficult to treat.
What do you do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if your next dose is less than 12 hours away, skip the missed dose. Just take your next dose at the scheduled time.
Most importantly: Never take a double dose of medication to make up for a forgotten dose.
What if I take too much medicine?
If you think you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other medications that may interact with this medicine
This is a very important part because this medicine can interact with some other medications. Therefore, it is essential to inform your doctor about all the medications you are taking.
| Absolutely Do Not Take With This Medicine! | |
|---|---|
| Alfuzosin | Rifampin |
| Heart disease medications like Dronedarone, Ivabradine, Ranolazine | Sildenafil (for pulmonary hypertension) |
| Antiepileptic drugs such as Carbamazepine, Phenytoin, Phenobarbital | St. John's Wort (herbal medicine) |
| Cholesterol medications like Lomiptide, Lovastatin, Simvastatin | Triazolam, Midazolam (used to induce sleep) |
| Medicines such as Ergotamine and Dihydroergotamine for migraines | Cisapride, Pimozide, Lurasidone |
| May Also Interact With These Medications | |
|---|---|
| Other HIV or AIDS medications | Other cholesterol medications such as Atorvastatin, Rosuvastatin |
| Types of hormones, including birth control pills | Antibiotics such as Clarithromycin |
| Blood thinners such as Warfarin and Apixaban | Antifungals such as ketoconazole |
| High blood pressure medications such as Amlodipine and Metoprolol | Antidepressants such as Sertraline and Amitriptyline |
| Sexual stimulants such as Sildenafil (Viagra), Tadalafil | Steroids such as Fluticasone and Budesonide |
| Anticancer drugs, painkillers and many other medications | Vitamins, herbal medicines, and supplements you take |
This list is not exhaustive. Therefore, give your doctor a complete list of all medications you take (including vitamins, herbal remedies, and supplements), and whether you smoke or drink alcohol.
Things to be careful about when taking medicine
- Regular medical checkups: Be sure to go to the clinic on the days your doctor tells you to and get checked. Get the necessary blood tests done.
- Severe skin reactions: This medicine can sometimes cause very serious skin reactions . These can occur even weeks after starting the medicine. If you develop a red, purplish rash with symptoms such as fever or chills, followed by blisters or peeling skin, tell your doctor immediately. Also, if you develop a red rash along with swelling of the face, lips, or swollen lymph nodes in the neck or armpits, this can be a very serious sign. If you notice anything like this, seek medical advice immediately without delay.
- Birth control: If you are using birth control pills, their effectiveness may be reduced while taking this medication. Therefore, be sure to talk to your doctor about using another form of barrier contraception, such as condoms .
- Blood sugar levels: This medicine may increase your blood sugar levels. If you have diabetes, check your blood sugar levels regularly. Talk to your doctor about diet or medication changes if necessary.
- HIV transmission: Although this medicine reduces the risk of HIV transmission, it does not completely stop it. So talk to your doctor about practicing safer sex and ways to prevent the spread of the disease through blood.
What are the possible side effects?
Like any medicine, this one can cause some side effects.
| Type of side effect | Symptoms |
|---|---|
| Side effects that should be reported to the doctor immediately | |
| Severe allergies | Skin rash , itching, swelling of the face, lips or tongue. |
| Liver problems | Dark urine, yellowing of the eyes or skin (jaundice), stomach pain, nausea, loss of appetite. |
| Severe skin reactions | Redness of the skin, blistering, peeling of the skin (even inside the mouth), fever, swelling of the gums. |
| Kidney problems | Difficulty urinating, change in the amount of urine that comes out, lower back pain. |
| Increased blood sugar | More thirst/hunger than usual, frequent urination, extreme fatigue, blurred vision. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Stomach ache | Diarrhea |
| Headache | General headache |
| Changes in body fat distribution | Fat accumulation in the waist and back areas, thinning of the face and limbs. |
Take-Home Message
- This medicine is a treatment that controls HIV infection, but it does not completely cure it.
- Most importantly: Never skip a dose of medication. Do not stop taking your medication without your doctor's advice.
- This medicine should definitely be taken with a meal .
- Tell your doctor about all other medications, vitamins, and herbal remedies you are taking.
- If you notice anything like a severe skin rash accompanied by fever and swelling, seek medical advice immediately.
- If you are using birth control pills, talk to your doctor about using an extra protective method, such as a condom, as they may be less effective.
- It is very important to stay in regular contact with your doctor and attend clinics on scheduled dates.
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