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# Tabovoihep ## Overview Tabovoihep is a brand name for a combination medication containing **emtricitabine**, **tenofovir disoproxil fumarate (TDF)**, and **elvitegravir/cobicistat**. It is a complete regimen for the treatment of HIV-1 infection. ## Primary Indications Treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and pediatric patients weighing at least 25 kg who have no history of treatment failure and no known substitutions associated with high-level resistance to any of the three components. ## Adult Dosing One tablet (emtricitabine 200 mg / tenofovir disoproxil fumarate 300 mg / elvitegravir 150 mg / cobicistat 100 mg) orally once daily. ## Pediatric Dosing For pediatric patients weighing at least 25 kg and less than 40 kg: One tablet orally once daily. For pediatric patients weighing 40 kg or more: One tablet orally once daily. *Note: Pediatric dosing for patients weighing less than 25 kg is not established.* ## Dose Adjustments No dose adjustment is required for mild to moderate renal impairment (CrCl ≥ 30 mL/min). Tabovoihep should not be used in patients with severe renal impairment (CrCl < 30 mL/min) or end-stage renal disease. No dose adjustment is necessary for mild or moderate hepatic impairment. Use with caution in severe hepatic impairment. ## Contraindications * Concomitant use with rifampin, phenobarbital, phenytoin, carbamazepine, St. John's Wort, or drugs that strongly induce CYP3A. * Previous hypersensitivity to any of the active components. ## Adverse Effects * **Common:** Nausea, diarrhea, abdominal pain, headache, fatigue, rash. * **Serious:** Lactic acidosis and severe hepatomegaly with steatosis (including fatalities), acute renal failure, immune reconstitution inflammatory syndrome (IRIS), new-onset or worsening renal impairment, decreases in bone mineral density. ## Key Drug Interactions * **CYP3A Inhibitors/Inducers:** Cobicistat is a strong inhibitor of CYP3A, leading to increased concentrations of coadministered drugs metabolized by CYP3A (e.g., certain statins, benzodiazepines). Conversely, strong CYP3A inducers can decrease concentrations of tabovoihep components. * **Nephrotoxic Drugs:** Concurrent use with drugs that can impair renal function may increase the risk of renal-related adverse events. * **Antacids/Supplements:** Separate administration of antacids (e.g., aluminum hydroxide/magnesium hydroxide) by at least 2 hours. Separate administration of calcium and iron supplements by at least 2 hours. ## Monitoring * Renal function (serum creatinine, urinalysis, CrCl) at baseline and periodically throughout treatment. * Bone mineral density at baseline and periodically for patients with a history of pathological bone fractures. * Liver function tests at baseline and periodically. * Viral load and CD4+ T-cell count to assess efficacy. ## Clinical Pearls * Tabovoihep should be taken with food to enhance absorption. * Patients should be advised to avoid St. John's Wort and other interacting medications. * Routine monitoring of renal function is crucial due to the TDF component. * This formulation contains cobicistat, a pharmacokinetic enhancer, which can lead to significant drug interactions. *** **Disclaimer:** This information is for educational purposes only and does not substitute for professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information for complete details before making any treatment decisions.