The Medical Letter on Drugs and Therapeutics
A 4-Drug Combination (Stribild) for HIV
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Revised 1/3/13: In the “Drug Interactions” paragraph, the word “oral” has been inserted before “midazolam” in the 3rd sentence.

The FDA has approved a fixed-dose combination of the integrase strand transfer inhibitor (INSTI) elvitegravir, the pharmacokinetic enhancer cobicistat, and the nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) emtricitabine and tenofovir disoproxil fumarate (Stribild – Gilead) for treatment of HIV-1 infection in antiretroviral treament-naïve adults. Elvitegravir is the second INSTI to be approved by the FDA for use in HIV treatment; raltegravir (Isentress) was the first.1

FIRST-LINE TREATMENT OF HIV — Antiretroviral treatment regimens usually include a "backbone" and a "base". Recommended choices for first-line therapy of HIV infection, depending on the results of resistance testing, include a non-nucleoside reverse transcriptase inhibitor (NNRTI) such as efavirenz, a ritonavir-boosted protease inhibitor such as atazanavir, or an INSTI as the base, ... more      

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Title: A 4-Drug Combination (Stribild) for HIV
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