SYMTUZA (cobicistat)
Symtuza is a complete, once-daily single-tablet regimen for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 40 kg. It is indicated for individuals with no prior antiretroviral treatment history, or those who are virologically suppressed (HIV-1 RNA < 50 copies/mL) on a stable regimen for at least 6 months. Use in suppressed patients requires no known substitutions associated with resistance to darunavir or tenofovir. The regimen combines darunavir (a protease inhibitor), cobicistat (a CYP3A inhibitor), emtricitabine (an NRTI), and tenofovir alafenamide (an NRTI).
How SYMTUZA Works
Symtuza functions through the synergistic action of four components: Darunavir is a protease inhibitor that prevents the cleavage of viral polyproteins, resulting in the formation of immature, non-infectious virions. Emtricitabine and tenofovir alafenamide (TAF) are nucleoside analog reverse transcriptase inhibitors (NRTIs) that inhibit HIV-1 reverse transcriptase, leading to DNA chain termination. Cobicistat has no antiviral activity but acts as a pharmacokinetic enhancer by inhibiting CYP3A, thereby increasing the systemic exposure and therapeutic levels of darunavir.
Development Insights
Details
- Status
- Prescription
- First Approved
- 2018-07-17
- Patent Cliff
- 2038
- Routes
- ORAL
- Dosage Forms
- TABLET
Companies
SYMTUZA Approval History
What SYMTUZA Treats
1 indicationsSYMTUZA is approved for 1 conditions since its original approval in 2018. These indications span multiple therapeutic areas including oncology, immunology, and more.
- Human Immunodeficiency Virus
SYMTUZA Boxed Warning
POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B Severe acute exacerbations of hepatitis B (HBV) have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of SYMTUZA. Closely monitor hepatic function with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue SYMTUZA. If appr...
WARNING: POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B Severe acute exacerbations of hepatitis B (HBV) have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of SYMTUZA. Closely monitor hepatic function with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue SYMTUZA. If appropriate, anti-hepatitis B therapy may be warranted [see Warnings and Precautions (5.1) ] . WARNING: POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B See full prescribing information for complete boxed warning. Severe acute exacerbations of hepatitis B (HBV) have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of SYMTUZA. Hepatic function should be monitored closely in these patients. If appropriate, anti-hepatitis B therapy may be warranted. ( 5.1 )
SYMTUZA Competitive Set
ProThree rings of competition based on shared molecular targets and treated indications.
Direct competitors
Same target(s) AND same indication — head-to-head.
MoA expansion candidates
Same target(s), different indications — where else is this mechanism being explored?
Indication competitors
Same indication, different mechanism — what else might this patient receive?
Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.
Drugs Similar to SYMTUZA
3 of 10FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.
Clinical Trial Registry
29 trials| Trial | Sponsor ID | Phase | Status | Title |
|---|---|---|---|---|
| NCT02016924 | GS-US-216-0128 2013-001402-28, IS000883 | Ph 2, Ph 3 | active not recruiting | Study of Cobicistat-Boosted Atazanavir (ATV/co), Cobicistat-Boosted Darunavir (DRV/co) and Emtricitabine/Tenofovir Alafenamide (F/TAF) in Children With HIV |
| NCT06385119 results posted | F8394-101 | Ph 1 | completed | A Study of the Effects of Food and Cobicistat on Plixorafenib Pharmacokinetics in Healthy Participants. |
| NCT04065399 AUGMENT-101 | SNDX-5613-0700 2020-004104-34 | Ph 1, Ph 2 | recruiting | A Study of Revumenib in R/R Leukemias Including Those With an MLL/KMT2A Gene Rearrangement or NPM1 Mutation |
| NCT03696160 LAPTOP results posted | NEAT44 | Ph 3 | completed | The Late Presenter Treatment Optimisation Study |
| NCT03480646 results posted | 1205-201 | Ph 1, Ph 2 | completed | ProSTAR: A Study Evaluating CPI-1205 in Patients With Metastatic Castration Resistant Prostate Cancer |
| NCT04718805 | CR108955 TMC114IFD1004, 2020-003397-43 | Ph 1 | completed | A Study of Darunavir in the Presence of Cobicistat When Administered as a Fixed Dose Combination Under Fed Conditions |
| NCT04661397 | CR108922 2020-003396-18, TMC114FD2HTX1007 | Ph 1 | completed | A Study in Healthy Participants to Assess the Effect of Darunavir, Emtricitabine, and Tenofovir Alafenamide in the Presence of Cobicistat as Fixed Dose Combination (Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide) Compared With Co-administration of the Separate Agents |
| NCT02578550 | CR107887 TMC114FD2HTX1001, 2015-001264-18 | Ph 1 | completed | A Bioequivalence Study of Darunavir, Emtricitabine, and Tenofovir Alafenamide, in the Presence of Cobicistat in Healthy Participants |
| NCT05458102 results posted | GS-US-382-1587 | Ph 1 | terminated | Drug-Drug Interaction Study of Vesatolimod in Adults With HIV-1 Who Have Very Low or Undetectable Virus Levels |
| NCT04240210 SymITA | TMC114FD2HTX4005 | Ph 4 | terminated | Integrase Regimen Switch to Symtuza to Increase Tolerability/Adherence (SYMita) |
| NCT05748093 OSIBOOST 2 | OSIBOOST 2 2023-505700-35-00 | Ph 4 | recruiting | Improving Osimertinib Exposure and Cost-effectiveness Using Pharmacokinetic Boosting With Cobicistat |
| NCT05078671 PROACTIVE | PROACTIVE | Ph 4 | recruiting | Pharmacokinetic Boosting of Olaparib to Improve Exposure, Tolerance and Cost-effectiveness |
| NCT04653194 BIC-T&T | CRF002 2019-003208-11 | Ph 3 | completed | Efficacy of BIC/F/TAF Versus Standard of Care in the Treatment of New HIV Infection Diagnoses in the Context of 'Test and Treat' |
| NCT06014489 HO171 | HO171 | Ph 2 | recruiting | A Trial to Assess Cobicistat Boosted Venetoclax in Combination With Azacitidine in Adult Patients With Newly Diagnosed AML |
| NCT03864406 results posted | 190063 19-CC-0063 | Ph 1 | completed | Impact of Steady State Cobicistat and Darunavir/Cobicistat on the Pharmacokinetics and Pharmacodynamics of Oral Anticoagulants (Rivaroxaban, Apixaban) in Health Volunteers |
| NCT05716854 | SCR-014 | Ph 1 | completed | Electrophysiological Effects of Potential QT Prolonging Drugs |
| NCT05236738 | AI424-578 | Ph 1 | completed | A Study to Compare the Drug Levels of Atazanavir and Cobicistat Between the Coadministration of Age-Appropriate Mini-Tablet Formulations and the Coadministration of the Individual Reference Products in Healthy Adults Under Fed Conditions |
| NCT02307656 | AI424-517 | Ph 1 | completed | Taste Properties of Atazanavir and Cobicistat |
| NCT04263350 | AI424-567 | Ph 1 | completed | A Study to Examine the Acceptable Taste and to Estimate the Amount of Atazanavir and Cobicistat in the Body When Taken as a Combination Product Versus When Taken as Separate Products at the Same Time |
| NCT02565888 DATE-4 | UMCN-AKF 14.12 | Ph 1 | completed | A Drug-drug Interaction Study Between Daclatasvir and Atazanavir/Ritonavir or Atazanavir/Cobicistat |
| NCT04236453 | CR108649 2019-002245-37, TMC114FD2HTX1005 | Ph 1 | terminated | A Study in Healthy Participants to Assess the Effect of Darunavir, Emtricitabine, and Tenofovir Alafenamide in the Presence of Cobicistat When Administered as a Fixed Dose Combination (Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide) Compared to the Co-administration of the Separate Agents |
| NCT03045861 results posted | 200911 | Ph 2 | completed | Safety and Efficacy Study of GSK2838232 in Human Immunodeficiency Virus (HIV)-1 Infected Adults |
| NCT02661373 | BUZZOFF | Ph 1 | completed | First-in-Human Study of an Oral Plasmodium Falciparum Plasma Membrane Protein Inhibitor |
| NCT02277600 | 206285 AI438-044 | Ph 1 | completed | A Phase 1 Antiretroviral Drug-Drug Interaction Study in Healthy Volunteers (DDI) |
| NCT02475135 | CR107430 2015-001213-27, TMC114FD2HTX1002 | Ph 1 | completed | Relative Bioavailability and Food Effect for Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Fixed Dose Combination |
| NCT01896622 | 130160 13-CC-0160 | Ph 1 | completed | The Interaction of Two HIV Medications With Blood Clot Medications in Healthy Volunteers |
| NCT02503462 | DRVCOBI | Ph 4 | terminated | Effect of Cobicistat Versus Ritonavir Boosting on the Brain Permeation of Darunavir in HIV-infected Individuals |
| NCT01837719 Atazanavir results posted | AI424-511 | Ph 1 | completed | Bioequivalence Study of Individual Atazanavir and Cobicistat Compared With Atazanavir in Fixed-dose Combination With Cobicistat |
| NCT01619527 | CR100699 TMC114IFD1003, 2012-000273-23 | Ph 1 | completed | A Study to Assess the Bioequivalence of Darunavir When Co-Administrated With Cobicistat Under Fed and Fasted Conditions |
Active Pipeline
Ongoing clinical trials by development phase
Key Completed Trials
Completed studies with published results, ranked by significance
Trial Timeline
Full development history with FDA approval milestones
Understanding FDA Approval Types
| Count | Type | What it means |
|---|---|---|
| - | ORIG | Original approval - drug first enters market |
| - | SUPPL - Efficacy | New indication (new disease/condition approved) |
| - | SUPPL - Labeling | Label text changes (warnings, dosing updates) |
| - | SUPPL - Manufacturing | Production changes (new facility) |
| - | SUPPL - Chemistry | Formulation changes (new dosage strength) |
Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.
SYMTUZA FDA Label Details
Indications & Usage
FDA Label (PDF)SYMTUZA is indicated for the treatment of Human Immunodeficiency Virus.
WARNING: POST TREATMENT ACUTE EXACERBATION OF HEPATITIS B Severe acute exacerbations of hepatitis B (HBV) have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF), and may occur with discon...
SYMTUZA Patents & Exclusivity
Patents (6 active)
Pro Intelligence Preview
Deep insights for SYMTUZA
Revenue Insights
- • Quarterly revenue tracking
- • Historical trend analysis
Patent Timeline
- • Cliff: 2038
- • 13 active patents
Trial Analysis
- • 3 total trials
- • Stage: Declining
Competitive Landscape
- • 10 similar drugs
- • Same target/indication analysis
Full approval history • All patents • Revenue trends • Competitor analysis
Data Sources
Data sourced from official FDA and NIH databases. Click links to verify on original sources.
How We Calculate These Metrics
Trial Activity Stage
Measures the current development activity pattern based on trial phases, status, and trends. Important: This measures R&D activity, not commercial lifecycle.
Trial statuses: "Active" means recruiting or ongoing. "Completed" means reached planned endpoint. "Terminated" means stopped early—often due to safety, efficacy, or business reasons.
- Growth: High proportion of early-phase trials (Phase 1/2), active development
- Expansion: Significant Phase 3 activity, approaching or pursuing approvals
- Mature: Substantial Phase 4 post-marketing studies
- Stable: Mixed phase distribution, steady development
- Declining: Low active trial ratio, reduced R&D investment