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Corticosteroids Can Cause Stribild and Tybost Drug Resistance


FDA updates prescribing information on two HIV meds after corticosteroids are shown to reduce effectiveness and increase drug resistance.

The Food and Drug Administration has issued warnings about using corticosteroids in combination with the HIV medications Stribild and Tybost.

Stribild, a once-a-day combination medication, and Tybost, a drug used to boost the effectiveness of other HIV medications, are both impacted by corticosteroids (like cortisone).

Corticosteroids are drugs that are used to relieve the impact of inflammation and allergic reactions. They can reduce swelling and itching, and are often used to treat asthma, arthritis (and other pain causing issues with joints), severe allergies, and other skin conditions.

But the FDA warns, when used in conjunction with Stribild, corticosteroids can lower the therapeutic effect of the drug and cause users to develop a resistance to elvitegravir (one of the Stribild’s key ingredients). Tybost is  often prescribed with other HIV medications. If it is also used with corticosteroids it could cause those HIV meds to fail, and — if those HIV drugs include atazanavir or darunavirp — cause

resistance to those drugs to develop.  Those taking Stribild are encouraged to avoid using oral dexamethasone or other systemic corticosteroids that induce CYP3A which can reduce how well HIV drugs are metabolized.  

Gilead the pharmaceutical company behind both drugs has already changed its online drug information for both Stribild and Tybost by adding this warning: “Alternative corticosteroids, including beclomethasone and prednisolone (whose PK and/or PD are less affected by strong CYP3A inhibitors relative to other studied steroids) should be considered, particularly for long-term use.”

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