| Human immunodeficiency virus I infection
Norvir vs Symtuza
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Norvir vs Symtuza with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSymtuza has a higher rate of injection site reactions vs Norvir based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Symtuza but not Norvir, including UnitedHealthcare
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Category
Norvir
Symtuza
At A Glance
Oral
Twice daily
HIV protease inhibitor
Oral
Once daily
Protease inhibitor + CYP3A inhibitor + NRTI combination
Indications
- Human immunodeficiency virus I infection
- Human immunodeficiency virus I infection
Dosing
Human immunodeficiency virus I infection (Adults) 600 mg twice daily by mouth with meals; initiate at 300 mg twice daily and increase by 100 mg q2-3 days to minimize adverse events.
Human immunodeficiency virus I infection (Pediatrics >1 month) 350-400 mg/m2 twice daily by mouth with meals, not to exceed 600 mg twice daily; initiate at 250 mg/m2 twice daily and increase by 50 mg/m2 q2-3 days.
Human immunodeficiency virus I infection One tablet orally once daily with food in adults and pediatric patients weighing at least 40 kg (800 mg darunavir/150 mg cobicistat/200 mg emtricitabine/10 mg tenofovir alafenamide).
Contraindications
- Known hypersensitivity (e.g., TEN or Stevens-Johnson syndrome) to ritonavir or any excipient
- Co-administration with drugs highly dependent on CYP3A for clearance with potential for serious or life-threatening reactions: alfuzosin, ranolazine, amiodarone, dronedarone, flecainide, propafenone, quinidine, voriconazole, colchicine (renal/hepatic impairment), lurasidone, pimozide, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, lomitapide, sildenafil (Revatio for PAH), triazolam, oral midazolam
- Co-administration with potent CYP3A inducers associated with potential loss of virologic response: apalutamide, St. John's Wort (hypericum perforatum)
- Alfuzosin co-administration
- Carbamazepine, phenobarbital, or phenytoin co-administration
- Colchicine in patients with renal and/or hepatic impairment
- Rifampin co-administration
- Lurasidone or pimozide co-administration
- Dronedarone, ivabradine, or ranolazine co-administration
- Ergot derivatives (dihydroergotamine, ergotamine, methylergonovine) co-administration
- St. John's wort co-administration
- Elbasvir/grazoprevir co-administration
- Lomitapide, lovastatin, or simvastatin co-administration
- Naloxegol co-administration
- Sildenafil when used for pulmonary arterial hypertension
- Orally administered midazolam or triazolam co-administration
Adverse Reactions
Most common (>=1%) Diarrhea, nausea, vomiting, abdominal pain, paresthesia (including oral), rash, fatigue/asthenia, dysgeusia, coughing, arthralgia, back pain, dizziness, pruritus, myalgia, flushing, hypertriglyceridemia, peripheral neuropathy, oropharyngeal pain
Serious Hepatotoxicity, pancreatitis, allergic reactions/hypersensitivity
Postmarketing Dehydration, AV block (first-, second-, third-degree), right bundle branch block, Cushing's syndrome, adrenal suppression, seizure, nephrolithiasis, toxic epidermal necrolysis
Most common (>=2%) Diarrhea, rash, nausea, fatigue, headache, abdominal discomfort, flatulence
Serious Severe acute exacerbations of hepatitis B, hepatotoxicity, severe skin reactions, immune reconstitution syndrome, new onset or worsening renal impairment, lactic acidosis/severe hepatomegaly with steatosis
Postmarketing Redistribution of body fat, rhabdomyolysis, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, acute renal failure, acute tubular necrosis, proximal renal tubulopathy, Fanconi syndrome, crystal nephropathy, crystalluria
Pharmacology
Ritonavir is a peptidomimetic inhibitor of the HIV-1 protease that renders the enzyme incapable of processing the Gag-Pol polyprotein precursor, leading to production of non-infectious immature HIV particles; it also potently inhibits CYP3A and, to a lesser extent, CYP2D6, significantly affecting plasma concentrations of many co-administered drugs.
Symtuza is a fixed-dose combination containing darunavir (an HIV-1 protease inhibitor that prevents cleavage of Gag-Pol polyproteins), cobicistat (a CYP3A inhibitor that enhances darunavir exposure), emtricitabine (an NRTI that inhibits HIV reverse transcriptase through chain termination), and tenofovir alafenamide (an NRTI prodrug converted to tenofovir diphosphate that inhibits HIV reverse transcriptase).
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Norvir
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Symtuza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Norvir
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (1/8)
Symtuza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Norvir
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (2/3)
Symtuza
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.