Drug interactions
Amiodarone + Cobicistat
Severity: Major
Amiodarone and Cobicistat: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cobicistat is a potent CYP3A4 and CYP2D6 inhibitor and may substantially raise amiodarone concentrations. This increases the risk of bradycardia, QT prolongation and torsades de pointes.
What this interaction means in plain words
Amiodarone and Cobicistat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Cobicistat belongs to Miscellaneous.
Why it happens
Cobicistat inhibits CYP3A4 (and CYP2D6), reducing amiodarone metabolism.
What to do
Avoid if possible or monitor ECG and amiodarone levels closely. Choose an alternative booster or antiarrhythmic where feasible.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Cobicistat
- Alfuzosin + Cobicistat Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Cobicistat + Colchicine Contraindicated
- Cobicistat + Dronedarone Contraindicated
- Cobicistat + Eletriptan Contraindicated
- Cobicistat + Eplerenone Contraindicated
Frequently asked questions
Can I take Amiodarone with Cobicistat?
MediHelp rates the interaction as major. Amiodarone and Cobicistat can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cobicistat is a potent CYP3A4 and CYP2D6 inhibitor and may substantially raise amiodarone concentrations. This increases the risk of bradycardia, QT prolongation and torsades de pointes.
How serious is the interaction between Amiodarone and Cobicistat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible or monitor ECG and amiodarone levels closely. Choose an alternative booster or antiarrhythmic where feasible.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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