Drug interactions
Amitriptyline + Cobicistat
Severity: Moderate
Amitriptyline and Cobicistat: moderate 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 inhibits CYP2D6 and CYP3A4, which can raise amitriptyline concentrations. Elevated tricyclic exposure increases the risk of anticholinergic effects, sedation, and cardiac conduction abnormalities.
What this interaction means in plain words
Amitriptyline and Cobicistat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Cobicistat belongs to Miscellaneous.
Why it happens
Inhibition of CYP2D6 and CYP3A4 metabolism of amitriptyline.
What to do
Start amitriptyline at a low dose and titrate to response, monitoring for toxicity. Consider an ECG or tricyclic levels in higher-risk patients.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide 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 Amitriptyline with Cobicistat?
MediHelp rates the interaction as moderate. Amitriptyline and Cobicistat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat inhibits CYP2D6 and CYP3A4, which can raise amitriptyline concentrations. Elevated tricyclic exposure increases the risk of anticholinergic effects, sedation, and cardiac conduction abnormalities.
How serious is the interaction between Amitriptyline and Cobicistat?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start amitriptyline at a low dose and titrate to response, monitoring for toxicity. Consider an ECG or tricyclic levels in higher-risk patients.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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