Drug interactions
Amlodipine-atorvastatin + Cobicistat
Severity: Major
Amlodipine-atorvastatin 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 strong CYP3A4 inhibitor and also inhibits OATP1B1/1B3 and P-gp. It can substantially increase exposure to amlodipine and atorvastatin, raising risks of hypotension, edema and statin myopathy.
What this interaction means in plain words
Amlodipine-atorvastatin 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.
Amlodipine-atorvastatin belongs to Cardiovascular; Cobicistat belongs to Miscellaneous.
Why it happens
Strong CYP3A4 and transporter inhibition by cobicistat reduces clearance of both amlodipine and atorvastatin.
What to do
Use a lower amlodipine dose with blood pressure monitoring, and limit atorvastatin to the lowest effective dose per labeling, or choose a statin with less interaction such as rosuvastatin or pravastatin at low dose.
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 Amlodipine-atorvastatin
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 Amlodipine-atorvastatin with Cobicistat?
MediHelp rates the interaction as major. Amlodipine-atorvastatin 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 strong CYP3A4 inhibitor and also inhibits OATP1B1/1B3 and P-gp. It can substantially increase exposure to amlodipine and atorvastatin, raising risks of hypotension, edema and statin myopathy.
How serious is the interaction between Amlodipine-atorvastatin 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: Use a lower amlodipine dose with blood pressure monitoring, and limit atorvastatin to the lowest effective dose per labeling, or choose a statin with less interaction such as rosuvastatin or pravastatin at low dose.
What other medicines interact with Amlodipine-atorvastatin?
MediHelp also lists interactions of Amlodipine-atorvastatin with, for example, Amifostine, Apalutamide, Atazanavir. The full list is on the Amlodipine-atorvastatin page.
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