Drug interactions
Avanafil + Cobicistat
Severity: Major
Avanafil and Cobicistat: major interaction.
Last updated Sources: US FDA label
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 CYP3A inhibitor that can markedly increase avanafil exposure. This may cause severe hypotension, syncope, visual disturbance and prolonged erection.
What this interaction means in plain words
Avanafil 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.
Avanafil belongs to Genitourinary; Cobicistat belongs to Miscellaneous.
Why it happens
Cobicistat inhibits CYP3A4, greatly reducing avanafil clearance.
What to do
Avoid avanafil with cobicistat; use a PDE5 inhibitor with a defined reduced dose, such as sildenafil or tadalafil at labeled low doses, if needed.
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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References
Other interactions of Avanafil
- Amyl nitrite + Avanafil Contraindicated
- Atazanavir + Avanafil Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Avanafil + Conivaptan Contraindicated
- Avanafil + Darunavir Contraindicated
- Avanafil + Fosamprenavir 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 Avanafil with Cobicistat?
MediHelp rates the interaction as major. Avanafil 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 CYP3A inhibitor that can markedly increase avanafil exposure. This may cause severe hypotension, syncope, visual disturbance and prolonged erection.
How serious is the interaction between Avanafil 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 avanafil with cobicistat; use a PDE5 inhibitor with a defined reduced dose, such as sildenafil or tadalafil at labeled low doses, if needed.
What other medicines interact with Avanafil?
MediHelp also lists interactions of Avanafil with, for example, Amyl nitrite, Atazanavir, Clarithromycin. The full list is on the Avanafil page.
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