Drug interactions
Buspirone + Cobicistat
Severity: Major
Buspirone 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 CYP3A4 inhibitor that markedly increases buspirone exposure. This can cause dizziness, drowsiness, nausea and headache, and possibly serotonergic effects.
What this interaction means in plain words
Buspirone 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.
Buspirone belongs to Central Nervous System; Cobicistat belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4-mediated first-pass and hepatic metabolism of buspirone by cobicistat.
What to do
Start buspirone at a low dose and titrate based on response, reducing the dose substantially during cobicistat therapy. Monitor for excessive sedation and adverse effects.
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 Buspirone
- Buspirone + Isocarboxazid Contraindicated
- Buspirone + Linezolid Contraindicated
- Buspirone + Phenelzine Contraindicated
- Buspirone + Procarbazine Contraindicated
- Buspirone + Selegiline Contraindicated
- Buspirone + Selegiline transdermal 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 Buspirone with Cobicistat?
MediHelp rates the interaction as major. Buspirone 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 that markedly increases buspirone exposure. This can cause dizziness, drowsiness, nausea and headache, and possibly serotonergic effects.
How serious is the interaction between Buspirone 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: Start buspirone at a low dose and titrate based on response, reducing the dose substantially during cobicistat therapy. Monitor for excessive sedation and adverse effects.
What other medicines interact with Buspirone?
MediHelp also lists interactions of Buspirone with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Buspirone page.
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