Drug interactions
Cariprazine + Cobicistat
Severity: Major
Cariprazine 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 and raises cariprazine and its active metabolites. This increases the risk of akathisia, parkinsonism, sedation and other dose-related effects.
What this interaction means in plain words
Cariprazine 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.
Cariprazine belongs to Central Nervous System; Cobicistat belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4-mediated cariprazine metabolism by cobicistat.
What to do
Halve the cariprazine dose when starting a strong CYP3A4 inhibitor (every other day dosing if on 1.5 mg), and monitor for adverse effects for several weeks. Increase back to the usual dose after the inhibitor is stopped.
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 Cariprazine
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 Cariprazine with Cobicistat?
MediHelp rates the interaction as major. Cariprazine 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 raises cariprazine and its active metabolites. This increases the risk of akathisia, parkinsonism, sedation and other dose-related effects.
How serious is the interaction between Cariprazine 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: Halve the cariprazine dose when starting a strong CYP3A4 inhibitor (every other day dosing if on 1.5 mg), and monitor for adverse effects for several weeks. Increase back to the usual dose after the inhibitor is stopped.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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