Drug interactions
Chlordiazepoxide + Cobicistat
Severity: Major
Chlordiazepoxide 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 can raise chlordiazepoxide concentrations, causing prolonged sedation and possible respiratory depression. Benzodiazepines cleared by CYP3A4 are cautioned with boosted antiretroviral regimens.
What this interaction means in plain words
Chlordiazepoxide 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.
Chlordiazepoxide belongs to Central Nervous System; Cobicistat belongs to Miscellaneous.
Why it happens
Strong inhibition of CYP3A4-mediated metabolism of chlordiazepoxide by cobicistat.
What to do
Use a lower chlordiazepoxide dose with careful monitoring for oversedation, or choose a benzodiazepine less dependent on CYP3A4 such as lorazepam.
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 Chlordiazepoxide
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 Chlordiazepoxide with Cobicistat?
MediHelp rates the interaction as major. Chlordiazepoxide 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 can raise chlordiazepoxide concentrations, causing prolonged sedation and possible respiratory depression. Benzodiazepines cleared by CYP3A4 are cautioned with boosted antiretroviral regimens.
How serious is the interaction between Chlordiazepoxide 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 chlordiazepoxide dose with careful monitoring for oversedation, or choose a benzodiazepine less dependent on CYP3A4 such as lorazepam.
What other medicines interact with Chlordiazepoxide?
MediHelp also lists interactions of Chlordiazepoxide with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide page.
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