Drug interactions
Cilostazol + Cobicistat
Severity: Major
Cilostazol 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 raises cilostazol exposure, increasing risks of headache, tachycardia, palpitations and diarrhea. Cilostazol is contraindicated in heart failure, so excess exposure matters.
What this interaction means in plain words
Cilostazol 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.
Cilostazol belongs to Cardiovascular; Cobicistat belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4-mediated cilostazol metabolism by cobicistat.
What to do
Reduce cilostazol to 50 mg twice daily during co-administration. Monitor for tachycardia, palpitations, headache and signs of heart failure.
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 Cilostazol
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 Cilostazol with Cobicistat?
MediHelp rates the interaction as major. Cilostazol 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 cilostazol exposure, increasing risks of headache, tachycardia, palpitations and diarrhea. Cilostazol is contraindicated in heart failure, so excess exposure matters.
How serious is the interaction between Cilostazol 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: Reduce cilostazol to 50 mg twice daily during co-administration. Monitor for tachycardia, palpitations, headache and signs of heart failure.
What other medicines interact with Cilostazol?
MediHelp also lists interactions of Cilostazol with, for example, Abrocitinib, Anagrelide, Betrixaban. The full list is on the Cilostazol page.
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