Drug interactions
Citalopram + Cobicistat
Severity: Moderate
Citalopram and Cobicistat: moderate 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 also inhibits CYP2D6, which may raise citalopram concentrations. Higher exposure increases the risk of serotonergic adverse effects and QT prolongation.
What this interaction means in plain words
Citalopram and Cobicistat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Citalopram belongs to Central Nervous System; Cobicistat belongs to Miscellaneous.
Why it happens
Cobicistat inhibits CYP3A4 and CYP2D6, reducing citalopram metabolism.
What to do
Start citalopram at the lowest dose and titrate slowly while monitoring response and tolerability. Consider an ECG if the dose is raised or other QT-prolonging drugs are present.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine 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 Citalopram with Cobicistat?
MediHelp rates the interaction as moderate. Citalopram and Cobicistat can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat is a strong CYP3A4 inhibitor and also inhibits CYP2D6, which may raise citalopram concentrations. Higher exposure increases the risk of serotonergic adverse effects and QT prolongation.
How serious is the interaction between Citalopram and Cobicistat?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start citalopram at the lowest dose and titrate slowly while monitoring response and tolerability. Consider an ECG if the dose is raised or other QT-prolonging drugs are present.
What other medicines interact with Citalopram?
MediHelp also lists interactions of Citalopram with, for example, Cisapride, Dronedarone, Escitalopram. The full list is on the Citalopram page.
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