Drug interactions
Cobicistat + Dabigatran etexilate
Severity: Major
Cobicistat and Dabigatran etexilate: 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 inhibits P-glycoprotein and increases dabigatran exposure, raising the risk of bleeding, especially with renal impairment.
What this interaction means in plain words
Cobicistat and Dabigatran etexilate 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 belongs to Miscellaneous; Dabigatran etexilate belongs to Cardiovascular.
Why it happens
Inhibition of intestinal P-glycoprotein efflux of dabigatran etexilate.
What to do
Avoid the combination in patients with reduced renal function; otherwise monitor for bleeding and consider dabigatran dose reduction per labeling.
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 Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate Major
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 Cobicistat with Dabigatran etexilate?
MediHelp rates the interaction as major. Cobicistat and Dabigatran etexilate 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 inhibits P-glycoprotein and increases dabigatran exposure, raising the risk of bleeding, especially with renal impairment.
How serious is the interaction between Cobicistat and Dabigatran etexilate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in patients with reduced renal function; otherwise monitor for bleeding and consider dabigatran dose reduction per labeling.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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