Drug interactions
Cobicistat + Desipramine
Severity: Moderate
Cobicistat and Desipramine: 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 inhibits CYP2D6 and CYP3A4, which can raise desipramine concentrations. Higher levels increase the risk of anticholinergic effects, sedation and cardiac conduction abnormalities.
What this interaction means in plain words
Cobicistat and Desipramine 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 belongs to Miscellaneous; Desipramine belongs to Central Nervous System.
Why it happens
Cobicistat inhibition of CYP2D6-mediated desipramine metabolism.
What to do
Start desipramine at a low dose and titrate to response, monitoring for toxicity. Consider an ECG and drug levels with higher doses.
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 Desipramine
- Desipramine + Disopyramide Contraindicated
- Desipramine + Dofetilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Desipramine + Isocarboxazid Contraindicated
- Desipramine + Methylene blue Contraindicated
- Desipramine + Pentamidine 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 Cobicistat with Desipramine?
MediHelp rates the interaction as moderate. Cobicistat and Desipramine 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 inhibits CYP2D6 and CYP3A4, which can raise desipramine concentrations. Higher levels increase the risk of anticholinergic effects, sedation and cardiac conduction abnormalities.
How serious is the interaction between Cobicistat and Desipramine?
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 desipramine at a low dose and titrate to response, monitoring for toxicity. Consider an ECG and drug levels with higher doses.
What other medicines interact with Desipramine?
MediHelp also lists interactions of Desipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Desipramine page.
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