Drug interactions
Cobicistat + Drospirenone
Severity: Moderate
Cobicistat and Drospirenone: 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 can raise drospirenone exposure. Higher drospirenone levels increase its potassium-sparing anti-mineralocorticoid effect and the risk of hyperkalemia, especially in patients with renal impairment or on other potassium-raising drugs.
What this interaction means in plain words
Cobicistat and Drospirenone 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; Drospirenone belongs to Endocrine.
Why it happens
Cobicistat inhibits CYP3A4, reducing the metabolism of drospirenone.
What to do
Monitor serum potassium during the first cycle of combined use, particularly in patients taking other potassium-raising drugs. Consider an alternative contraceptive method if hyperkalemia risk factors 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 Drospirenone
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 Drospirenone?
MediHelp rates the interaction as moderate. Cobicistat and Drospirenone 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 can raise drospirenone exposure. Higher drospirenone levels increase its potassium-sparing anti-mineralocorticoid effect and the risk of hyperkalemia, especially in patients with renal impairment or on other potassium-raising drugs.
How serious is the interaction between Cobicistat and Drospirenone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium during the first cycle of combined use, particularly in patients taking other potassium-raising drugs. Consider an alternative contraceptive method if hyperkalemia risk factors are present.
What other medicines interact with Drospirenone?
MediHelp also lists interactions of Drospirenone with, for example, Belzutifan, Bosentan, Carbamazepine. The full list is on the Drospirenone page.
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