Drug interactions
Cobicistat + Enzalutamide
Severity: Major
Cobicistat and Enzalutamide: 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 inhibits CYP3A4 and may increase enzalutamide exposure, raising the risk of dose-related adverse effects including seizures. Enzalutamide may also lower concentrations of cobicistat and its boosted antiretrovirals, risking virologic failure.
What this interaction means in plain words
Cobicistat and Enzalutamide 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; Enzalutamide belongs to Endocrine.
Why it happens
Cobicistat inhibits CYP3A4 while enzalutamide induces it, giving opposing and unpredictable pharmacokinetic effects.
What to do
Avoid the combination; use a non-boosted antiretroviral regimen without CYP3A interaction. If unavoidable, reduce the enzalutamide dose and monitor HIV viral load and adverse effects.
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 Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir 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 Enzalutamide?
MediHelp rates the interaction as major. Cobicistat and Enzalutamide 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 CYP3A4 and may increase enzalutamide exposure, raising the risk of dose-related adverse effects including seizures. Enzalutamide may also lower concentrations of cobicistat and its boosted antiretrovirals, risking virologic failure.
How serious is the interaction between Cobicistat and Enzalutamide?
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; use a non-boosted antiretroviral regimen without CYP3A interaction. If unavoidable, reduce the enzalutamide dose and monitor HIV viral load and adverse effects.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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