Drug interactions
Cobicistat + Ergotamine
Severity: Contraindicated
Cobicistat and Ergotamine: contraindicated 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 strongly inhibits CYP3A4 and can sharply raise ergotamine concentrations. This can precipitate acute ergotism with severe peripheral vasospasm and ischemia of the limbs, brain or heart.
What this interaction means in plain words
Cobicistat and Ergotamine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Cobicistat belongs to Miscellaneous; Ergotamine belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated ergotamine metabolism.
What to do
Do not co-administer. Use a non-ergot migraine therapy during treatment with cobicistat.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ergotamine
- Almotriptan + Ergotamine Contraindicated
- Atazanavir + Ergotamine Contraindicated
- Clarithromycin + Ergotamine Contraindicated
- Darunavir + Ergotamine Contraindicated
- Dihydroergotamine intranasal + Ergotamine Contraindicated
- Dihydroergotamine + Ergotamine 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 Ergotamine?
MediHelp rates the interaction as contraindicated. Cobicistat and Ergotamine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cobicistat strongly inhibits CYP3A4 and can sharply raise ergotamine concentrations. This can precipitate acute ergotism with severe peripheral vasospasm and ischemia of the limbs, brain or heart.
How serious is the interaction between Cobicistat and Ergotamine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer. Use a non-ergot migraine therapy during treatment with cobicistat.
What other medicines interact with Ergotamine?
MediHelp also lists interactions of Ergotamine with, for example, Almotriptan, Atazanavir, Clarithromycin. The full list is on the Ergotamine page.
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