Drug interactions
Cobicistat + Escitalopram
Severity: Moderate
Cobicistat and Escitalopram: 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 CYP3A4 and CYP2D6 and may raise escitalopram exposure. Higher levels increase dose-related QT prolongation and serotonergic effects.
What this interaction means in plain words
Cobicistat and Escitalopram 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; Escitalopram belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 by cobicistat decreases escitalopram metabolism.
What to do
Start escitalopram at a low dose and titrate to effect without exceeding labeled maximum. Monitor for QT symptoms and serotonergic effects.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide 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 Escitalopram?
MediHelp rates the interaction as moderate. Cobicistat and Escitalopram 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 CYP3A4 and CYP2D6 and may raise escitalopram exposure. Higher levels increase dose-related QT prolongation and serotonergic effects.
How serious is the interaction between Cobicistat and Escitalopram?
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 escitalopram at a low dose and titrate to effect without exceeding labeled maximum. Monitor for QT symptoms and serotonergic effects.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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