Drug interactions
Cobicistat + Everolimus
Severity: Major
Cobicistat and Everolimus: major interaction.
Last updated Sources: US FDA label
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 and P-gp inhibitor and can markedly increase everolimus concentrations. This increases the risk of toxicity such as stomatitis, myelosuppression, infection, hyperglycemia and pneumonitis.
What this interaction means in plain words
Cobicistat and Everolimus 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; Everolimus belongs to Oncology.
Why it happens
Inhibition of CYP3A4 and P-gp by cobicistat, reducing everolimus clearance.
What to do
Avoid the combination where possible and use a regimen without a booster. If unavoidable, reduce the everolimus dose and monitor trough concentrations and toxicity.
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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References
Other interactions of Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine 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 Everolimus?
MediHelp rates the interaction as major. Cobicistat and Everolimus 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 is a strong CYP3A4 and P-gp inhibitor and can markedly increase everolimus concentrations. This increases the risk of toxicity such as stomatitis, myelosuppression, infection, hyperglycemia and pneumonitis.
How serious is the interaction between Cobicistat and Everolimus?
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 where possible and use a regimen without a booster. If unavoidable, reduce the everolimus dose and monitor trough concentrations and toxicity.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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