Drug interactions
Cobicistat + Formoterol-mometasone
Severity: Major
Cobicistat and Formoterol-mometasone: 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 inhibitor and markedly raises mometasone exposure, including the small fraction absorbed from the lungs and swallowed. This can produce systemic corticosteroid effects such as Cushing's syndrome and adrenal suppression, particularly with long-term use.
What this interaction means in plain words
Cobicistat and Formoterol-mometasone 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; Formoterol-mometasone belongs to Respiratory.
Why it happens
Inhibition of CYP3A4-mediated metabolism of mometasone, increasing systemic exposure.
What to do
Avoid long-term combination where possible and consider an alternative corticosteroid with less CYP3A4 dependence, such as beclomethasone. If combined, monitor for Cushingoid features and adrenal suppression.
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 Formoterol-mometasone
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 Formoterol-mometasone?
MediHelp rates the interaction as major. Cobicistat and Formoterol-mometasone 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 inhibitor and markedly raises mometasone exposure, including the small fraction absorbed from the lungs and swallowed. This can produce systemic corticosteroid effects such as Cushing's syndrome and adrenal suppression, particularly with long-term use.
How serious is the interaction between Cobicistat and Formoterol-mometasone?
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 long-term combination where possible and consider an alternative corticosteroid with less CYP3A4 dependence, such as beclomethasone. If combined, monitor for Cushingoid features and adrenal suppression.
What other medicines interact with Formoterol-mometasone?
MediHelp also lists interactions of Formoterol-mometasone with, for example, Amiodarone, Amisulpride, Amoxapine. The full list is on the Formoterol-mometasone page.
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