Drug interactions
Cobicistat + Itraconazole
Severity: Moderate
Cobicistat and Itraconazole: 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
Both drugs are CYP3A4 inhibitors and substrates, so each can raise the other's concentrations. This increases the risk of itraconazole toxicity, including cardiac effects, and of cobicistat-related effects.
What this interaction means in plain words
Cobicistat and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Mutual inhibition of CYP3A4-mediated metabolism, and possibly P-gp.
What to do
Monitor for itraconazole toxicity and consider limiting the itraconazole dose per labeling of the cobicistat-containing product. Monitor itraconazole levels where available.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole?
MediHelp rates the interaction as moderate. Cobicistat and Itraconazole 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. Both drugs are CYP3A4 inhibitors and substrates, so each can raise the other's concentrations. This increases the risk of itraconazole toxicity, including cardiac effects, and of cobicistat-related effects.
How serious is the interaction between Cobicistat and Itraconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for itraconazole toxicity and consider limiting the itraconazole dose per labeling of the cobicistat-containing product. Monitor itraconazole levels where available.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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