Drug interactions
Cobicistat + Lidocaine-prilocaine
Severity: Minor
Cobicistat and Lidocaine-prilocaine: minor 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 may raise systemic lidocaine concentrations when topical lidocaine-prilocaine is applied. With limited skin areas and short use the effect is small, but large areas, broken skin or prolonged occlusion could allow systemic toxicity.
What this interaction means in plain words
Cobicistat and Lidocaine-prilocaine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Cobicistat belongs to Miscellaneous; Lidocaine-prilocaine belongs to Genitourinary.
Why it happens
Cobicistat inhibits CYP3A4-mediated hepatic and intestinal metabolism of lidocaine.
What to do
Apply the cream only to intact skin over a limited area for the shortest time needed. Watch for signs of lidocaine toxicity such as dizziness, perioral numbness or arrhythmia if large amounts are used.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Lidocaine-prilocaine
- Lidocaine-prilocaine + Phenazopyridine Major
- Bupivacaine implant + Lidocaine-prilocaine Moderate
- Bupivacaine liposome + Lidocaine-prilocaine Moderate
- Disopyramide + Lidocaine-prilocaine Moderate
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lidocaine-prilocaine Moderate
- Lidocaine-prilocaine + Mexiletine Moderate
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 Lidocaine-prilocaine?
MediHelp rates the interaction as minor. Cobicistat and Lidocaine-prilocaine have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Cobicistat strongly inhibits CYP3A4 and may raise systemic lidocaine concentrations when topical lidocaine-prilocaine is applied. With limited skin areas and short use the effect is small, but large areas, broken skin or prolonged occlusion could allow systemic toxicity.
How serious is the interaction between Cobicistat and Lidocaine-prilocaine?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Apply the cream only to intact skin over a limited area for the shortest time needed. Watch for signs of lidocaine toxicity such as dizziness, perioral numbness or arrhythmia if large amounts are used.
What other medicines interact with Lidocaine-prilocaine?
MediHelp also lists interactions of Lidocaine-prilocaine with, for example, Phenazopyridine, Bupivacaine implant, Bupivacaine liposome. The full list is on the Lidocaine-prilocaine page.
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