Drug interactions
Cobicistat + Lidocaine
Severity: Moderate
Cobicistat and Lidocaine: 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 is a strong CYP3A4 inhibitor and can raise systemic lidocaine concentrations. This increases the risk of lidocaine toxicity, including CNS effects and cardiac arrhythmias, especially with systemic dosing.
What this interaction means in plain words
Cobicistat and Lidocaine 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; Lidocaine belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4, reducing lidocaine metabolism.
What to do
Monitor ECG and for signs of lidocaine toxicity when given systemically or in large doses; consider dose reduction and serum level monitoring. Single local anesthetic doses are generally tolerated.
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 Lidocaine
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide Major
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?
MediHelp rates the interaction as moderate. Cobicistat and Lidocaine 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 is a strong CYP3A4 inhibitor and can raise systemic lidocaine concentrations. This increases the risk of lidocaine toxicity, including CNS effects and cardiac arrhythmias, especially with systemic dosing.
How serious is the interaction between Cobicistat and Lidocaine?
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 ECG and for signs of lidocaine toxicity when given systemically or in large doses; consider dose reduction and serum level monitoring. Single local anesthetic doses are generally tolerated.
What other medicines interact with Lidocaine?
MediHelp also lists interactions of Lidocaine with, for example, Bupivacaine liposome, Disopyramide, Ex vivo expanded autologous human corneal epithelial cells containing stem cells. The full list is on the Lidocaine page.
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