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Drug interactions

Cobicistat + Lurasidone

Severity: Contraindicated

Cobicistat and Lurasidone: contraindicated 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 that can greatly raise lurasidone exposure. This increases the risk of serious adverse effects, including extrapyramidal symptoms, sedation and QT effects, and lurasidone labeling contraindicates strong CYP3A4 inhibitors.

What this interaction means in plain words

Cobicistat and Lurasidone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Cobicistat belongs to Miscellaneous; Lurasidone belongs to Central Nervous System.

Evidence level: High

Why it happens

Cobicistat strongly inhibits CYP3A4, markedly reducing lurasidone clearance.

What to do

Do not combine; choose an antipsychotic less dependent on CYP3A4 or an antiretroviral regimen without a booster.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Cobicistat with Lurasidone?

MediHelp rates the interaction as contraindicated. Cobicistat and Lurasidone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cobicistat is a strong CYP3A4 inhibitor that can greatly raise lurasidone exposure. This increases the risk of serious adverse effects, including extrapyramidal symptoms, sedation and QT effects, and lurasidone labeling contraindicates strong CYP3A4 inhibitors.

How serious is the interaction between Cobicistat and Lurasidone?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine; choose an antipsychotic less dependent on CYP3A4 or an antiretroviral regimen without a booster.

What other medicines interact with Lurasidone?

MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.

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