Drug interactions
Cobicistat + Methylprednisolone
Severity: Major
Cobicistat and Methylprednisolone: 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 can substantially raise methylprednisolone concentrations. This increases the risk of Cushing's syndrome, adrenal suppression and other steroid toxicity, especially with prolonged use.
What this interaction means in plain words
Cobicistat and Methylprednisolone 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; Methylprednisolone belongs to Endocrine.
Why it happens
Potent inhibition of CYP3A4-mediated methylprednisolone metabolism by cobicistat.
What to do
Avoid long-term coadministration where possible, or reduce the methylprednisolone dose and monitor closely; consider prednisolone or other alternatives less dependent on CYP3A4.
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 Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella vaccine 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 Methylprednisolone?
MediHelp rates the interaction as major. Cobicistat and Methylprednisolone 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 can substantially raise methylprednisolone concentrations. This increases the risk of Cushing's syndrome, adrenal suppression and other steroid toxicity, especially with prolonged use.
How serious is the interaction between Cobicistat and Methylprednisolone?
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 coadministration where possible, or reduce the methylprednisolone dose and monitor closely; consider prednisolone or other alternatives less dependent on CYP3A4.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
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