Drug interactions
Cobicistat + Metoprolol
Severity: Moderate
Cobicistat and Metoprolol: 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 inhibits CYP2D6, the main metabolic pathway of metoprolol, which raises metoprolol exposure. This can cause excessive bradycardia, hypotension and fatigue.
What this interaction means in plain words
Cobicistat and Metoprolol 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; Metoprolol belongs to Cardiovascular.
Why it happens
Inhibition of CYP2D6-mediated metoprolol metabolism increases plasma concentrations.
What to do
Monitor heart rate and blood pressure and reduce the metoprolol dose if bradycardia or hypotension develops. Consider a beta-blocker less dependent on CYP2D6 if needed.
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 Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol 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 Metoprolol?
MediHelp rates the interaction as moderate. Cobicistat and Metoprolol 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 inhibits CYP2D6, the main metabolic pathway of metoprolol, which raises metoprolol exposure. This can cause excessive bradycardia, hypotension and fatigue.
How serious is the interaction between Cobicistat and Metoprolol?
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 heart rate and blood pressure and reduce the metoprolol dose if bradycardia or hypotension develops. Consider a beta-blocker less dependent on CYP2D6 if needed.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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