Drug interactions
Cobicistat + Nevirapine
Severity: Major
Cobicistat and Nevirapine: 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
Nevirapine induces CYP3A4 and can lower cobicistat and co-administered protease inhibitor exposure, risking loss of virologic response. Cobicistat may also raise nevirapine levels.
What this interaction means in plain words
Cobicistat and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Opposing CYP3A4 effects: nevirapine induction lowers cobicistat, while cobicistat inhibition raises nevirapine.
What to do
Avoid the combination, especially with atazanavir/cobicistat; choose a regimen without a boosted protease inhibitor alongside nevirapine.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine 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 Nevirapine?
MediHelp rates the interaction as major. Cobicistat and Nevirapine 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. Nevirapine induces CYP3A4 and can lower cobicistat and co-administered protease inhibitor exposure, risking loss of virologic response. Cobicistat may also raise nevirapine levels.
How serious is the interaction between Cobicistat and Nevirapine?
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 the combination, especially with atazanavir/cobicistat; choose a regimen without a boosted protease inhibitor alongside nevirapine.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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