Drug interactions
Cobicistat + Nicardipine
Severity: Major
Cobicistat and Nicardipine: major 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 CYP3A inhibitor and can substantially increase nicardipine exposure. This may cause pronounced hypotension, tachycardia and edema, and PR prolongation is possible with some calcium channel blockers.
What this interaction means in plain words
Cobicistat and Nicardipine 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; Nicardipine belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4, reducing nicardipine metabolism.
What to do
Start nicardipine at a low dose with careful titration and monitor blood pressure, heart rate and ECG. Consider an alternative antihypertensive 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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Other interactions of Nicardipine
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 Nicardipine?
MediHelp rates the interaction as major. Cobicistat and Nicardipine 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 CYP3A inhibitor and can substantially increase nicardipine exposure. This may cause pronounced hypotension, tachycardia and edema, and PR prolongation is possible with some calcium channel blockers.
How serious is the interaction between Cobicistat and Nicardipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start nicardipine at a low dose with careful titration and monitor blood pressure, heart rate and ECG. Consider an alternative antihypertensive less dependent on CYP3A4.
What other medicines interact with Nicardipine?
MediHelp also lists interactions of Nicardipine with, for example, Amifostine, Amlodipine-olmesartan-hydrochlorothiazide, Betrixaban. The full list is on the Nicardipine page.
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