Drug interactions
Cobicistat + Nifedipine
Severity: Major
Cobicistat and Nifedipine: 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 CYP3A4 inhibitor and markedly increases nifedipine exposure. This can cause pronounced hypotension, edema, and reflex tachycardia.
What this interaction means in plain words
Cobicistat and Nifedipine 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; Nifedipine belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4, reducing first-pass and systemic metabolism of nifedipine.
What to do
Start with a low nifedipine dose and titrate by blood pressure response, or consider an alternative antihypertensive. Monitor blood pressure and heart rate closely.
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 Nifedipine
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 Nifedipine?
MediHelp rates the interaction as major. Cobicistat and Nifedipine 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 markedly increases nifedipine exposure. This can cause pronounced hypotension, edema, and reflex tachycardia.
How serious is the interaction between Cobicistat and Nifedipine?
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 with a low nifedipine dose and titrate by blood pressure response, or consider an alternative antihypertensive. Monitor blood pressure and heart rate closely.
What other medicines interact with Nifedipine?
MediHelp also lists interactions of Nifedipine with, for example, Amifostine, Amlodipine-benazepril, Apalutamide. The full list is on the Nifedipine page.
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