Drug interactions
Cobicistat + Nimodipine
Severity: Major
Cobicistat and Nimodipine: 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 markedly increases exposure to CYP3A4 substrates such as nimodipine. This may cause profound hypotension, which is particularly hazardous in patients with subarachnoid hemorrhage.
What this interaction means in plain words
Cobicistat and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4, greatly decreasing nimodipine metabolism.
What to do
Avoid the combination where possible. If unavoidable, monitor blood pressure frequently and consider splitting or reducing the nimodipine dose.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cobicistat and Nimodipine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Darunavir + Nimodipine Major
- Duvelisib + Nimodipine 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 Nimodipine?
MediHelp rates the interaction as major. Cobicistat and Nimodipine 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 markedly increases exposure to CYP3A4 substrates such as nimodipine. This may cause profound hypotension, which is particularly hazardous in patients with subarachnoid hemorrhage.
How serious is the interaction between Cobicistat and Nimodipine?
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 where possible. If unavoidable, monitor blood pressure frequently and consider splitting or reducing the nimodipine dose.
What other medicines interact with Nimodipine?
MediHelp also lists interactions of Nimodipine with, for example, Apalutamide, Carbamazepine, Ceritinib. The full list is on the Nimodipine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
