Drug interactions
Cobicistat + Paroxetine
Severity: Moderate
Cobicistat and Paroxetine: 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 is a strong CYP3A4 and CYP2D6 inhibitor, and paroxetine is mainly cleared by CYP2D6. Paroxetine levels may rise, increasing adverse effects such as nausea, sedation and serotonergic toxicity.
What this interaction means in plain words
Cobicistat and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2D6 by cobicistat reduces paroxetine clearance.
What to do
Titrate paroxetine to clinical effect, starting with the lowest feasible dose. Monitor for adverse effects and reduce the dose if they occur.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
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 Paroxetine?
MediHelp rates the interaction as moderate. Cobicistat and Paroxetine 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 is a strong CYP3A4 and CYP2D6 inhibitor, and paroxetine is mainly cleared by CYP2D6. Paroxetine levels may rise, increasing adverse effects such as nausea, sedation and serotonergic toxicity.
How serious is the interaction between Cobicistat and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate paroxetine to clinical effect, starting with the lowest feasible dose. Monitor for adverse effects and reduce the dose if they occur.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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