Drug interactions
Cobicistat + Pravastatin
Severity: Moderate
Cobicistat and Pravastatin: 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
Pravastatin is not significantly metabolised by CYP3A4, so the CYP3A4 explanation is not the main concern. Cobicistat inhibits transporters including OATP1B1 and may modestly raise pravastatin exposure. The effect is usually manageable and not a contraindication.
What this interaction means in plain words
Cobicistat and Pravastatin 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; Pravastatin belongs to Cardiovascular.
Why it happens
Cobicistat inhibits hepatic uptake transporters such as OATP1B1, modestly increasing pravastatin exposure.
What to do
Start with the lowest pravastatin dose and titrate according to response and tolerability. Monitor for muscle symptoms.
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 Pravastatin
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 Pravastatin?
MediHelp rates the interaction as moderate. Cobicistat and Pravastatin 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. Pravastatin is not significantly metabolised by CYP3A4, so the CYP3A4 explanation is not the main concern. Cobicistat inhibits transporters including OATP1B1 and may modestly raise pravastatin exposure. The effect is usually manageable and not a contraindication.
How serious is the interaction between Cobicistat and Pravastatin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with the lowest pravastatin dose and titrate according to response and tolerability. Monitor for muscle symptoms.
What other medicines interact with Pravastatin?
MediHelp also lists interactions of Pravastatin with, for example, Cyclosporin, Gemfibrozil, Ombitasvir / paritaprevir / ritonavir and dasabuvir. The full list is on the Pravastatin page.
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