Drug interactions
Cobicistat + Ranolazine
Severity: Contraindicated
Cobicistat and Ranolazine: contraindicated 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 strongly inhibits CYP3A4 and markedly raises ranolazine concentrations. This increases dose-related QT prolongation and other adverse effects, and strong CYP3A inhibitors are contraindicated with ranolazine.
What this interaction means in plain words
Cobicistat and Ranolazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Cobicistat belongs to Miscellaneous; Ranolazine belongs to Cardiovascular.
Why it happens
Potent CYP3A4 inhibition by cobicistat reduces ranolazine clearance.
What to do
Do not use together. Use an alternative antianginal for patients who need a cobicistat-boosted regimen.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine?
MediHelp rates the interaction as contraindicated. Cobicistat and Ranolazine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Cobicistat strongly inhibits CYP3A4 and markedly raises ranolazine concentrations. This increases dose-related QT prolongation and other adverse effects, and strong CYP3A inhibitors are contraindicated with ranolazine.
How serious is the interaction between Cobicistat and Ranolazine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together. Use an alternative antianginal for patients who need a cobicistat-boosted regimen.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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