Drug interactions
Cobicistat + Rimegepant
Severity: Major
Cobicistat and Rimegepant: 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 also inhibits P-glycoprotein, so it can considerably increase rimegepant exposure. This raises the risk of rimegepant adverse effects.
What this interaction means in plain words
Cobicistat and Rimegepant 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; Rimegepant belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces rimegepant clearance.
What to do
Avoid concomitant use. Choose an alternative acute migraine treatment.
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 Rimegepant
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 Rimegepant?
MediHelp rates the interaction as major. Cobicistat and Rimegepant 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 also inhibits P-glycoprotein, so it can considerably increase rimegepant exposure. This raises the risk of rimegepant adverse effects.
How serious is the interaction between Cobicistat and Rimegepant?
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 concomitant use. Choose an alternative acute migraine treatment.
What other medicines interact with Rimegepant?
MediHelp also lists interactions of Rimegepant with, for example, Amobarbital, Atazanavir, Butabarbital. The full list is on the Rimegepant page.
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