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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.

Evidence level: Moderate

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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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.

Full monographs, dosing and an interaction checker in the MediHelp app

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