Drug interactions
Cobicistat + Simvastatin
Severity: Contraindicated
Cobicistat and Simvastatin: 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 is a strong CYP3A inhibitor and greatly increases simvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Labeling contraindicates the combination.
What this interaction means in plain words
Cobicistat and Simvastatin 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; Simvastatin belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated simvastatin metabolism by cobicistat.
What to do
Do not combine; use an alternative statin such as pravastatin or low-dose rosuvastatin. Stop simvastatin before starting cobicistat.
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 Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
- Darunavir + Simvastatin 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 Simvastatin?
MediHelp rates the interaction as contraindicated. Cobicistat and Simvastatin 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 is a strong CYP3A inhibitor and greatly increases simvastatin exposure, raising the risk of myopathy and rhabdomyolysis. Labeling contraindicates the combination.
How serious is the interaction between Cobicistat and Simvastatin?
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 combine; use an alternative statin such as pravastatin or low-dose rosuvastatin. Stop simvastatin before starting cobicistat.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cyclosporine. The full list is on the Simvastatin page.
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