Drug interactions
Cobicistat + Solifenacin
Severity: Major
Cobicistat and Solifenacin: major interaction.
Last updated Sources: US FDA label
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 substantially raises solifenacin exposure. This increases anticholinergic effects and the risk of QT prolongation.
What this interaction means in plain words
Cobicistat and Solifenacin 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; Solifenacin belongs to Genitourinary.
Why it happens
Inhibition of CYP3A4-mediated solifenacin metabolism by cobicistat.
What to do
Limit solifenacin to 5 mg daily with strong CYP3A4 inhibitors and monitor for anticholinergic toxicity and QT effects.
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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References
Other interactions of Solifenacin
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 Solifenacin?
MediHelp rates the interaction as major. Cobicistat and Solifenacin 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 CYP3A inhibitor and substantially raises solifenacin exposure. This increases anticholinergic effects and the risk of QT prolongation.
How serious is the interaction between Cobicistat and Solifenacin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit solifenacin to 5 mg daily with strong CYP3A4 inhibitors and monitor for anticholinergic toxicity and QT effects.
What other medicines interact with Solifenacin?
MediHelp also lists interactions of Solifenacin with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Solifenacin page.
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