Drug interactions
Cobicistat + Sunitinib
Severity: Major
Cobicistat and Sunitinib: 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 CYP3A4 inhibitor and can substantially raise sunitinib and its active metabolite levels, increasing toxicities such as hepatotoxicity, QT prolongation and myelosuppression.
What this interaction means in plain words
Cobicistat and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
Cobicistat inhibits CYP3A4, reducing sunitinib metabolism.
What to do
Avoid if possible; otherwise lower the sunitinib dose per labeling for strong CYP3A4 inhibitors and monitor for toxicity.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib Major
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 Sunitinib?
MediHelp rates the interaction as major. Cobicistat and Sunitinib 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 can substantially raise sunitinib and its active metabolite levels, increasing toxicities such as hepatotoxicity, QT prolongation and myelosuppression.
How serious is the interaction between Cobicistat and Sunitinib?
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 if possible; otherwise lower the sunitinib dose per labeling for strong CYP3A4 inhibitors and monitor for toxicity.
What other medicines interact with Sunitinib?
MediHelp also lists interactions of Sunitinib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Sunitinib page.
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