Drug interactions
Cobicistat + Temsirolimus
Severity: Major
Cobicistat and Temsirolimus: 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 potent CYP3A4 inhibitor and can raise exposure to temsirolimus and its active metabolite sirolimus. Higher exposure may increase mucositis, myelosuppression, hyperglycemia, hyperlipidemia, infection and pneumonitis risk.
What this interaction means in plain words
Cobicistat and Temsirolimus 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; Temsirolimus belongs to Oncology.
Why it happens
Cobicistat inhibits CYP3A4 (and P-gp), reducing the metabolism of temsirolimus and sirolimus.
What to do
Prefer an alternative to cobicistat-boosted regimens; if unavoidable, reduce the temsirolimus dose per labeling for strong CYP3A4 inhibitors and monitor for toxicity. After stopping cobicistat, allow about a week before returning to the usual temsirolimus dose.
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 Temsirolimus
- Bcg vaccine live + Temsirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Temsirolimus Contraindicated
- Measles mumps and rubella vaccine live + Temsirolimus Contraindicated
- Measles mumps rubella and varicella vaccine live + Temsirolimus Contraindicated
- Measles vaccine + Temsirolimus Contraindicated
- Rotavirus oral vaccine live + Temsirolimus 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 Temsirolimus?
MediHelp rates the interaction as major. Cobicistat and Temsirolimus 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 potent CYP3A4 inhibitor and can raise exposure to temsirolimus and its active metabolite sirolimus. Higher exposure may increase mucositis, myelosuppression, hyperglycemia, hyperlipidemia, infection and pneumonitis risk.
How serious is the interaction between Cobicistat and Temsirolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative to cobicistat-boosted regimens; if unavoidable, reduce the temsirolimus dose per labeling for strong CYP3A4 inhibitors and monitor for toxicity. After stopping cobicistat, allow about a week before returning to the usual temsirolimus dose.
What other medicines interact with Temsirolimus?
MediHelp also lists interactions of Temsirolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Measles mumps and rubella vaccine live. The full list is on the Temsirolimus page.
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