Drug interactions
Cobicistat + Topotecan
Severity: Major
Cobicistat and Topotecan: 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 inhibits P-glycoprotein and BCRP, both of which transport topotecan. Increased topotecan exposure may worsen neutropenia and other toxicities.
What this interaction means in plain words
Cobicistat and Topotecan 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; Topotecan belongs to Oncology.
Why it happens
Cobicistat inhibits P-gp and BCRP efflux of topotecan, increasing its absorption and reducing elimination.
What to do
Avoid with oral topotecan. With IV topotecan, monitor blood counts closely and consider dose reduction.
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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Other interactions of Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
- Darunavir + Topotecan 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 Topotecan?
MediHelp rates the interaction as major. Cobicistat and Topotecan 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 inhibits P-glycoprotein and BCRP, both of which transport topotecan. Increased topotecan exposure may worsen neutropenia and other toxicities.
How serious is the interaction between Cobicistat and Topotecan?
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 with oral topotecan. With IV topotecan, monitor blood counts closely and consider dose reduction.
What other medicines interact with Topotecan?
MediHelp also lists interactions of Topotecan with, for example, Adenovirus types 4 and 7 live, Amiodarone, Cisplatin. The full list is on the Topotecan page.
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