Drug interactions
Cobicistat + Trimipramine
Severity: Moderate
Cobicistat and Trimipramine: moderate 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 CYP2D6 and CYP3A4 and can raise tricyclic antidepressant concentrations. This may increase anticholinergic effects, sedation and cardiac conduction disturbances.
What this interaction means in plain words
Cobicistat and Trimipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cobicistat belongs to Miscellaneous; Trimipramine belongs to Central Nervous System.
Why it happens
Inhibition of CYP2D6 and CYP3A4 metabolism of trimipramine.
What to do
Start trimipramine at the lowest dose and titrate slowly to response. Monitor for toxicity and consider an ECG and drug levels.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine 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 Trimipramine?
MediHelp rates the interaction as moderate. Cobicistat and Trimipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat inhibits CYP2D6 and CYP3A4 and can raise tricyclic antidepressant concentrations. This may increase anticholinergic effects, sedation and cardiac conduction disturbances.
How serious is the interaction between Cobicistat and Trimipramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start trimipramine at the lowest dose and titrate slowly to response. Monitor for toxicity and consider an ECG and drug levels.
What other medicines interact with Trimipramine?
MediHelp also lists interactions of Trimipramine with, for example, Disopyramide, Dofetilide, Ibutilide. The full list is on the Trimipramine page.
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