Drug interactions
Cobicistat + Upadacitinib
Severity: Moderate
Cobicistat and Upadacitinib: 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 is a strong CYP3A4 inhibitor that raises upadacitinib exposure. This increases the risk of infections and hematologic toxicity.
What this interaction means in plain words
Cobicistat and Upadacitinib 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; Upadacitinib belongs to Musculoskeletal.
Why it happens
Cobicistat inhibits CYP3A4, reducing metabolic clearance of upadacitinib.
What to do
Use a reduced upadacitinib dose per labeling for strong CYP3A4 inhibitors. Monitor for infection and cytopenias.
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 Upadacitinib
- Abrocitinib + Upadacitinib Contraindicated
- Adenovirus types 4 and 7 live + Upadacitinib Contraindicated
- Baricitinib + Upadacitinib Contraindicated
- Bcg vaccine live + Upadacitinib Contraindicated
- Dengue vaccine + Upadacitinib Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Upadacitinib 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 Upadacitinib?
MediHelp rates the interaction as moderate. Cobicistat and Upadacitinib 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 is a strong CYP3A4 inhibitor that raises upadacitinib exposure. This increases the risk of infections and hematologic toxicity.
How serious is the interaction between Cobicistat and Upadacitinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced upadacitinib dose per labeling for strong CYP3A4 inhibitors. Monitor for infection and cytopenias.
What other medicines interact with Upadacitinib?
MediHelp also lists interactions of Upadacitinib with, for example, Abrocitinib, Adenovirus types 4 and 7 live, Baricitinib. The full list is on the Upadacitinib page.
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