Drug interactions
Cobicistat + Vardenafil
Severity: Major
Cobicistat and Vardenafil: 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 substantially raises vardenafil levels. This can cause severe hypotension, syncope, visual changes and priapism.
What this interaction means in plain words
Cobicistat and Vardenafil 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; Vardenafil belongs to Genitourinary.
Why it happens
Inhibition of CYP3A4-mediated vardenafil metabolism by cobicistat.
What to do
Keep vardenafil at the reduced maximum dose and long interval recommended in labeling, and monitor blood pressure. Counsel the patient on seeking help for prolonged erection.
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 Vardenafil
- Amyl nitrite + Vardenafil Contraindicated
- Glyceryl trinitrate pr + Vardenafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Nicorandil + Vardenafil Contraindicated
- Nitroglycerin po + Vardenafil 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 Vardenafil?
MediHelp rates the interaction as major. Cobicistat and Vardenafil 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 substantially raises vardenafil levels. This can cause severe hypotension, syncope, visual changes and priapism.
How serious is the interaction between Cobicistat and Vardenafil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep vardenafil at the reduced maximum dose and long interval recommended in labeling, and monitor blood pressure. Counsel the patient on seeking help for prolonged erection.
What other medicines interact with Vardenafil?
MediHelp also lists interactions of Vardenafil with, for example, Amyl nitrite, Glyceryl trinitrate pr, Isosorbide dinitrate. The full list is on the Vardenafil page.
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