Drug interactions
Cobicistat + Vincristine
Severity: Major
Cobicistat and Vincristine: 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 strongly inhibits CYP3A4 and P-glycoprotein, which can raise vincristine exposure. This increases the risk of neurotoxicity (peripheral neuropathy, constipation, ileus, seizures) and hematologic toxicity. Serious toxicity has been reported with boosted antiretrovirals and vincristine.
What this interaction means in plain words
Cobicistat and Vincristine 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; Vincristine belongs to Oncology.
Why it happens
Cobicistat inhibits CYP3A4 and P-glycoprotein, reducing vincristine metabolism and efflux.
What to do
Avoid the combination where possible and use an antiretroviral regimen without a booster or CYP3A/P-gp inhibitor during vincristine therapy. If unavoidable, monitor closely for neurotoxicity, constipation and myelosuppression 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cobicistat and Vincristine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Apalutamide + Vincristine Major
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine 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 Vincristine?
MediHelp rates the interaction as major. Cobicistat and Vincristine 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 strongly inhibits CYP3A4 and P-glycoprotein, which can raise vincristine exposure. This increases the risk of neurotoxicity (peripheral neuropathy, constipation, ileus, seizures) and hematologic toxicity. Serious toxicity has been reported with boosted antiretrovirals and vincristine.
How serious is the interaction between Cobicistat and Vincristine?
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 the combination where possible and use an antiretroviral regimen without a booster or CYP3A/P-gp inhibitor during vincristine therapy. If unavoidable, monitor closely for neurotoxicity, constipation and myelosuppression and consider dose reduction.
What other medicines interact with Vincristine?
MediHelp also lists interactions of Vincristine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vincristine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
