Drug interactions
Cobicistat + Voriconazole
Severity: Major
Cobicistat and Voriconazole: 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 CYP3A inhibitor and can increase voriconazole exposure, while voriconazole may in turn raise cobicistat-boosted drug levels. This raises the risk of adverse effects from both sides, including QT prolongation, visual disturbance and hepatotoxicity.
What this interaction means in plain words
Cobicistat and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Cobicistat inhibits CYP3A4, and voriconazole is itself a CYP3A4 inhibitor, producing bidirectional exposure increases.
What to do
Avoid unless benefit outweighs risk; if combined, monitor for voriconazole toxicity and consider voriconazole levels and ECG monitoring.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Voriconazole?
MediHelp rates the interaction as major. Cobicistat and Voriconazole 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 CYP3A inhibitor and can increase voriconazole exposure, while voriconazole may in turn raise cobicistat-boosted drug levels. This raises the risk of adverse effects from both sides, including QT prolongation, visual disturbance and hepatotoxicity.
How serious is the interaction between Cobicistat and Voriconazole?
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 unless benefit outweighs risk; if combined, monitor for voriconazole toxicity and consider voriconazole levels and ECG monitoring.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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