Drug interactions
Cobicistat + Warfarin
Severity: Moderate
Cobicistat and Warfarin: 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 and may increase warfarin exposure, with variable effects on INR. This can increase bleeding risk.
What this interaction means in plain words
Cobicistat and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Cobicistat inhibits CYP3A4 (and CYP2D6), reducing metabolism of R-warfarin.
What to do
Monitor INR more frequently when cobicistat is started or stopped and adjust the warfarin dose as needed.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin 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 Warfarin?
MediHelp rates the interaction as moderate. Cobicistat and Warfarin 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 and may increase warfarin exposure, with variable effects on INR. This can increase bleeding risk.
How serious is the interaction between Cobicistat and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor INR more frequently when cobicistat is started or stopped and adjust the warfarin dose as needed.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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