Drug interactions
Cobicistat + Zolpidem
Severity: Moderate
Cobicistat and Zolpidem: 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 can raise zolpidem exposure, increasing sedation and psychomotor impairment. Zolpidem is partly metabolized by CYP3A4, so the effect can be significant.
What this interaction means in plain words
Cobicistat and Zolpidem 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; Zolpidem belongs to Central Nervous System.
Why it happens
Cobicistat inhibits CYP3A4, reducing zolpidem clearance.
What to do
Use the lowest zolpidem dose, such as 5 mg or less, and monitor for excess sedation and next-day impairment.
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 Zolpidem
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 Zolpidem?
MediHelp rates the interaction as moderate. Cobicistat and Zolpidem 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 can raise zolpidem exposure, increasing sedation and psychomotor impairment. Zolpidem is partly metabolized by CYP3A4, so the effect can be significant.
How serious is the interaction between Cobicistat and Zolpidem?
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 the lowest zolpidem dose, such as 5 mg or less, and monitor for excess sedation and next-day impairment.
What other medicines interact with Zolpidem?
MediHelp also lists interactions of Zolpidem with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Benzhydrocodone / acetaminophen. The full list is on the Zolpidem page.
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