Drug interactions
Cobimetinib + Verapamil
Severity: Major
Cobimetinib and Verapamil: major interaction.
Last updated Sources: Health Canada product monograph
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
Verapamil is a moderate CYP3A4 inhibitor and increases cobimetinib exposure. This can increase toxicities such as hemorrhage, rhabdomyolysis, rash and diarrhea.
What this interaction means in plain words
Cobimetinib and Verapamil 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.
Cobimetinib belongs to Oncology; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4, reducing cobimetinib clearance.
What to do
Use an alternative to verapamil if possible. If unavoidable, follow labeling for reducing the cobimetinib dose and monitor for adverse effects.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
Other interactions of Cobimetinib
- Cobimetinib + Efavirenz Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Amobarbital + Cobimetinib Major
- Apalutamide + Cobimetinib Major
- Aprepitant + Cobimetinib Major
- Bosentan + Cobimetinib Major
Frequently asked questions
Can I take Cobimetinib with Verapamil?
MediHelp rates the interaction as major. Cobimetinib and Verapamil 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. Verapamil is a moderate CYP3A4 inhibitor and increases cobimetinib exposure. This can increase toxicities such as hemorrhage, rhabdomyolysis, rash and diarrhea.
How serious is the interaction between Cobimetinib and Verapamil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative to verapamil if possible. If unavoidable, follow labeling for reducing the cobimetinib dose and monitor for adverse effects.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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