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Interactions médicamenteuses

Amlodipine-atorvastatin + Cobicistat

Gravité: Majeure

Amlodipine-atorvastatin and Cobicistat: major interaction.

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Résumé

Cobicistat is a strong CYP3A4 inhibitor and also inhibits OATP1B1/1B3 and P-gp. It can substantially increase exposure to amlodipine and atorvastatin, raising risks of hypotension, edema and statin myopathy.

Ce que signifie cette interaction, en termes simples

Amlodipine-atorvastatin and Cobicistat 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.

Amlodipine-atorvastatin belongs to Cardiovascular; Cobicistat belongs to Miscellaneous.

Niveau de preuve: Moderate

Pourquoi elle survient

Strong CYP3A4 and transporter inhibition by cobicistat reduces clearance of both amlodipine and atorvastatin.

Conduite à tenir

Use a lower amlodipine dose with blood pressure monitoring, and limit atorvastatin to the lowest effective dose per labeling, or choose a statin with less interaction such as rosuvastatin or pravastatin at low dose.

Questions à poser à votre pharmacien

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Amlodipine-atorvastatin with Cobicistat?

MediHelp rates the interaction as major. Amlodipine-atorvastatin and Cobicistat 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 CYP3A4 inhibitor and also inhibits OATP1B1/1B3 and P-gp. It can substantially increase exposure to amlodipine and atorvastatin, raising risks of hypotension, edema and statin myopathy.

How serious is the interaction between Amlodipine-atorvastatin and Cobicistat?

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 a lower amlodipine dose with blood pressure monitoring, and limit atorvastatin to the lowest effective dose per labeling, or choose a statin with less interaction such as rosuvastatin or pravastatin at low dose.

What other medicines interact with Amlodipine-atorvastatin?

MediHelp also lists interactions of Amlodipine-atorvastatin with, for example, Amifostine, Apalutamide, Atazanavir. The full list is on the Amlodipine-atorvastatin page.

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