Interactions médicamenteuses
Cobicistat + Vincristine
Gravité: Majeure
Cobicistat and Vincristine: major interaction.
Dernière mise à jour Sources: US FDA label
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Résumé
Cobicistat strongly inhibits CYP3A4 and P-glycoprotein, which can raise vincristine exposure. This increases the risk of neurotoxicity (peripheral neuropathy, constipation, ileus, seizures) and hematologic toxicity. Serious toxicity has been reported with boosted antiretrovirals and vincristine.
Ce que signifie cette interaction, en termes simples
Cobicistat and Vincristine 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; Vincristine belongs to Oncology.
Pourquoi elle survient
Cobicistat inhibits CYP3A4 and P-glycoprotein, reducing vincristine metabolism and efflux.
Conduite à tenir
Avoid the combination where possible and use an antiretroviral regimen without a booster or CYP3A/P-gp inhibitor during vincristine therapy. If unavoidable, monitor closely for neurotoxicity, constipation and myelosuppression and consider dose reduction.
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?
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Références
Autres interactions de Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contre-indiquée
- Apalutamide + Vincristine Majeure
- Atazanavir + Vincristine Majeure
- Ceritinib + Vincristine Majeure
- Chloramphenicol + Vincristine Majeure
- Clarithromycin + Vincristine Majeure
Autres interactions de Cobicistat
- Alfuzosin + Cobicistat Contre-indiquée
- Apalutamide + Cobicistat Contre-indiquée
- Cobicistat + Colchicine Contre-indiquée
- Cobicistat + Dronedarone Contre-indiquée
- Cobicistat + Eletriptan Contre-indiquée
- Cobicistat + Eplerenone Contre-indiquée
Questions fréquentes
Can I take Cobicistat with Vincristine?
MediHelp rates the interaction as major. Cobicistat and Vincristine 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 strongly inhibits CYP3A4 and P-glycoprotein, which can raise vincristine exposure. This increases the risk of neurotoxicity (peripheral neuropathy, constipation, ileus, seizures) and hematologic toxicity. Serious toxicity has been reported with boosted antiretrovirals and vincristine.
How serious is the interaction between Cobicistat and Vincristine?
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 the combination where possible and use an antiretroviral regimen without a booster or CYP3A/P-gp inhibitor during vincristine therapy. If unavoidable, monitor closely for neurotoxicity, constipation and myelosuppression and consider dose reduction.
What other medicines interact with Vincristine?
MediHelp also lists interactions of Vincristine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vincristine page.
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