相互作用
Cobicistat + Vincristine
重症度: 重大
Cobicistat and Vincristine: major interaction.
最終更新日 出典: US FDA label
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概要
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.
この相互作用をわかりやすく説明すると
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.
なぜ起こるのか
Cobicistat inhibits CYP3A4 and P-glycoprotein, reducing vincristine metabolism and efflux.
対処法
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.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、CobicistatとVincristineの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Vincristineのその他の相互作用
Cobicistatのその他の相互作用
よくある質問
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
