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Interações medicamentosas

Cobicistat + Irinotecan

Gravidade: Grave

Cobicistat and Irinotecan: major interaction.

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Resumo

Cobicistat inhibits CYP3A4, which converts irinotecan and its active metabolite SN-38 to inactive products. Exposure to toxic species may rise, increasing severe diarrhea and neutropenia.

O que esta interação significa em palavras simples

Cobicistat and Irinotecan 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; Irinotecan belongs to Oncology.

Nível de evidência: Moderate

Por que acontece

Cobicistat inhibits CYP3A4 (and transporters), reducing irinotecan oxidative clearance and increasing exposure to irinotecan and SN-38.

O que fazer

Avoid the combination when possible and use a non-boosted antiretroviral regimen. If it cannot be avoided, monitor closely for diarrhea and neutropenia and consider irinotecan dose reduction.

O que perguntar ao farmacêutico

  • 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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Perguntas frequentes

Can I take Cobicistat with Irinotecan?

MediHelp rates the interaction as major. Cobicistat and Irinotecan 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 inhibits CYP3A4, which converts irinotecan and its active metabolite SN-38 to inactive products. Exposure to toxic species may rise, increasing severe diarrhea and neutropenia.

How serious is the interaction between Cobicistat and Irinotecan?

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 when possible and use a non-boosted antiretroviral regimen. If it cannot be avoided, monitor closely for diarrhea and neutropenia and consider irinotecan dose reduction.

What other medicines interact with Irinotecan?

MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.

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