▶Cobicistatis predicted to increase the exposure to
corticosteroids(betamethasone, budesonide, ciclesonide,
deflazacort, dexamethasone, fludrocortisone, fluticasone,
hydrocortisone, methylprednisolone, mometasone,
prednisolone, prednisone, triamcinolone). Avoid or monitor
side effects.rStudy
▶Cobicistatis predicted to moderately increase the exposure to
crizotinib. Avoid.oStudy
▶Cobicistatis predicted to increase the exposure todabrafenib.
Use with caution or avoid.oStudy
▶Cobicistatis predicted to moderately increase the exposure to
daclatasvir. Adjustdaclatasvirdose.oStudy
▶Cobicistatis predicted to markedly to very markedly increase
the exposure todarifenacin. Avoid.rStudy
▶Cobicistatis predicted to markedly increase the exposure to
dasatinib. Avoid.rStudy
▶Cobicistatvery slightly increases the exposure todelamanid.
rStudy
▶Cobicistatincreases the risk of QT-prolongation when given
withdomperidone. Avoid.rStudy
▶Cobicistatincreases the exposure todopamine receptor agonists
(bromocriptine).rStudy
▶Cobicistatis predicted to increase the concentration of
dopamine receptor agonists(cabergoline).oAnecdotal
▶Cobicistatis predicted to increase the exposure todutasteride.
Monitor side effects and adjust dose.oTheoretical
▶Efavirenzis predicted to decrease the exposure tocobicistat.
Avoid.rTheoretical
▶Cobicistatslightly to moderately increases the exposure to
elbasvir. Avoid.oStudy
▶Cobicistatis predicted to markedly increase the exposure to
eletriptan. Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toeliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶Enzalutamideis predicted to decrease the exposure to
cobicistat. Avoid.rTheoretical
▶Cobicistatis predicted to increase the risk of ergotism when
given withergometrine. Avoid.rTheoretical
▶Cobicistatis predicted to increase the risk of ergotism when
given withergotamine. Avoid.rTheoretical
▶Cobicistatis predicted to slightly increase the exposure to
erlotinib. Use with caution and adjust dose.oStudy
▶Cobicistatis predicted to increase the concentration of
everolimus. Avoid.rStudy
▶Cobicistatis predicted to moderately increase the exposure to
fesoterodine. Adjustfesoterodinedose with potent inhibitors
of CYP3A4; avoid in hepatic and renal impairment.r
Study
▶Cobicistatis predicted to increase the exposure to
fosaprepitant.oTheoretical
▶Cobicistatis predicted to increase the exposure togefitinib.
oStudy
▶Cobicistatpotentially increases the exposure toglecaprevir.
oTheoretical
▶Cobicistatis predicted to moderately to markedly increase the
exposure tograzoprevir. Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toguanfacine.
Adjustguanfacinedose,p. 231.oStudy
▶Cobicistatis predicted to very markedly increase the exposure
toibrutinib. Avoid potent inhibitors of CYP3A4 or adjust
ibrutinibdose.rStudy
▶Cobicistatis predicted to increase the exposure toimatinib.
oStudy
▶Cobicistatis predicted to increase the risk of toxicity when
given withirinotecan. Avoid.oStudy
▶Cobicistatis predicted to increase the exposure toivabradine.
Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toivacaftor.
Adjustivacaftorp. 186orlumacaftor with ivacaftorp. 187dose
with potent inhibitors of CYP3A4.rStudy
▶Cobicistatis predicted to increase the exposure tolapatinib.
Avoid.oStudy
▶Cobicistatis predicted to markedly increase the exposure to
lomitapide. Avoid.rStudy
▶Cobicistatis predicted to increase the exposure tolurasidone.
Avoid.rStudy
▶Cobicistatis predicted to increase the exposure tomacitentan.
oStudy
▶Cobicistatmarkedly increases the exposure tomaraviroc. Refer
to specialist literature.rStudy
▶Cobicistatis predicted to markedly to very markedly increase
the exposure tomidazolam. Avoid or adjust dose.rStudy
▶Cobicistatis predicted to very markedly increase the exposure
tomidostaurin. Avoid or monitor for toxicity.rStudy
▶Cobicistatis predicted to increase the exposure tomirabegron.
Adjustmirabegrondose in hepatic and renal impairment.
oStudy
▶Cobicistatis predicted to increase the exposure tomirtazapine.
oStudy
▶Mitotaneis predicted to decrease the exposure tocobicistat.
Avoid.rTheoretical
▶Cobicistatis predicted to increase the exposure tomodafinil.
nTheoretical
▶Cobicistatis predicted to increase the exposure tomonoclonal
antibodies(trastuzumab emtansine). Avoid.rTheoretical
▶Cobicistatis predicted to markedly increase the exposure to
naloxegol. Avoid.rStudy
▶Cobicistatis predicted to increase the exposure tonetupitant.
oStudy
▶Nevirapineis predicted to decrease the exposure tocobicistat.
Avoid.rTheoretical
▶Cobicistatis predicted to moderately increase the exposure to
nilotinib. Avoid.rStudy
▶Cobicistatis predicted to increase the exposure tonitisinone.
Adjust dose.oTheoretical
▶Cobicistatis predicted to increase the exposure toolaparib.
Avoid potent inhibitors of CYP3A4 or adjustolaparibdose.
oStudy
▶Cobicistatis predicted to increase the exposure toopioids
(alfentanil, buprenorphine, fentanyl, oxycodone, sufentanil).
Monitor and adjust dose.rStudy
▶Cobicistatis predicted to increase the exposure tooxybutynin.
nStudy
▶Cobicistatis predicted to increase the exposure topalbociclib.
Avoid or adjustpalbociclibdose.rStudy
▶Cobicistatis predicted to increase the exposure to
panobinostat. Adjustpanobinostatdose; in hepatic
impairment avoid.oStudy
▶Cobicistatis predicted to increase the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rTheoretical
▶Cobicistatis predicted to increase the exposure topazopanib.
Avoid or adjustpazopanibdose.oStudy
▶Cobicistatis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(avanafil, vardenafil). Avoid.
rStudy
▶Cobicistatis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(sildenafil). Avoid potent
inhibitors of CYP3A4 or adjustsildenafildose,p. 120.r
Study
▶Cobicistatis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(tadalafil). Use with caution
or avoid.rStudy
▶Cobicistatis predicted to increase the exposure topimozide.
Avoid.rStudy
▶Cobicistatis predicted to slightly increase the exposure to
ponatinib. Monitor and adjustponatinibdose.oStudy
▶Cobicistatis predicted to moderately increase the exposure to
praziquantel.nStudy
▶Cobicistatis predicted to increase the exposure toquetiapine.
Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toranolazine.
Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toreboxetine.
Avoid.oStudy
▶Cobicistatis predicted to increase the exposure toregorafenib.
Avoid.oStudy
▶Cobicistatis predicted to increase the exposure torepaglinide.
oStudyBNFC 2018 – 2019 Cobicistat—Cobicistat 899
Interactions|Appendix 1A1