Date of report 13 May 2019
Reported case interaction between
 Cobicistat and Alprazolam

FLS Science

Drugs suspected to be involved in the DDI

Perpetrator
Cobicistat
Daily Dose
150 (mg)
Dose adjustment performed
No
Administration Route
Oral
Start date
Unknown
End date
Ongoing
Victim
Alprazolam
Daily Dose
0.75 (mg)
Dose adjustment performed
No
Administration Route
Oral
Start date
Unknown
End date
Ongoing

Complete list of drugs taken by the patient

Antiretroviral treatment
Darunavir/Cobicistat
Raltegravir
Lamivudine
Complete list of all comedications taken by the patient, included that involved in the DDI

alprazolam, escitalopram, ipratropium bromide, salbutamol

Clinical case description

Gender
Female
Age
56
eGFR (mL/min)
>60
Liver function impairment
No
Description

Female patient with potential DDI between DRV/c and alprazolam. No toxicity was observed

Clinical Outcome

No unwanted outcome

Editorial Comment

Coadministration has not been studied. Alprazolam is mainly metabolized by CYP3A4. Coadministration of darunavir/cobicistat may increase alprazolam concentrations and may result in enhanced sedation. A decrease in alprazolam dose may be needed.

University of Liverpool Recommendation

Potential interaction - may require close monitoring, alteration of drug dosage or timing of administration
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