CriticalPharmacokinetic enhancer (booster) for antiretroviral therapy×HMG-CoA reductase inhibitors (statins)
Updated · Methodology
Mechanism
Cobicistat is a strong CYP3A4 inhibitor. Simvastatin rises 30-fold with fatal rhabdomyolysis risk. EMA Tybost Section 4.3.
Symptoms
Myalgia, weakness, dark urine within 5 days.
Management
Combination contraindicated. Alternative statin: pravastatin 20–40 mg or rosuvastatin 5–10 mg.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- EMA: Tybost (cobicistat) Summary of Product Characteristics (2024)– EMA EPAR Tybost
- AEMPS: Ficha técnica: Simvastatina (nº registro 65199), sección 4.3 (2026)– AEMPS, CIMA, nº registro 65199, revisión 03/2026, sección 4.3