Cobicistat and Acalabrutinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cobicistat
Acalabrutinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased acalabrutinib exposure
Interaction Deep Dive
Avoid long-term use of acalabrutinib with a CYP3A strong inhibitor; if short-term use of CYP3A stong inhibitor is required, interrupt acalabrutinib. Coadministration of itraconazole, a strong CYP3A inhibitor, with acalabrutinib resulted in an increase of acalabrutinib Cmax and AUC1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of acalabrutinib
Literature reports
1 report — tap to read
a) Coadministration of itraconazole, a strong CYP3A inhibitor, 200 mg/day for 5 days with acalabrutinib resulted in an increase of acalabrutinib Cmax and AUC by 3.9- and 5.1-fold, respectively 1.
Common questions
Can I take Cobicistat and Acalabrutinib together?
Increased acalabrutinib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cobicistat and Acalabrutinib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Cobicistat or Acalabrutinib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: CALQUENCE(R) oral capsules, acalabrutinib oral capsules. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2017. DailyMed
Keep reading about Cobicistat
Keep reading about Acalabrutinib
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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