Fluvastatin and Cobicistat: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cobicistat
Fluvastatin
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 HMG-CoA reductase inhibitor that also are OATP1B1/B3 substrates exposure
Interaction Deep Dive
Coadministration of cobicistat with HMG-CoA reductase inhibitors that also are OATP1B1/B3 substrates may increase HMG-CoA reductase inhibitors that also are OATP1B1/B3 substrates exposure. If coadministered, start with the lowest recommended statin dose and titrate while monitoring for safety (eg, myopathy)123.
Why it happens (mechanism)
Inhibition of OATP1B1-mediated efflux transport of cobicistat; inhibition of OATP1B3-mediated efflux transport of cobicistat
Common questions
Can I take Fluvastatin and Cobicistat together?
Increased HMG-CoA reductase inhibitor that also are OATP1B1/B3 substrates exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Fluvastatin and Cobicistat 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Fluvastatin or Cobicistat 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 (3)
- Product Information: SYMTUZA(R) oral tablets, darunavir, cobicistat, emtricitabine, tenofovir alafenamide oral tablets. Janssen Products, LP (per FDA), Horsham, PA, 2023. DailyMed
- Product Information: PREZCOBIX® PED oral tablets for suspension, darunavir cobicistat oral tablets for suspension. Janssen Products, LP (per FDA), Horsham, PA, 2026. DailyMed
- Product Information: PREZCOBIX® oral tablets, darunavir cobicistat oral tablets. Janssen Products, LP (per FDA), Horsham, PA, 2026. DailyMed
Keep reading about Cobicistat
Keep reading about Fluvastatin
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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