Drug Interaction Report

Lovastatin and Cobicistat: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Cobicistat

Tybost
+

Lovastatin

Altocor® Altoprev Altoprev® Mevacor®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Contraindicated
These should generally not be used together.
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.

Of 127 documented Lovastatin interactions, 36 are rated contraindicated — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Contraindicated

What happens

Increased risk of lovastatin toxicity and an increased risk of myopathy or rhabdomyolysis

Interaction Deep Dive

Coadministration of cobicistat (a strong CYP3A inhibitor) and lovastatin (CYP3A/OATP1B1 substrate and HMG-CoA reductase inhibitor) is contraindicated due to the potential for increased exposure of lovastatin and increased serious adverse effects including myopathy and rhabdomyolysis23. If short-term treatment with strong CYP3A inhibitors is required or if treatment with a CYP3A inhibitor is unavoidable, suspend lovastatin during the course of strong CYP3A inhibitor treatment 1.

Why it happens (mechanism)

Inhibition of CYP3A-mediated metabolism of lovastatin; inhibition of OATP1B1-mediated efflux transport of cobicistat

Common questions

Can I take Lovastatin and Cobicistat together?

Increased risk of lovastatin toxicity and an increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.

How serious is the Lovastatin and Cobicistat interaction?

It is rated contraindicated. These should generally not be used together.

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 Lovastatin 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)

  1. Product Information: ALTOPREV(R) oral extended-release tablets, lovastatin oral extended-release tablets. Covis Pharma (per FDA), King of Prussia, PA, 2024. DailyMed
  2. Product Information: STRIBILD(TM) oral tablets, elvitegravir cobicistat emtricitabine tenofovir disoproxil fumarate oral tablets. Gilead Sciences, Inc. (per manufacturer), Foster City, CA, 2012. DailyMed
  3. Product Information: TYBOST(R) oral tablets, cobicistat oral tablets. Gilead Sciences Inc (per FDA), Foster City, CA, 2025. DailyMed
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Beyond drug–drug

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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.