Darunavir and cobicistat and Naloxegol interaction
Darunavir and cobicistat and Naloxegol: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Darunavir and cobicistat (PREZCOBIX) label · effective 2026-02-01
John's wort ( Hypericum perforatum ) Hepatitis C direct acting antiviral: elbasvir/grazoprevir Lipid modifying agents: lomitapide, lovastatin, simvastatin Opioid Antagonist: naloxegol PDE-5 inhibitor: sildenafil when used for treatment of pulmonary arterial hypertension Sedatives/hypnotics: orally administered midazolam, triazolam PREZCOBIX or PREZCOBIX PED is…
Opioid Antagonist naloxegol ↑ naloxegol Co-administration of PREZCOBIX or PREZCOBIX PED and naloxegol is contraindicated due to potential for precipitating opioid withdrawal symptoms.
Narcotic analgesic for treatment of opioid dependence: buprenorphine, buprenorphine/naloxone, methadone buprenorphine or buprenorphine/ naloxone: effects unknown methadone: effects unknown Initiation of buprenorphine, buprenorphine/naloxone or methadone in patients taking PREZCOBIX or PREZCOBIX PED : Carefully titrate the dose of buprenorphine, buprenorphine/naloxone…
Initiation of PREZCOBIX or PREZCOBIX PED in patients taking buprenorphine, buprenorphine/naloxone or methadone : A dose adjustment for buprenorphine, buprenorphine/naloxone or methadone may be needed.
From the Naloxegol (MOVANTIK) label · effective 2026-09-01
Patients concomitantly using strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) because these medications can significantly increase exposure to naloxegol which may precipitate opioid withdrawal symptoms such as hyperhidrosis, chills, diarrhea, abdominal pain, anxiety, irritability, and yawning [see Drug Interactions (7.1) and Clinical Pharmacology…
Concomitant use with strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole).
Moderate CYP3A4 inhibitors (e.g., diltiazem, erythromycin, verapamil) : Increased naloxegol concentrations; avoid concomitant use; if unavoidable, reduce dosage to 12.5 mg once daily and monitor for adverse reactions.
•Use with strong CYP3A4 inhibitors is contraindicated [see Contraindications (4) ] .
•Moderate CYP3A4 inhibitors (e.g., diltiazem, erythromycin, verapamil) •Avoid use with moderate CYP3A4 inhibitors; if unavoidable, decrease the dosage of MOVANTIK to 12.5 mg once daily and monitor for adverse reactions [see Dosage and Administration (2.4) ] .
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.