What the FDA labels say about taking them together
Cobicistat and dihydroergotamine
Cobicistat's FDA label of February 10, 2026 names dihydroergotamine in its contraindications section; the dihydroergotamine labels PlainMeds reads (4) do not name cobicistat. The cobicistat label: “Coadministration is contraindicated due to potential for serious and/or life-threatening reactions such as acute ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities and other tissues.”
Check it at the source: the cobicistat FDA label on DailyMed (effective February 10, 2026, Gilead Sciences, Inc.); the dihydroergotamine FDA label on DailyMed (effective March 6, 2025, Oceanside Pharmaceuticals).
What does the cobicistat label say about dihydroergotamine?
Cobicistat label, contraindicationsAlpha 1-adrenoreceptor antagonist: alfuzosin Antianginal: ranolazine Antiarrhythmic: dronedarone Anticonvulsants: carbamazepine, phenobarbital, phenytoin Anti-gout: colchicine Antimycobacterial: rifampin Antineoplastics: irinotecan These contraindications apply only to TYBOST coadministered with atazanavir Antipsychotics: lurasidone, pimozide Ergot Derivatives: dihydroergotamine, ergotamine, methylergonovine Herbal Products:
Cobicistat label, drug interactionsConcomitant Drug Class/Drug Name: Ergot Derivatives: dihydroergotamine, ergotamine, methylergonovine; Potential Effect ↑ = Increase, ↓ = Decrease, ↔ = No change: ↑ ergot derivatives; Clinical Comment: Coadministration is contraindicated due to potential for serious and/or life-threatening reactions such as acute ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities and other tissues.
Source: FDA drug label (Tybost), Gilead Sciences, Inc., effective February 10, 2026 (SPL set 3784c35c-e87f-410c-900b-8fd6313c6010), via openFDA; the full label on DailyMed
What does the dihydroergotamine label say about cobicistat?
Dihydroergotamine's label (effective March 6, 2025) and its 3 other brand-application labels do not name cobicistat in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (Dihydroergotamine Mesylate), NDA020148 (Bausch), as published by Oceanside Pharmaceuticals, effective March 6, 2025 (SPL set 977de209-c53a-4cb4-9f3f-1e850600a9dc), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Cobicistat | Dihydroergotamine | |
|---|---|---|
| Labeled for | HIV | Migraine |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | n/a | $29.44 per mL 4 mg/mL nasal spray |
| Shortage now | A presentation being discontinued | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once