What the FDA labels say about taking them together
Cobicistat and tacrolimus
Cobicistat's FDA label of February 10, 2026 names tacrolimus in its drug interactions section, and tacrolimus's label names cobicistat too. The cobicistat label: “These immunosuppressant agents are metabolized by CYP3A. Therapeutic drug monitoring is recommended if coadministered.”
Check it at the source: the cobicistat FDA label on DailyMed (effective February 10, 2026, Gilead Sciences, Inc.); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the cobicistat label say about tacrolimus?
Cobicistat label, drug interactionsConcomitant Drug Class/Drug Name: Immuno-suppressants: cyclosporine everolimus sirolimus tacrolimus; Potential Effect ↑ = Increase, ↓ = Decrease, ↔ = No change: ↑ immuno-suppressants; Clinical Comment: These immunosuppressant agents are metabolized by CYP3A. Therapeutic drug monitoring is recommended if coadministered.
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 tacrolimus label say about cobicistat?
Envarsus Xr label (Veloxis Pharmaceuticals, Inc, February 26, 2025), drug interactionsDrug/Substance Class or Name: Strong CYP3A Inhibitors c,, such as: Protease inhibitors (e.g., nelfinavir, telaprevir, boceprevir, ritonavir or ritonavir containing products), azole antifungals (e.g., voriconazole, posaconazole, itraconazole, ketoconazole), antibiotics (e.g., clarithromycin, troleandomycin, chloramphenicol), nefazodone, Schisandra sphenanthera extracts, cobicistat; Drug Interaction Effect: May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation). A rapid, sharp rise in tacrolimus levels may occur early, despite an immediate reduction of tacrolimus dose [see ].; …
Source: FDA drug label (Envarsus Xr, NDA206406), Veloxis Pharmaceuticals, Inc, effective February 26, 2025 (SPL set de2315b0-6344-43ac-9aea-3e3b68d828e7), via openFDA
Source: FDA drug label (Tacrolimus), Stellon Biotech Inc., effective July 17, 2026 (SPL set 6b89e8a4-9f11-42e3-8e79-fe617e7c461f), 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 | Tacrolimus | |
|---|---|---|
| Labeled for | HIV | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | n/a | $0.970 per gram 0.1% ointment |
| 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