Abemaciclib and Daridorexant: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Daridorexant
No brand names on recordAbemaciclib
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.
You've been prescribed two medicines that can interact. Daridorexant is a sleep medicine, and abemaciclib (Verzenio) is a cancer medicine. Daridorexant can slow down the liver enzyme that breaks abemaciclib down. That means abemaciclib may build up in your body a bit more than expected, which can raise the chance of side effects like diarrhea, tiredness, or low blood counts.
The good news is this is very manageable. Your care team can keep a closer eye on how you're feeling and adjust things if needed. Please don't stop or change either medicine on your own, just let your pharmacist or doctor know you're taking both so they can plan accordingly.
Effect: Daridorexant is a moderate CYP3A4 inhibitor; abemaciclib is a CYP3A4 substrate. Co-administration may reduce abemaciclib clearance, increasing its AUC/Cmax and the risk of dose-related toxicity (diarrhea, neutropenia, hepatotoxicity, fatigue).
- Direction: Increased abemaciclib exposure (active drug, not a prodrug).
- Mechanism: Inhibition of CYP3A4-mediated abemaciclib metabolism by daridorexant.
- Evidence: Probable. Onset: unspecified.
- Management: Use daridorexant with caution. Monitor for abemaciclib toxicity; the oncology team may individualize/adjust the abemaciclib dose per prescribing guidance.
What happens
Increased CYP3A4 substrate with NTI exposure
Interaction Deep Dive
Exercise caution when daridorexant is used together with a CYP3A4 substrate that has a narrow therapeutic index (NTI). Giving daridorexant alongside a CYP3A4 NTI substrate may raise exposure to that NTI CYP3A4 substrate1.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by daridorexant
How to manage this interaction
Both medicines can be used together, but your team will want to manage this carefully.
- Keep taking both as prescribed unless your care team tells you otherwise.
- Your team may monitor you more closely for abemaciclib side effects such as diarrhea, unusual tiredness, signs of infection, or lab changes in blood counts and liver tests.
- The abemaciclib dose may need to be adjusted and individualized by your oncology team.
- Tell your pharmacist and prescriber that you take both, and report any new or worsening side effects promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Taking a single 50 mg dose of daridorexant together with 2 mg of midazolam (a CYP3A4 substrate) raised the daridorexant AUC by a geometric mean ratio (GMR) of 1.4 (90% CI, 1.3 to 1.6) and the Cmax by a GMR of 1.1 (90% CI, 1 to 1.3) 1.
Common questions
Can I take Abemaciclib and Daridorexant together?
Daridorexant can raise abemaciclib levels by slowing its breakdown, so watch for increased side effects; keep taking both as prescribed and let your care team monitor you and adjust the dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abemaciclib and Daridorexant 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 is the Abemaciclib and Daridorexant interaction managed?
Both medicines can be used together, but your team will want to manage this carefully. Keep taking both as prescribed unless your care team tells you otherwise. Your team may monitor you more closely for abemaciclib side effects such as diarrhea, unusual tiredness, signs of infection, or lab changes in blood counts and liver tests. The abemaciclib dose may need to be adjusted and individualized by… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Abemaciclib or Daridorexant 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 (1)
- Product Information: QUVIVIQ(R) oral tablets, daridorexant oral tablets. Idorsia Pharmaceuticals US Inc (per FDA), Radnor, PA, 2023. DailyMed
Keep reading about Daridorexant
Keep reading about Abemaciclib
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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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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