Abrocitinib and Mavorixafor: 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
Mavorixafor
Abrocitinib
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.
Taking these two together can make one of them build up in your body. Mavorixafor (Xolremdi) is normally moved out of your system by a kind of cellular pump. Abrocitinib (Cibinqo) can slow that pump down, so more mavorixafor stays in your blood. That means you could feel more of mavorixafor's side effects.
The good news is this is very manageable. Your care team can keep a closer eye on how you're feeling and, if needed, gently lower your mavorixafor dose. Please don't change anything on your own. Just let your pharmacist or doctor know you take both so they can tailor things for you.
Interaction: Abrocitinib inhibits P-gp (P-glycoprotein), reducing the efflux transport of mavorixafor, a P-gp substrate. Result is increased mavorixafor exposure (AUC/Cmax) and heightened risk of mavorixafor-related adverse reactions.
- Direction: increased mavorixafor effect/toxicity
- Evidence: probable
- Severity: major
- Onset: unspecified
Management: Monitor more frequently for mavorixafor adverse reactions. If necessary, reduce the mavorixafor daily dose in 100 mg decrements, but not below 200 mg/day. Neither drug requires bioactivation, so no prodrug reversal applies.
What happens
Increased mavorixafor exposure and an increased risk of mavorixafor-related adverse effects
Interaction Deep Dive
Because mavorixafor is a P-gp substrate, giving it together with a P-gp inhibitor can raise mavorixafor levels and heighten the potential for adverse reactions linked to mavorixafor. Increase the frequency of monitoring for such adverse reactions, and when needed, lower the daily mavorixafor dose in 100 mg decrements, though not below a dose of 200 mg1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of mavorixafor
How to manage this interaction
What your care team may do:
- Keep taking both medications exactly as prescribed unless your prescriber tells you otherwise.
- Watch you more closely for side effects from mavorixafor.
- If needed, lower your mavorixafor dose in steps of 100 mg, but not below 200 mg per day. This dose can be adjusted and individualized by your care team.
What you should do: Make sure your pharmacist and doctor know you take both. Report any new or worsening symptoms so they can fine-tune your dose. This is a manageable interaction with the right monitoring.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a drug interaction study conducted in healthy subjects, the systemic exposure of mavorixafor (a CYP3A4 substrate and P-gp substrate) after a single 200 mg dose of mavorixafor (0.5 times the recommended dosage for adult and adolescent patients 12 years and older weighing over 50 kg) given together with 200 mg itraconazole (a strong CYP3A4 inhibitor and P-gp inhibitor) dosed to steady state was comparable to the mavorixafor systemic exposure produced by a single 400 mg dose of mavorixafor given alone. These findings indicate an approximately 2-fold increase in mavorixafor exposure attributable to itraconazole 1.
Common questions
Can I take Abrocitinib and Mavorixafor together?
Abrocitinib can raise mavorixafor levels and side effects; keep taking both as prescribed while your care team monitors you and adjusts the mavorixafor dose if needed (not below 200 mg/day). Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abrocitinib and Mavorixafor 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 Abrocitinib and Mavorixafor interaction managed?
What your care team may do: Keep taking both medications exactly as prescribed unless your prescriber tells you otherwise. Watch you more closely for side effects from mavorixafor. If needed, lower your mavorixafor dose in steps of 100 mg, but not below 200 mg per day. This dose can be adjusted and individualized by your care team. What you should do: Make sure your pharmacist and doctor know you… 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 Abrocitinib or Mavorixafor 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: XOLREMDI(TM) oral capsules, mavorixafor oral capsules. X4 Pharmaceuticals, Inc. (Per FDA), Boston, MA, 2024. DailyMed
Keep reading about Mavorixafor
Keep reading about Abrocitinib
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