Cabozantinib and Thioridazine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Thioridazine
No brand names on recordCabozantinib
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.
What happens
Reduced cabozantinib exposure and reduced efficacy of cabozantinib
Interaction Deep Dive
Avoid coadministration of cabozantinib with a moderate CYP3A4 inducer due to the potential for reduced cabozantinib exposure and efficacy. If coadministration is required, increase the daily cabozantinib dosage by 20 mg (eg, from 60 mg to 80 mg daily or from 40 mg to 60 mg), and do not exceed 80 mg daily. Upon discontinuation of the CYP3A4 inducer, wait 2 to 3 days before resuming the cabozantinib dosage used prior to initiation of the inducer1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of cabozantinib
Literature reports
2 reports — tap to read
a) In a pharmacokinetic study in 25 healthy subjects, the administration of a single dose of cabozantinib 140 mg (a CYP3A4 substrate) after 11 continuous daily doses of rifAMPin 600 mg (a strong CYP3A inducer) decreased the cabozantinib AUC by 77% and the cabozantinib elimination half-life decreased from 111 hours to 27.7 hours 2.
b) In a drug interaction study, coadministration of a strong CYP3A4 inducer, rifAMPin (600 mg daily for 31 days), with a cabozantinib capsule formulation to healthy subjects decreased single-dose cabozantinib exposure (AUC0-inf) by 77% 1.
Common questions
Can I take Cabozantinib and Thioridazine together?
Reduced cabozantinib exposure and reduced efficacy of cabozantinib Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cabozantinib and Thioridazine 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 strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Cabozantinib or Thioridazine 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 (2)
- Product Information: CABOMETYX(R) oral tablets, cabozantinib oral tablets. Exelixis Inc (per FDA), Alameda, CA, 2025. DailyMed
- Nguyen L, Holland J, Miles D, et al: Pharmacokinetic (PK) drug interaction studies of cabozantinib: effect of CYP3A inducer rifampin and inhibitor ketoconazole on cabozantinib plasma PK and effect of cabozantinib on CYP2C8 probe substrate rosiglitazone plasma PK. J Clin Pharmacol 2015; 55(9):1012-1023. PubMed
Keep reading about Thioridazine
Keep reading about Cabozantinib
These medications also interact with supplements
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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