Clindamycin and Mavacamten: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 1, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mavacamten
Clindamycin
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 mavacamten (Camzyos) for your heart, and clindamycin is an antibiotic. Mavacamten can gently speed up the liver enzyme that breaks down clindamycin. In theory, that could lower the clindamycin level in your body a little, which might make it work slightly less well at fighting your infection.
The good news is this is only a theoretical, mostly small effect, and it's very manageable. Keep taking both exactly as prescribed, and let your pharmacist or doctor know you're on both so they can keep an eye on how well your infection is clearing. Don't stop or change anything on your own.
Mechanism: Mavacamten is a mild CYP3A4 inducer; clindamycin is partly a CYP3A4 substrate. Induction may modestly increase clindamycin clearance, lowering exposure (AUC/Cmax) and potentially antibacterial efficacy.
Direction: reduced clindamycin exposure and efficacy. Neither drug is a prodrug here.
Magnitude/evidence: Theoretical, extrapolated from midazolam probe data (AUC decreased ~13%, up to ~45% at upper therapeutic mavacamten range). Effect on clindamycin is likely small.
Onset: unspecified.
- Monitor for adequate clinical response of the infection.
- No fixed dose adjustment established; individualize and consider alternative antibiotic only if clinical failure is a concern.
What happens
Reduced CYP3A4 substrate exposure and reduced efficacy of CYP3A4 substrate
Interaction Deep Dive
When mavacamten is given together with CYP3A4 substrates, the exposure to those substrates may fall, which can in turn lessen their effectiveness. For this reason, careful monitoring is warranted whenever mavacamten and CYP3A4 substrates are used together. A drug interaction study in healthy subjects showed that a 16 day regimen of mavacamten (25 mg on days 1 and 2, then 15 mg for 14 days) lowered the AUC(inf) and Cmax of midazolam by 13% and 7%, respectively. In symptomatic obstructive hypertrophic cardiomyopathy (HCM) patients receiving mavacamten once daily at the upper end of the therapeutic range, midazolam AUC(inf) and Cmax are projected to fall by as much as 45% and 24%, respectively1.
Why it happens (mechanism)
Induction of CYP3A4-substrate metabolism by mavacamten
How to manage this interaction
What your care team may do:
- Keep watching to make sure your infection is responding well to clindamycin.
- Adjust or individualize therapy if needed, or consider a different antibiotic if your infection isn't improving.
What you can do:
- Keep taking both medications exactly as prescribed unless told otherwise.
- Tell your pharmacist or prescriber you're taking both, and report if symptoms of your infection (fever, worsening pain, redness) are not getting better.
This is a theoretical, usually small interaction that your team can manage with 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, giving a 16 day regimen of mavacamten together (25 mg on days 1 and 2, then 15 mg for 14 days) reduced the AUC(inf) and Cmax of midazolam by 13% and 7%, respectively, in healthy subjects. When mavacamten is given once daily to symptomatic obstructive hypertrophic cardiomyopathy (HCM) patients at the higher end of the therapeutic range, midazolam AUC(inf) and Cmax are projected to fall by up to 45% and 24%, respectively 1.
Common questions
Can I take Clindamycin and Mavacamten together?
Mavacamten may slightly lower clindamycin levels and could make the antibiotic a little less effective, but this is theoretical and small. Keep taking both as prescribed and tell your care team so they can watch that your infection clears. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Mavacamten interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Clindamycin and Mavacamten interaction managed?
What your care team may do: Keep watching to make sure your infection is responding well to clindamycin. Adjust or individualize therapy if needed, or consider a different antibiotic if your infection isn't improving. What you can do: Keep taking both medications exactly as prescribed unless told otherwise. Tell your pharmacist or prescriber you're taking both, and report if symptoms of your infec… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Clindamycin or Mavacamten 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: CAMZYOS(R) oral capsules, mavacamten oral capsules. Bristol-Myers Squibb Company (per Manufacturer), Princeton, NJ, 2025. DailyMed
Keep reading about Mavacamten
Keep reading about Clindamycin
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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