Clindamycin and Omaveloxolone: 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
Omaveloxolone
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.
Let's talk about taking Skyclarys (omaveloxolone) together with the antibiotic clindamycin. Your body uses a liver enzyme called CYP3A4 to help process clindamycin. Skyclarys can gently speed that enzyme up, which means your body may clear clindamycin a little faster than usual. The concern is that this could make the antibiotic less effective at fighting your infection.
The good news is this is based mostly on theory, not strong real-world reports. Your care team can watch to make sure the antibiotic is working. Don't stop or change either medicine on your own, just let your pharmacist or doctor know you take both so they can keep an eye on things.
Mechanism: Omaveloxolone is a weak CYP3A4 inducer. Clindamycin is partly metabolized by CYP3A4 (to its active bioactive metabolite and other products). Induction may increase clindamycin clearance, lowering systemic exposure (AUC/Cmax) and potentially reducing antibacterial efficacy.
- Direction: reduced clindamycin exposure and possible reduced efficacy
- Magnitude: weak inducer; midazolam AUC fell ~45% in a probe study, clindamycin-specific data lacking
- Onset: unspecified (enzyme induction is typically delayed over days)
- Evidence: theoretical
Management: Monitor for lack of clinical/antimicrobial efficacy. Consider therapeutic response assessment; dose or agent selection may be individualized by the treating team if response is inadequate.
What happens
Reduced CYP3A4 substrate exposure and reduced efficacy of CYP3A4 substrate
Interaction Deep Dive
When omaveloxolone (a weak inducer of CYP3A4) is taken together with substrates of CYP3A4, the exposure to those substrates can decline, potentially diminishing their therapeutic effect. Patients receiving a CYP3A4 substrate alongside omaveloxolone should therefore be watched for any loss of efficacy of that co-administered therapy. Findings from a drug interaction study showed that giving omaveloxolone with midazolam lowered the AUC of midazolam (a CYP3A4 substrate) by roughly 45%1.
Why it happens (mechanism)
Induction of CYP3A4 substrate metabolism by omaveloxolone
How to manage this interaction
Here is how a care team usually handles this combination:
- Keep taking both as prescribed unless your doctor tells you otherwise.
- Your team may watch more closely to confirm the antibiotic is working, for example checking that your infection is improving on schedule.
- If your infection does not seem to be responding, your team may adjust the treatment plan, and the choice or dose can be individualized for you.
Tell your pharmacist or prescriber that you take both. Report any signs your infection is not clearing (persistent fever, worsening redness, or symptoms that stall or return) so they can act quickly.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a study evaluating drug interactions, giving omaveloxolone together with midazolam reduced the AUC of midazolam (a CYP3A4 substrate) by about 45% 1.
Common questions
Can I take Clindamycin and Omaveloxolone together?
Skyclarys may make clindamycin work a bit less effectively by speeding up how your body clears it, so your care team may monitor to be sure the antibiotic is doing its job. Keep taking both as prescribed and report any signs the infection isn't improving. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Omaveloxolone 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 Clindamycin and Omaveloxolone interaction managed?
Here is how a care team usually handles this combination: Keep taking both as prescribed unless your doctor tells you otherwise. Your team may watch more closely to confirm the antibiotic is working, for example checking that your infection is improving on schedule. If your infection does not seem to be responding, your team may adjust the treatment plan, and the choice or dose can be individualiz… 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 Omaveloxolone 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: Skyclarys® oral capsules, omaveloxolone oral capsules. Biogen U.S. Corporation, Cambridge, MA, 2026. DailyMed
Keep reading about Omaveloxolone
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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