Clindamycin and Sotorasib: 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
Sotorasib
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 sotorasib (Lumakras) for cancer and clindamycin, an antibiotic. Here's the thing to know: sotorasib can speed up how your body breaks down clindamycin. That means the antibiotic level in your blood may drop lower than needed, so it might not fight your infection as well as it should.
This is based on how sotorasib behaved with a similar drug in a study, so it's a theoretical concern rather than something proven with clindamycin itself. The good news is your care team can handle this by adjusting your antibiotic dose or watching how you respond. Please don't change anything on your own, just check in with your pharmacist or doctor.
Effect: Sotorasib is a moderate CYP3A4 inducer and may reduce exposure (decreased AUC/Cmax) to CYP3A substrates, risking subtherapeutic levels and therapeutic failure.
- Direction: Sotorasib induces clindamycin metabolism, lowering clindamycin exposure (clindamycin is a CYP3A4 substrate, not a prodrug requiring activation).
- Magnitude: In a clinical study sotorasib significantly decreased midazolam exposure; the clindamycin-specific effect is theoretical.
- Onset: Unspecified.
- Management: Avoid concomitant use where minimal concentration changes could cause failure. If required, increase the CYP3A substrate dose as appropriate and monitor clinical response to therapy.
What happens
Reduced exposure to CYP3A substrate and an increased risk of therapeutic failure
Interaction Deep Dive
Concurrent administration of sotorasib with a CYP3A substrate should be avoided in cases where even small shifts in concentration could result in loss of therapeutic effect. A clinical study demonstrated that giving sotorasib together with midazolam (a CYP3A substrate) markedly reduced midazolam exposure. When such combined use cannot be avoided, adjust the dose of the CYP3A substrate upward as appropriate1.
Why it happens (mechanism)
Induction of CYP3A substrate metabolism by sotorasib
How to manage this interaction
Keep taking both medications exactly as prescribed unless your care team tells you otherwise. Here is what your team may do:
- Reassess the pairing: They may prefer a different antibiotic when possible.
- Adjust the dose: If clindamycin is still needed, the dose may need to be increased and individualized by your care team.
- Monitor you more closely: They will watch to make sure your infection is responding.
Tell your pharmacist or prescriber that you are on sotorasib, and let them know if your infection is not improving as expected.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a clinical study, giving sotorasib together with midazolam (a sensitive CYP3A substrate) reduced midazolam exposure, lowering the Cmax by 48% and the AUC by 53% 1.
Common questions
Can I take Clindamycin and Sotorasib together?
Sotorasib may lower clindamycin levels and make the antibiotic less effective, so your care team may choose a different antibiotic or adjust the dose and monitor your response. Do not stop or change either drug on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Sotorasib 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 Sotorasib interaction managed?
Keep taking both medications exactly as prescribed unless your care team tells you otherwise. Here is what your team may do: Reassess the pairing: They may prefer a different antibiotic when possible. Adjust the dose: If clindamycin is still needed, the dose may need to be increased and individualized by your care team. Monitor you more closely: They will watch to make sure your infection is respo… 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 Sotorasib 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: LUMAKRAS(TM) oral tablets, sotorasib oral tablets. Amgen Inc (per FDA), Thousand Oaks, CA, 2021. DailyMed
Keep reading about Sotorasib
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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