Clindamycin and Vorasidenib: 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
Clindamycin
Vorasidenib
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.
Here's what's going on when you take clindamycin (an antibiotic) together with vorasidenib (Voranigo, used for certain brain tumors). Vorasidenib can speed up the way your body breaks down clindamycin. That means less clindamycin stays in your system, and it may not fight your infection as well as it should.
The good news is your care team can plan around this. If you need both, your doctor or pharmacist may choose a different antibiotic or watch closely to make sure your infection is clearing. Please don't stop or change either medicine on your own, just bring it up with your pharmacist or prescriber so they can guide you.
Effect: Vorasidenib is a CYP3A4 inducer and may reduce exposure (decreased AUC/Cmax) of CYP3A substrates, potentially lowering efficacy. Clindamycin is partially metabolized by CYP3A4, so induction could reduce its systemic concentrations.
- Direction: Reduced clindamycin effect (induction, not a prodrug scenario).
- Mechanism: Induction of CYP3A-mediated metabolism by vorasidenib.
- Evidence: Probable; magnitude not quantified; onset unspecified (induction typically develops over days).
- Management: Avoid concomitant use where feasible; consider a non-CYP3A alternative antibiotic or monitor closely for treatment failure and adjust therapy accordingly.
What happens
Reduced CYP3A substrate with NTI exposure and reduced efficacy of CYP3A substrate with NTI
Interaction Deep Dive
Do not combine vorasidenib, which acts as a CYP3A4 inducer, with a CYP3A substrate that has a narrow therapeutic index (NTI). Because vorasidenib can lower the exposure of CYP3A substrates, even small shifts in concentration may result in diminished efficacy. Administering multiple doses of vorasidenib alongside CYP3A substrates is projected to lower the concentrations of those substrates1.
Why it happens (mechanism)
Induction of CYP3A-substrate metabolism by vorasidenib
How to manage this interaction
The documented guidance is to avoid combining these when possible, because vorasidenib can lower clindamycin levels and reduce how well it treats your infection.
- Keep taking both as prescribed unless your care team tells you otherwise.
- Your team may choose a different antibiotic that isn't affected this way, or watch you more closely to confirm the infection is responding.
- Tell your prescriber or pharmacist that you're on vorasidenib before starting any antibiotic.
- Report signs your infection isn't improving (persistent fever, worsening redness, pain, or drainage).
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Administering repeated doses of vorasidenib together with CYP3A substrates is anticipated to lower the levels of these substrates 1.
Common questions
Can I take Clindamycin and Vorasidenib together?
Vorasidenib can speed up the breakdown of clindamycin and make the antibiotic less effective, so your care team may pick a different antibiotic or monitor your infection closely. Don't stop either drug on your own; check with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin and Vorasidenib 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 Vorasidenib interaction managed?
The documented guidance is to avoid combining these when possible, because vorasidenib can lower clindamycin levels and reduce how well it treats your infection. Keep taking both as prescribed unless your care team tells you otherwise. Your team may choose a different antibiotic that isn't affected this way, or watch you more closely to confirm the infection is responding. Tell your prescriber or… 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.
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 Vorasidenib 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: VORANIGO® oral tablets, vorasidenib oral tablets. Servier Pharmaceuticals LLC (per FDA), Boston, MA, 2024. DailyMed
Keep reading about Clindamycin
Keep reading about Vorasidenib
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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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