Entrectinib and Mavorixafor: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mavorixafor
Entrectinib
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
Increased mavorixafor exposure, increased CYP3A4 substrate with NTI exposure, increased risk of mavorixafor-related adverse effects, increased risk of CYP3A4 substrate with NTI-related adverse effects and an increased risk of QT interval prolongation and
Interaction Deep Dive
Coadministration of mavorixafor (P-gp substrate and CYP3A4 inhibitor) with P-gp inhibitors that are CYP3A4 substrates with NTI may increase mavorixafor and CYP3A4 substrates with NTI exposure and may increase the risk of adverse reactions. Monitor more frequently for both mavorixafor and CYP3A substrate with NTI-related adverse reactions and reduce the mavorixafor daily dosage by steps of 100 mg, if necessary, but not to a dose less than 200 mg. Additionally, concomitant use of mavorixafor with drugs that prolong the QT interval, increases the risk of QT prolongation including torsade de pointes, other serious arrhythmias and sudden death. Consider obtaining electrocardiograms, correct any modifiable risk factors for QT prolongation and monitor patients during coadministration. A dose reduction or discontinuation of mavorixafor may be required. In a drug interaction study in healthy subjects, coadministration of mavorixafor 400 mg and midazolam (CYP3A4 substrate) increased Cmax and AUC by 1.1-fold and 1.7-fold, respectively1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of mavorixafor; inhibition of CYP3A4-mediated metabolism by mavorixafor; additive QT interval prolongation
Literature reports
1 report — tap to read
a) In a drug interaction study in healthy subjects, coadministration of mavorixafor (CYP3A4 inhibitor) 400 mg and midazolam (CYP3A4 substrate) increased Cmax and AUC by 1.1-fold and 1.7-fold, respectively 1.
Common questions
Can I take Entrectinib and Mavorixafor together?
Increased mavorixafor exposure, increased CYP3A4 substrate with NTI exposure, increased risk of mavorixafor-related adverse effects, increased risk of CYP3A4 substrate with NTI-related adverse effects and an increased risk of QT interval prolongation and Always confirm with your pharmacist or prescriber before making any change.
How serious is the Entrectinib and Mavorixafor 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 "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Entrectinib or Mavorixafor 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: XOLREMDI(TM) oral capsules, mavorixafor oral capsules. X4 Pharmaceuticals, Inc. (Per FDA), Boston, MA, 2024. DailyMed
Keep reading about Mavorixafor
Keep reading about Entrectinib
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