Maraviroc and Berotralstat: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Berotralstat
Maraviroc
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 P-gp substrate exposure
Interaction Deep Dive
Berotralstat at 2-times the maximum recommended dose of 150 mg is a P-gp inhibitor. Concomitant use of berotralstat and P-gp substrates may can increase exposure of P-gp substrates, leading to increased risk of adverse reactions associated with the substrates. Higher-than-recommended dosages of berotralstat are not recommended. Closely monitor or modify the dosage of the P-gp substrate1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport by berotralstat
Literature reports
1 report — tap to read
a) In drug interaction study, coadministration of berotralstat with digoxin at the dose of 300 mg increased the AUC by approximately 1.5 fold and Cmax by approximately 1.5 fold 1.
Common questions
Can I take Maraviroc and Berotralstat together?
Increased P-gp substrate exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Maraviroc and Berotralstat 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 Maraviroc or Berotralstat 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: ORLADEYO® oral capsules, oral pellets, berotralstat oral capsules, oral pellets. BioCryst Pharmaceuticals Inc (per manufacturer), Durham, NC, 2025. DailyMed
Keep reading about Berotralstat
Keep reading about Maraviroc
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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:
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