Drug Interaction Report

Maraviroc and Duvelisib: Interaction Details

A pharmacist-reviewed analysis of the Maraviroc and Duvelisib interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Duvelisib

Copiktra
+

Maraviroc

Selzentry Selzentry®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 94 documented Maraviroc interactions, 72 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased exposure of sensitive CYP3A4 substrates and risk of toxicity

Interaction Deep Dive

Coadministration of duvelisib (a CYP3A4 inhibitor) with a CYP3A4 substrate increases the exposure of sensitive substrates, which may increase the risk of toxicities of these drugs. When duvelisib was given with midazolam (sensitive CYP3A4 substrate), the AUC and Cmax of midazolam was increased. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate1.

Why it happens (mechanism)

Inhibition of CYP3A4 substrate metabolism by duvelisib

Literature reports

1 report — tap to read

a) Coadministration of duvelisib 25 mg twice daily for 5 days with a single oral 2-mg dose of midazolam (a sensitive CYP3A4 substrate) increased in the midazolam AUC by 4.3-fold and Cmax by 2.2-fold in healthy adults 2.

Common questions

Can I take Maraviroc and Duvelisib together?

Increased exposure of sensitive CYP3A4 substrates and risk of toxicity Always confirm with your pharmacist or prescriber before making any change.

How serious is the Maraviroc and Duvelisib 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Maraviroc or Duvelisib 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 (2)

  1. Product Information: COPIKTRA(TM) oral capsules, duvelisib oral capsules. Verastem Inc (per FDA), Needham, MA, 2018. DailyMed
  2. Product Information: COPIKTRA(R) oral capsules, duvelisib oral capsules. Secura Bio Inc (per FDA), Las Vegas, NV, 2021. DailyMed
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Duvelisib

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All Duvelisib interactions (51)
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Maraviroc

Keep reading about Maraviroc

All Maraviroc interactions (94) Maraviroc drug information
Also serious with: Darunavir Atazanavir Delavirdine Conivaptan
Beyond drug–drug

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:

Duvelisib + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 135 more
Maraviroc + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 160 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.