Drug Interaction Report

Maraviroc and Kratom: Interaction Details

A pharmacist-reviewed analysis of the Maraviroc and Kratom 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

Kratom

No brand names on record
+

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
Moderate
Can be significant — usually manageable with 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, 11 are rated moderate — including this one.
Onset
unspecified
Evidence
probable
Severity
Moderate

What happens

Increased CYP3A substrate exposure

Interaction Deep Dive

Concomitant use of kratom (CYP3A inhibitor) and a CYP3A substrate may increase exposure of the CYP3A substrate, especially at higher kratom doses or with chronic use1. Close monitoring is suggested 2.

Why it happens (mechanism)

Inhibition of CYP3A-mediated metabolism by kratom

Literature reports

1 report — tap to read

a) Consumption of a single, low dose of kratom tea (2 g) together with oral midazolam (CYP3A probe substrate; 2.5 mg) and oral dextromethorphan (CYP2D6 probe substrate; 30 mg) was evaluated in an open-label crossover study of healthy adults (N=12). Kratom modestly increased midazolam geometric mean AUC (1.39; 90% CI, 1.23 to 1.57) and Cmax (1.5; 90% CI, 1.32 to 1.7); no effect on dextromethorphan AUC or Cmax was observed. Midazolam half life was not significantly altered with concomitant use of kratom which suggests inhibition of first-pass metabolism, primarily CYP3A in the intestine. Participants (median age, 30 years) were previously exposed to kratom and willing to abstain from concomitant medications and botanical or other natural products (including kratom) during the study 1.

Common questions

Can I take Maraviroc and Kratom together?

Increased CYP3A substrate exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Maraviroc and Kratom interaction?

It is rated moderate. Can be significant — usually manageable with 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.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Maraviroc or Kratom 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 anything you'd monitor while I'm on both?

References (2)

  1. Tanna RS, Nguyen JT, Hadi DL, et al: Clinical assessment of the drug interaction potential of the psychotropic natural product kratom. Clin Pharmacol Ther 2023; 113(6):1315-1325. PubMed
  2. Dhoble LR, Gour A, McCurdy CR, et al: Evaluating the drug interactions in kratom usage: clinical application. Expert Opin Drug Metab Toxicol 2025; 21(8):949-959. DOI
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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:

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.