Midostaurin and Mavorixafor: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mavorixafor
Midostaurin
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 CYP3A4 substrate with NTI exposure and an increased risk of CYP3A4 with NTI-related adverse events
Interaction Deep Dive
Coadministration of mavorixafor (CYP3A4 inhibitor) and CYP3A4 substrate with NTI may increase CYP3A4 substrate with NTI exposure and may increase risk of CYP3A4 substrate with NTI-related adverse events. Monitor for CYP3A4 substrate-related adverse reactions more frequently when mavorixafor is used concomitantly with CYP3A4 substrates where minimal substrate concentration changes may lead to serious adverse reactions. In a drug interaction study, coadministration of mavorixafor 400 mg and midazolam (CYP3A4 substrate) in healthy subjects increased Cmax and AUC by 1.1-fold and 1.7-fold, respectively1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by mavorixafor
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 Midostaurin and Mavorixafor together?
Increased CYP3A4 substrate with NTI exposure and an increased risk of CYP3A4 with NTI-related adverse events Always confirm with your pharmacist or prescriber before making any change.
How serious is the Midostaurin 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 Midostaurin 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 Midostaurin
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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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