Mifepristone and Everolimus: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mifepristone
Everolimus
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 everolimus exposure and an increased miFEPRIStone exposure
Interaction Deep Dive
Coadministration of miFEPRIStone (strong CYP3A inhibitor) (Korlym®) and everolimus (CYP3A substrates with NTI) is contraindicated. If coadministered, discontinuation or dose reduction of everolimus may be necessary5. However, exert caution when miFEPRIStone (Mifeprex®) is coadministered with everolimus. Due to the slow elimination of miFEPRIStone from the body, such interaction may be observed for a prolonged period after its administration 6. Coadministration of everolimus with miFEPRIStone (a dual strong CYP3A4 and P-gp inhibitor) may increase everolimus exposure 21. Coadministration of miFEPRIStone with everolimus (CYP3A inhibitor) may also increase miFEPRIStone exposure. Wait at least 2 weeks after stopping miFEPRIStone before initiating everolimus. If coadministered, use the lowest effective dose possible. Limit miFEPRIStone to 900 mg 5.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of everolimus; inhibition of P-gp mediated efflux transport of everolimus; inhibition of CYP3A-mediated metabolism of miFEPRIStone
Literature reports
3 reports — tap to read
a) In a drug interaction study, coadministration of miFEPRIStone 1200 mg once daily for 10 days and simvastatin (CYP3A4 substrate) 80 mg single dose, resulted in increased simvastatin AUC and Cmax by 10.40-fold and 7.02-fold, respectively. Also resulted in increased simvastatin acid AUC and Cmax by 15.7-fold and 18.20, respectively 5.
b) A 78-year-old female heart transplant recipient receiving everolimus-based immunosuppressive therapy for 11 years (1 mg every 12 hours) with stable trough levels experienced an 11.4-fold increase in everolimus (greater than 20 nanograms (ng)/mL) 4 days following initiation of clarithromycin (500 mg ever 12 hours) for the treatment of pneumonia. Despite a reduction in everolimus to 0.25 mg every 12 hours, her everolimus level remained elevated (18.59 ng/mL). Upon discontinuation of clarithromycin, the everolimus Cmin returned to a stable level of 8.53 ng/mL. The patient did not experience any adverse events 4.
c) Coadministration of everolimus (a CYP3A4 and P-gp substrate) and ketoconazole (a strong CYP3A4 and P-gp inhibitor) in healthy volunteers increased everolimus Cmax by 3.9-fold, AUC by 15-fold, and half-life by 89% 3.
Common questions
Can I take Mifepristone and Everolimus together?
Increased everolimus exposure and an increased miFEPRIStone exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Mifepristone and Everolimus interaction?
It is rated contraindicated. These should generally not be used together.
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 Mifepristone or Everolimus 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 (6)
- Product Information: AFINITOR DISPERZ® tablets for oral suspension, everolimus tablets for oral suspension. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2026. DailyMed
- Product Information: AFINITOR® oral tablets, everolimus oral tablets. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2026. DailyMed
- Product Information: ZORTRESS(R) oral tablets, everolimus oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Pea F, Cojutti P, Tursi V, et al: Everolimus overexposure in a heart transplant patient receiving clarithromycin for the treatment of pneumonia. Transpl Infect Dis 2015; 17(6):926-928. PubMed
- Product Information: KORLYM(R) oral tablets, mifepristone oral tablets. Corcept Therapeutics Incorporated (per Dailmed), Redwood City, CA, 2024. DailyMed
- Product Information: MIFEPREX(R) oral tablets, mifepristone oral tablets. Danco Laboratories, LLC (per FDA), New York, NY, 2023. DailyMed
Keep reading about Mifepristone
Keep reading about Everolimus
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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