Mitapivat and Paritaprevir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Paritaprevir
No brand names on recordMitapivat
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 mitapivat exposure, an increased risk of mitapivat-related adverse reactions and reduced CYP3A substrate exposure
Interaction Deep Dive
Avoid coadministration of mitapivat (CYP3A substrate) and strong CYP3A inhibitors that also are sensitive CYP3A substrates with NTI as concomitant use increases mitapivat exposure, which may increase the risk of adverse effects and/or reduces exposure of the sensitive CYP3A substrate21. If coadministration is required, monitor for loss of therapeutic effect 2.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of mitapivat; induction of CYP3A-mediated metabolism by mitapivat
Literature reports
3 reports — tap to read
a) Coadministration of mitapivat with itraconazole, a strong CYP3A inhibitor, increased mitapivat AUC (inf) and Cmax by 4.9-fold and 1.7-fold, respectively, following a single dose of mitapivat 20 mg. Following administration of mitapivat 50 mg twice daily with itraconazole, mitapivat AUC (0 to 12) and Cmax increased by 3.6-fold and 2.2-fold, respectively 21.
b) Coadministration of mitapivat with ketoconazole, a strong CYP3A inhibitor, increased mitapivat AUC (0 to 12) and Cmax by approximately 3.9-fold and 2.4-fold, respectively, following administration of mitapivat 5, 20 or 50 mg twice daily 21.
c) In drug interaction studies, coadministration of mitapivat with midazolam (a sensitive CYP3A substrate) decreased midazolam AUC(infinity) and Cmax by 21% and 19% with mitapivat 5 mg twice daily, by 43% and 39% with mitapivat 20 mg twice daily, and by 57% and 52% with mitapivat 50 mg twice daily, respectively 2. Similarly, midazolam AUC (inf) and Cmax decreased by 65% and 59%, respectively, with mitapivat 100 mg twice daily 1.
Common questions
Can I take Mitapivat and Paritaprevir together?
Increased mitapivat exposure, an increased risk of mitapivat-related adverse reactions and reduced CYP3A substrate exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Mitapivat and Paritaprevir 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 Mitapivat or Paritaprevir 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)
Keep reading about Paritaprevir
Keep reading about Mitapivat
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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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