Drug Interaction Report

Mitapivat and Quizartinib: Interaction Details

A pharmacist-reviewed analysis of the Mitapivat and Quizartinib 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

Mitapivat

Aqvesme Pyrukynd Pyrukynd®
+

Quizartinib

Vanflyta
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 295 documented Mitapivat interactions, 262 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
probable
Severity
Major

What happens

Reduced quizartinib exposure and reduced efficacy of quizartinib

Interaction Deep Dive

Avoid concomitant use of quizartinib with a strong or moderate CYP3A4 inducer. Coadministration of quizartinib (a CYP3A4 substrate) with a moderate or strong CYP3A4 inducer reduces quizartinib exposure, which may reduce the efficacy of quizartinib. The AUC(inf) of quizartinib decreased by 90% and Cmax by 45% following concomitant use of a single 53 mg dose of quizartinib with efavirenz (a moderate CYP3A inducer). The AUC of AC886 decreased by 96% and the Cmax by 68%. The effect of concomitant use with a strong CYP3A inducer may result in even greater effect on quizartinib pharmacokinetics based on mechanistic understanding of the drugs involved1.

Why it happens (mechanism)

Induction of CYP3A4-mediated metabolism of quizartinib

Literature reports

1 report — tap to read

a) The AUC(inf) of quizartinib decreased by 90% and Cmax by 45% following concomitant use of a single 53 mg dose of quizartinib with efavirenz (a moderate CYP3A4 inducer). The AUC of AC886 decreased by 96% and the Cmax by 68%. The effect of concomitant use with a strong CYP3A4 inducer may result in even greater effect on quizartinib pharmacokinetics based on mechanistic understanding of the drugs involved 1.

Common questions

Can I take Mitapivat and Quizartinib together?

Reduced quizartinib exposure and reduced efficacy of quizartinib Always confirm with your pharmacist or prescriber before making any change.

How serious is the Mitapivat and Quizartinib 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 Mitapivat or Quizartinib 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)

  1. Product Information: VANFLYTA® oral tablets, quizartinib oral tablets. Daiichi Sankyo, Basking Ridge, NJ, 2026. DailyMed
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Mitapivat

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All Mitapivat interactions (295) Mitapivat drug information
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Quizartinib

Keep reading about Quizartinib

All Quizartinib interactions (73)
Also serious with: Ketoconazole Topical Irinotecan Injection Dofetilide Arsenic Trioxide
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:

Mitapivat + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato Alkanna Alpine Ragwort + 146 more
Quizartinib + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Sida Cordifolia St. John's Wort + 138 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.