Pacritinib and Cyclosporine Ophthalmic: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cyclosporine Ophthalmic
Pacritinib
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
Altered (reduced/increased) CYP3A4/P-gp substrate with NTI exposure, an increased risk of CYP3A4/P-gp substrate with NTI-related adverse reactions and reduced efficacy of CYP3A4/P-gp substrate with NTI
Interaction Deep Dive
Coadministration of pacritinib (CYP3A4 inducer) and CYP3A4 substrates with NTI may reduce CYP3A4 substrates with NTI exposure and thus may also reduce efficacy of CYP3A4 substrates with NTI. Additionally, coadministration of pacritinib (P-gp inhibitor) and P-gp substrates with NTI may increase P-gp substrates with NTI exposure, which may increase the risk of adverse reactions from the P-gp substrate. If coadministered, monitor the efficacy of CYP3A4 substrate more frequently. Also, monitor for P-gp substrate related adverse reactions more frequently. Dose adjustment of CYP3A4 substrates with NTI may be needed1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport by pacritinib; induction of CYP3A4-substrate metabolism by pacritinib
Literature reports
2 reports — tap to read
a) In a drug interaction study, coadministration of pacritinib and midazolam (CYP3A4 substrate) may result in reduced midazolam Cmax and AUC by 0.40-fold and 0.40-fold respectively 1.
b) In a drug interaction study, coadministration of pacritinib dose of 200 mg twice daily and digoxin (P-gp substrate) 0.25 mg resulted in increased digoxin Cmax and AUC by 1.29-fold and 1.15-fold, respectively 1.
Common questions
Can I take Pacritinib and Cyclosporine Ophthalmic together?
Altered (reduced/increased) CYP3A4/P-gp substrate with NTI exposure, an increased risk of CYP3A4/P-gp substrate with NTI-related adverse reactions and reduced efficacy of CYP3A4/P-gp substrate with NTI Always confirm with your pharmacist or prescriber before making any change.
How serious is the Pacritinib and Cyclosporine Ophthalmic 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 Pacritinib or Cyclosporine Ophthalmic 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: VONJO(R) oral capsules, pacritinib oral capsules. CTI BioPharma Corp (per FDA), Seattle, WA, 2024. DailyMed
Keep reading about Cyclosporine Ophthalmic
Keep reading about Pacritinib
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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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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