Sonrotoclax and Lefamulin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lefamulin
Sonrotoclax
No brand names on record
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 sonrotoclax exposure, an increased risk sonrotoclax-related adverse reactions and an increased risk of tumor lysis syndrome
Interaction Deep Dive
Avoid coadministration of sonrotoclax with moderate CYP3A inhibitors at 1 mg and 2 mg dose of sonrotoclax as it may increase sonrotoclax exposure, which may increase the risk of sonrotoclax adverse reactions and an increased risk of tumor lysis syndrome. Reduce all other doses of sonrotoclax by at least 4-fold during initiation and ramp-up phase, as following: 5 mg to 1 mg, 10 mg to 2 mg, 20 mg to 5 mg, 40 mg to 10 mg, 80 mg to 20 mg, 160 mg to 40 mg and 320 mg to 80 mg. For dose adjustments after ramp-up, reduce sonrotoclax dose to 80 mg. Resume the sonrotoclax dosage that was used prior to treatment with a moderate CYP3A inhibitor at least 5 days after discontinuation of the inhibitor1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of sonrotoclax
Common questions
Can I take Sonrotoclax and Lefamulin together?
Increased sonrotoclax exposure, an increased risk sonrotoclax-related adverse reactions and an increased risk of tumor lysis syndrome Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sonrotoclax and Lefamulin 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 Sonrotoclax or Lefamulin 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: BEQALZI™ oral tablets, sonrotoclax oral tablets. BeOne Medicines USA, Inc, Pennington, NJ, 2026.
Keep reading about Lefamulin
Keep reading about Sonrotoclax
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