Vorasidenib and Abemaciclib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abemaciclib
Vorasidenib
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.
You've been prescribed two cancer medicines: abemaciclib (Verzenio) and vorasidenib (Voranigo). Here's the concern in plain terms. Your body clears abemaciclib using a liver enzyme called CYP3A4. Vorasidenib can speed up that enzyme, which means your body may break down abemaciclib faster and clear it out. The result is that abemaciclib levels can drop, and it may not work as well as it should against your cancer.
This is something your care team takes seriously and can plan around. Please don't change or stop either drug on your own. Talk with your oncologist or pharmacist so they can decide the safest combination and keep a close eye on you.
Interaction: Vorasidenib is a CYP3A4 inducer; abemaciclib is a CYP3A4 substrate. Induction increases abemaciclib metabolism, lowering its exposure (AUC/Cmax) and risking reduced antineoplastic efficacy.
- Direction: Reduced abemaciclib effect (neither drug is a prodrug here).
- Severity/evidence: Major; substantiation probable; onset unspecified (induction typically develops over days to weeks).
- Management: Avoid concomitant use per labeling. If unavoidable, dose may need individualization by the oncology team and closer monitoring of clinical response/disease control. Consider an alternative agent where feasible.
What happens
Reduced CYP3A substrate with NTI exposure and reduced efficacy of CYP3A substrate with NTI
Interaction Deep Dive
Do not combine vorasidenib, which acts as a CYP3A4 inducer, with a CYP3A substrate that has a narrow therapeutic index (NTI). By lowering the exposure of CYP3A substrates, vorasidenib can produce even small drops in concentration that may compromise efficacy. Administering repeated doses of vorasidenib together with CYP3A substrates is expected to lower the concentrations of those substrates1.
Why it happens (mechanism)
Induction of CYP3A-substrate metabolism by vorasidenib
How to manage this interaction
What your care team may do:
- Prefer to avoid using these two together when possible, and may choose an alternative medicine.
- If both are truly needed, they may adjust and individualize your abemaciclib dose and monitor you more closely to make sure it is still working.
What you should do:
- Keep taking both exactly as prescribed until your team tells you otherwise.
- Make sure your oncologist and pharmacist know you take both, and ask them how they want to handle it.
- Report any concerns about your treatment working to your care team.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Administering multiple doses of vorasidenib together with CYP3A substrates is anticipated to lower the levels of these substrates 1.
Common questions
Can I take Vorasidenib and Abemaciclib together?
Vorasidenib can lower abemaciclib levels and may make it less effective, so this combination is usually avoided. Do not stop either drug on your own; let your oncology team decide the safest plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Vorasidenib and Abemaciclib 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 is the Vorasidenib and Abemaciclib interaction managed?
What your care team may do: Prefer to avoid using these two together when possible, and may choose an alternative medicine. If both are truly needed, they may adjust and individualize your abemaciclib dose and monitor you more closely to make sure it is still working. What you should do: Keep taking both exactly as prescribed until your team tells you otherwise. Make sure your oncologist and pharm… Management is individual — always follow your own care team's guidance.
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 Vorasidenib or Abemaciclib 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: VORANIGO® oral tablets, vorasidenib oral tablets. Servier Pharmaceuticals LLC (per FDA), Boston, MA, 2024. DailyMed
Keep reading about Abemaciclib
Keep reading about Vorasidenib
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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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