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**fedratinib + efavirenz** is a combination of two drugs: **fedratinib**, an orally administered, selective inhibitor of Janus kinase 2 (JAK2) used primarily to treat adult patients with intermediate-2 or high-risk primary or secondary myelofibrosis; and **efavirenz**, a non-nucleoside reverse transcriptase inhibitor (NNRTI) commonly used as part of antiretroviral therapy for HIV infection. The combination of these two drugs is not used as a marketed therapy but may occur as a result of co-administration for patients who require both treatments. When efavirenz is co-administered with fedratinib, efavirenz induces CYP3A4, resulting in a significant reduction (about 47–50%) in fedratinib exposure, potentially reducing its efficacy. This interaction is considered clinically significant, and co-administration should generally be avoided.
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