pacritinib + caffeine + midazolam + omeprazole + digoxin + rosuvastatin + metformin

This is a combination drug consisting of **pacritinib**, **caffeine**, **midazolam**, **omeprazole**, **digoxin**, **rosuvastatin**, and **metformin**. - **Pacritinib** is a selective oral multikinase inhibitor primarily targeting JAK2 and FLT3, approved for the treatment of adults with intermediate or high-risk myelofibrosis with severe thrombocytopenia[2][1][6][7]. - **Caffeine** is a central nervous system stimulant that acts as an adenosine receptor antagonist. - **Midazolam** is a short-acting benzodiazepine used as a sedative and anxiolytic that acts as a GABA-A receptor positive allosteric modulator. - **Omeprazole** is a proton pump inhibitor that reduces gastric acid secretion by inhibiting the H+/K+ ATPase in stomach parietal cells. - **Digoxin** is a cardiac glycoside that inhibits Na+/K+ ATPase, increasing intracellular calcium and myocardial contractility. - **Rosuvastatin** is an HMG-CoA reductase inhibitor (statin) used to lower cholesterol. - **Metformin** is an antihyperglycemic agent that decreases hepatic glucose production and increases insulin sensitivity. Such combinations are mostly used for drug-drug interaction studies and not for clinical therapy. The main mechanism of each ingredient remains unchanged, and the combination allows assessment of metabolism and pharmacokinetics when taken together.