Wechselwirkungen von Efavirenz, Lamivudin und Tenofovir

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

CYP3A4 Inducers: Avoid concomitant strong CYP3A4 inducers during YONSA treatment. (Fachinformation zu Abirateron, Arzneimittelwechselwirkungen)

• CYP3A Inhibitors: Avoid co-administration with strong CYP3A inhibitors. (Fachinformation zu Acalabrutinib, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hepatitis B antiviral agents Adefovir dipivoxil Concomitant administration of adefovir dipivoxil is not recommended. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

…(Childs-Pugh categories B and C), since alfuzosin blood levels are increased in these patients [see Use in Specific Populations (8.7) and Clinical Pharmacology (12.3) ]. with potent CYP3A4 inhibitors such as ketoconazole, itraconazole, and ritonavir, since alfuzosin blood levels are increased [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . in… (Fachinformation zu Alfuzosin, Gegenanzeigen)

Concomitant use of almotriptan tablets and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Almotriptan, Arzneimittelwechselwirkungen)

CYP3A4 Inducers : Avoid coadministration of VIJOICE with a strong CYP3A4 inducer. (Fachinformation zu Alpelisib, Arzneimittelwechselwirkungen)

• taking strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, itraconazole), except ritonavir [see Dosage and Administration (2.5) , Warnings and Precautions (5.5) , Drug Interactions (7.1) ] . (Fachinformation zu Alprazolam, Gegenanzeigen)

• Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use. (Fachinformation zu Apixaban, Arzneimittelwechselwirkungen)

Drug Interactions : Use with strong cytochrome P450 enzyme inducers (e.g., rifampin, phenobarbital, carbamazepine, phenytoin) is not recommended because loss of efficacy may occur ( 5.5 , 7.1 ) (Fachinformation zu Apremilast, Warnhinweise und Vorsichtsmaßnahmen)

CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (Fachinformation zu Aripiprazol, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Atovaquone/ proguanil ↓ atovaquone ↓ proguanil Concomitant administration is not recommended. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Atovaquone/ proguanil ↓ atovaquone ↓ proguanil Concomitant administration is not recommended. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Do not use avanafil in patients taking strong CYP3A4 inhibitors [see Warnings and Precautions ( 5.2 ) and Dosage and Administration ( 2.3 )]. (Fachinformation zu Avanafil, Arzneimittelwechselwirkungen)

Moderate CYP3A4/5 inducers (e.g., bosentan, efavirenz, etravirine, modafinil, and nafcillin) may also reduce the plasma exposure of axitinib and should be avoided if possible. (Fachinformation zu Axitinib, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 Inducers: Avoid concomitant use. (Fachinformation zu Bortezomib, Arzneimittelwechselwirkungen)

Co-administration of such combinations of a CYP2C9 inhibitor plus a strong or moderate CYP3A inhibitor with TRACLEER is not recommended. (Fachinformation zu Bosentan, Arzneimittelwechselwirkungen)

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (Fachinformation zu Bosutinib, Arzneimittelwechselwirkungen)

Concomitant use of strong CYP3A4 inhibitors (e.g., azole antimycotics, HIV protease inhibitors) with CYCLOSET should be avoided. (Fachinformation zu Bromocriptin, Arzneimittelwechselwirkungen)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (Fachinformation zu Buprenorphin, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (Fachinformation zu Butalbital, Paracetamol, Koffein und Codein, Boxed Warning (umrahmter Warnhinweis))

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid taking a strong CYP3A4 inhibitor (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole) while taking COMETRIQ or reduce the dosage of COMETRIQ if concomitant use with strong CYP3A4 inhibitors cannot be avoided [see Dosage and Administration ( 2.2 ), Clinical Pharmacology… (Fachinformation zu Cabozantinib, Arzneimittelwechselwirkungen)

Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (Fachinformation zu Cariprazin, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid use of Citalopram Capsules in CYP2C19 poor metabolizers, patients receiving concomitant cimetidine or another CYP2C19 inhibitor, patients with hepatic impairment, and patients who are greater than 60 years of age, because Citalopram Capsules are only available in a 30 mg dose strength and dosage adjustments are not possible [see Drug Interactions ( 7 ),… (Fachinformation zu Citalopram, Warnhinweise und Vorsichtsmaßnahmen)

Antiviral and antiretroviral drugs: Avoid concomitant use. (Fachinformation zu Cladribin, Arzneimittelwechselwirkungen)

CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole. (Fachinformation zu Clopidogrel, Warnhinweise und Vorsichtsmaßnahmen)

• Concomitant use of Strong CYP3A4 Inducers is not recommended. (Fachinformation zu Clozapin, Arzneimittelwechselwirkungen)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (Fachinformation zu Codein, Boxed Warning (umrahmter Warnhinweis))

Patients with renal or hepatic impairment should not be given colchicine capsules with drugs that inhibit both P-glycoprotein and CYP3A4 inhibitors [see Drug Interactions (7) ] . (Fachinformation zu Colchicin, Gegenanzeigen)

Strong CYP3A4 inhibitors: Avoid concomitant use. (Fachinformation zu Daridorexant, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid concomitant use of strong CYP3A4 inhibitors. (Fachinformation zu Dasatinib, Arzneimittelwechselwirkungen)

Avoid use of moderate or strong CYP3A4 inducers with EMFLAZA, as they may reduce efficacy ( 7.1 ) (Fachinformation zu Deflazacort, Arzneimittelwechselwirkungen)

• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Fachinformation zu Dexamethason, Arzneimittelwechselwirkungen)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (Fachinformation zu Dextromethorphan und Chinidin, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

WARNING: PERIPHERAL ISCHEMIA FOLLOWING COADMINISTRATION WITH POTENT CYP3A4 INHIBITORS Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of dihydroergotamine with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics. (Fachinformation zu Dihydroergotamin, Boxed Warning (umrahmter Warnhinweis))

Concomitant use of Docetaxel Injection and drugs that inhibit CYP3A4 may increase exposure to docetaxel and should be avoided. (Fachinformation zu Docetaxel, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Avoid concomitant use of doxorubicin hydrochloride with inhibitors and inducers of CYP3A4, CYP2D6, and/or P-gp ( 7.1 ) (Fachinformation zu Doxorubicin, Arzneimittelwechselwirkungen)

• CYP3A inducers: Avoid concomitant use. (Fachinformation zu Dronedaron, Arzneimittelwechselwirkungen)

Drug-Drug Interactions Strong Inhibitors of Cytochrome P450 (CYP) 3A4 Tamsulosin-containing products, including JALYN, should not be coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole) as this can significantly increase tamsulosin exposure [see Drug Interactions (7.1) , Clinical Pharmacology (12.3) ]. (Fachinformation zu Dutasterid und Tamsulosin, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Recent use (i.e., within at least 72 hours) of the following potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ]. (Fachinformation zu Eletriptan, Gegenanzeigen)

Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (Fachinformation zu Elexacaftor, Tezacaftor und Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Therapy with BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also receiving highly active antiretroviral therapy (HAART) [see Warnings and Precautions (5.2) ] . (Fachinformation zu Entecavir, Boxed Warning (umrahmter Warnhinweis))

…Patients Eplerenone is contraindicated in all patients with: • serum potassium > 5.5 mEq/L at initiation, • creatinine clearance ≤ 30 mL/min, or • concomitant administration of strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, and nelfinavir) [see Drug Interactions (7.1) , Clinical Pharmacology (12.3)… (Fachinformation zu Eplerenon, Gegenanzeigen)

WARNING Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of ergotamine tartrate and caffeine tablets with potent CYP 3A4 inhibitors including protease inhibitors and macrolide antibiotics. (Fachinformation zu Ergotamin und Koffein, Boxed Warning (umrahmter Warnhinweis))

Avoid co-administering erlotinib with strong CYP3A4 inhibitors (e.g., boceprevir, clarithromycin, conivaptan, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telithromycin, voriconazole, grapefruit or grapefruit juice) or a combined CYP3A4 and CYP1A2 inhibitor (e.g., ciprofloxacin). (Fachinformation zu Erlotinib, Arzneimittelwechselwirkungen)

Consequently, estazolam should be avoided in patients receiving ketoconazole and itraconazole, which are very potent inhibitors of CYP3A (see CONTRAINDICATIONS ). (Fachinformation zu Estazolam, Warnhinweise)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

VYTORIN is contraindicated in the following conditions: Concomitant use of strong CYP3A4 inhibitors (select azole anti-fungals, macrolide antibiotics, anti-viral medications, and nefazodone) [see Drug Interactions (7.1) ] . (Fachinformation zu Ezetimib und Simvastatin, Gegenanzeigen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (Fachinformation zu Fentanyl, Boxed Warning (umrahmter Warnhinweis))

CYP3A4 Inhibitors Doses of Toviaz greater than 4 mg are not recommended in adult patients taking strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, and clarithromycin [see Dosage and Administration (2.5) ]. (Fachinformation zu Fesoterodin, Arzneimittelwechselwirkungen)

Contraindicated with Strong or Moderate CYP3A4 Inhibitors The concomitant use of ADDYI and moderate or strong CYP3A4 inhibitors increases flibanserin concentrations, which can cause severe hypotension and syncope [see Warnings and Precautions (5.2) ] . (Fachinformation zu Flibanserin, Boxed Warning (umrahmter Warnhinweis))

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (Fachinformation zu Fluticason, Arzneimittelwechselwirkungen)

Avoid strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): May increase risk of systemic corticosteroid and cardiovascular effects. (Fachinformation zu Fluticason und Salmeterol, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Cytochrome P450 3A4 Interaction The concomitant use of HYSINGLA ER with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (Fachinformation zu Hydrocodon, Boxed Warning (umrahmter Warnhinweis))

Cytochrome P450 3A4 Interaction The concomitant use of Hydrocodone Polistirex and Chlorpheniramine Polistirex with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. (Fachinformation zu Hydrocodon und Chlorphenamin, Boxed Warning (umrahmter Warnhinweis))

Cytochrome P450 3A4 Interaction The concomitant use of hydrocodone bitartrate and homatropine methylbromide with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. (Fachinformation zu Hydrocodon und Homatropin, Boxed Warning (umrahmter Warnhinweis))

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Cytochrome P450 3A4 Interaction The concomitant use of hydrocodone bitartrate and acetaminophen tablets with all Cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (Fachinformation zu Hydrocodon und Paracetamol, Boxed Warning (umrahmter Warnhinweis))

Increased Toxicity with Concomitant Use of Antiretroviral Drugs Pancreatitis Pancreatitis (including fatal cases) have occurred in patients with HIV infection during therapy with hydroxyurea and didanosine, with or without stavudine. (Fachinformation zu Hydroxycarbamid, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Strong CYP3A4 Inducers: Do not administer strong CYP3A4 inducers with CAMPTOSAR. (Fachinformation zu Irinotecan, Arzneimittelwechselwirkungen)

Antivirals Efavirenz Nevirapine Not recommended 2 weeks before and during TOLSURA treatment. (Fachinformation zu Itraconazol, Arzneimittelwechselwirkungen)

…bradycardia [see Warnings and Precautions ( 5.3 )] • Severe hepatic impairment [see Use in Specific Populations ( 8.6 )] • Pacemaker dependence (heart rate maintained exclusively by the pacemaker) [see Drug Interactions ( 7.3 )] • Concomitant use of strong cytochrome P450 3A4 (CYP3A4) inhibitors [see Drug Interactions ( 7.1 )] Acute decompensated heart failure ( 4 ) (Fachinformation zu Ivabradin, Gegenanzeigen)

Johanniskraut kann die Blutspiegel einiger HIV-Arzneimittel so stark senken, dass die Behandlung versagt. (NCCIH, St. John's Wort)

Therefore, administration of potent enzyme inducers of CYP3A4 with ketoconazole tablets is not recommended. (Fachinformation zu Ketoconazol, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid strong CYP3A4 inhibitors. (Fachinformation zu Lapatinib, Arzneimittelwechselwirkungen)

Strong CYP3A4 Inhibitors: Avoid coadministration of strong CYP3A4 inhibitors with VITRAKVI. (Fachinformation zu Larotrectinib, Arzneimittelwechselwirkungen)

Velpatasvir/Sofosbuvir ↓ velpatasvir Coadministration of EFV and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong or moderate CYP3A inhibitors: Avoid concomitant use. (Fachinformation zu Lemborexant, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant administration of JUXTAPID with moderate or strong CYP3A4 inhibitors, as this can increase JUXTAPID exposure [see Warnings and Precautions (5.6) , Drug Interactions (7.1) , and Clinical Pharmacology (12.3) ]. (Fachinformation zu Lomitapid, Gegenanzeigen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Strong CYP3A Inhibitors : Avoid concomitant use; reduce LORBRENA dose if concomitant use cannot be avoided. (Fachinformation zu Lorlatinib, Arzneimittelwechselwirkungen)

Concomitant administration with strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, posaconazole, voriconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, nefazodone and cobicistat-containing products) (see WARNINGS , Myopathy/Rhabdomyolysis ). (Fachinformation zu Lovastatin, Gegenanzeigen)

CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (Fachinformation zu Lumateperon, Arzneimittelwechselwirkungen)

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole, mibefradil, etc.) [see Drug Interactions ( 7.1 )]. (Fachinformation zu Lurasidon, Gegenanzeigen)

Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (Fachinformation zu Macitentan, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Although there have been no reports of such interactions with methylergonovine alone, strong and moderate CYP 3A4 inhibitors should not be co-administered with methylergonovine. (Fachinformation zu Methylergometrin, Arzneimittelwechselwirkungen)

CYP3A inducers: Do not use mifepristone with CYP3A inducers ( 7.3 ). (Fachinformation zu Mifepriston, Arzneimittelwechselwirkungen)

Strong CYP3A Inhibitors and Inducers: Avoid concomitant use. (Fachinformation zu Mitapivat, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

John's Wort) Clinical Impact Significant decrease in plasma naldemedine concentrations, which may reduce efficacy [see Clinical Pharmacology (12.3) ] Intervention Avoid use of SYMPROIC with strong CYP3A inducers. (Fachinformation zu Naldemedin, Arzneimittelwechselwirkungen)

Patients concomitantly using strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) because these medications can significantly increase exposure to naloxegol which may precipitate opioid withdrawal symptoms such as hyperhidrosis, chills, diarrhea, abdominal pain, anxiety, irritability, and yawning [see Drug Interactions (7.1) and Clinical Pharmacology… (Fachinformation zu Naloxegol, Gegenanzeigen)

CYP2B6 Inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) may reduce efficacy by reducing bupropion exposure, avoid concomitant use. (Fachinformation zu Naltrexon und Bupropion, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

John’s Wort reduce the bioavailability and efficacy of nifedipine; therefore nifedipine should not be used in combination with strong CYP3A inducers such as rifampin (See CONTRAINDICATIONS ). (Fachinformation zu Nifedipin, Arzneimittelwechselwirkungen)

Avoid use of concomitant drugs known to prolong the QT interval and strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 , 7.2 )] . (Fachinformation zu Nilotinib, Boxed Warning (umrahmter Warnhinweis))

Therefore, the concomitant administration of NYMALIZE and strong CYP3A4 inhibitors should generally be avoided [ see Warnings and Precautions (5.3) ]. (Fachinformation zu Nimodipin, Arzneimittelwechselwirkungen)

…contraindicated with drugs that are primarily metabolized by CYP3A and for which elevated concentrations are associated with serious and/or life-threatening reactions and drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance. (Fachinformation zu Nirmatrelvir und Ritonavir, Gegenanzeigen)

CYP3A4 inhibitors and inducers : SULAR is substrate of CYP3A4 and coadministration of SULAR with any known inducer or inhibitor of CYP3A4 should be avoided in general. (Fachinformation zu Nisoldipin, Arzneimittelwechselwirkungen)

Counsel patients to use a back-up method or alternative method of contraception when enzyme inducers are used with COCs ( 7.1 ) -- - ---------- ------ USE IN SPECIFIC POPULATIONS---- -- -- --------- ---- Lactation: Not recommended; Lo Loestrin Fe can decrease milk production ( 8.2 ) (Fachinformation zu Norethisteron und Ethinylestradiol, Arzneimittelwechselwirkungen)

If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (Fachinformation zu Oliceridin, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Cytochrome P450 3A4 Interaction The concomitant use of Oxycodone Hydrochloride Oral Solution with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (Fachinformation zu Oxycodon, Boxed Warning (umrahmter Warnhinweis))

Cytochrome P450 3A4 Interaction The concomitant use of oxycodone hydrochloride tablets with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (Fachinformation zu Oxycodon und Paracetamol, Boxed Warning (umrahmter Warnhinweis))

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (Fachinformation zu Palbociclib, Arzneimittelwechselwirkungen)

Strong CYP3A4 and P-glycoprotein (P-gp) inducers : Avoid using a strong inducer of CYP3A4 and/or P-gp during a dosing interval for ERZOFRI. (Fachinformation zu Paliperidon, Arzneimittelwechselwirkungen)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (Fachinformation zu Paracetamol und Codein, Boxed Warning (umrahmter Warnhinweis))

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 Inhibitors : Avoid coadministration of VOTRIENT with strong CYP3A4 inhibitors. (Fachinformation zu Pazopanib, Arzneimittelwechselwirkungen)

Cytochrome P450 3A4 Interaction The concomitant use of DEMEROL Injection with all cytochrome P450 3A4 inhibitors may result in an increase in meperidine plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (Fachinformation zu Pethidin, Boxed Warning (umrahmter Warnhinweis))

Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (Fachinformation zu Pimavanserin, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Posaconazole ↓ posaconazole Avoid concomitant use unless the benefit outweighs the risks. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

• Patients taking strong Cytochrome P450 3A enzyme (CYP3A) inducers, such as rifampin, [see Warnings and Precautions ( 5.6 ) and Drug Interactions ( 7.1 , 7.2 )] . (Fachinformation zu Praziquantel, Gegenanzeigen)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex, requiring careful consideration of the effects on the parent drug, codeine, and the active metabolite, morphine. (Fachinformation zu Promethazin und Codein, Boxed Warning (umrahmter Warnhinweis))

• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 (CYP2D6) inhibitor and a 3A4 inhibitor (CYP3A4). (Fachinformation zu Propafenon, Warnhinweise und Vorsichtsmaßnahmen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

ASPRUZYO Sprinkle is contraindicated in patients: Taking strong inhibitors of CYP3A [see Drug Interactions (7.1)] Taking inducers of CYP3A [see Drug Interactions (7.1)] With liver cirrhosis [see Use in Specific Populations (8.6)] Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin, nelfinavir) (4, 7.1) (Fachinformation zu Ranolazin, Gegenanzeigen)

Bictegravir 75 mg once a day 300 mg once a day (fasted) Healthy subjects ND ↓ AUC 38% ↓ C min 56% ↓ C max 20% Co-administration of rifabutin with Biktarvy (bictegravir/emtricitabine/ tenofovir alafenamide) is not recommended due to an expected decrease in tenofovir alafenamide in addition to the reported reduction in bictegravir. (Fachinformation zu Rifabutin, Arzneimittelwechselwirkungen)

…Concentrations Administered with rifampin 600 mg daily, unless otherwise specified AUC = area under the time-concentration curve Drug or Drug Class and Prevention or Management Clinical Effect Antiretrovirals Prevention or Management: Concomitant use is contraindicated (see CONTRAINDICATIONS ) Atazanavir Decrease AUC by 72% Darunavir Rifampin dosage used concomitantly with… (Fachinformation zu Rifampicin, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Strong CYP3A4 Inhibitors: Avoid concomitant administration. (Fachinformation zu Rimegepant, Arzneimittelwechselwirkungen)

• Certain CYP3A inducers: Coadministration with strong inducers of CYP3A is not recommended. (Fachinformation zu Ritlecitinib, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Use with P-gp and Strong CYP3A Inhibitors or Inducers Avoid concomitant use of XARELTO with known combined P-gp and strong CYP3A inhibitors [see Drug Interactions (7.2) ] . (Fachinformation zu Rivaroxaban, Warnhinweise und Vorsichtsmaßnahmen)

• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (Fachinformation zu Roflumilast, Warnhinweise und Vorsichtsmaßnahmen)

Intervention: Avoid the use of VARUBI in patients who require chronic administration of strong CYP3A4 inducers. (Fachinformation zu Rolapitant, Arzneimittelwechselwirkungen)

• Avoid use with rifampin and strong CYP3A4 inducers ( 7.3 ). (Fachinformation zu Romidepsin, Arzneimittelwechselwirkungen)

• Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (Fachinformation zu Salmeterol, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Severe renal impairment (CCr < 30 mL/min) Severe hepatic impairment (Child-Pugh score ≥ 10) Concomitant administration with strong Cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir) [see DRUG INTERACTIONS (7.1) ] Patients with a history of hypersensitivity to silodosin or any of the ingredients in silodosin capsules… (Fachinformation zu Silodosin, Gegenanzeigen)

ZOCOR is contraindicated in the following conditions: Concomitant use of strong CYP3A4 inhibitors (select azole anti-fungals, macrolide antibiotics, anti-viral medications, and nefazodone) [see Drug Interactions (7.1) ] . (Fachinformation zu Simvastatin, Gegenanzeigen)

Interaction with Strong Inhibitors and Inducers of CYP3A4 and/or P-gp Avoid concomitant use of sirolimus with strong inhibitors of CYP3A4 and/or P-gp (such as ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, or clarithromycin) or strong inducers of CYP3A4 and/or P-gp (such as rifampin or rifabutin) [ see Drug Interactions (7.2) ]. (Fachinformation zu Sirolimus, Warnhinweise und Vorsichtsmaßnahmen)

Velpatasvir/Sofosbuvir ↓ velpatasvir Coadministration of EFV and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

The dosage of Solifenacin succinate tablets greater than 5 mg once daily is not recommended when concomitantly used with strong CYP3A4 inhibitors [see Dosage and Administration ( 2.4 )] . (Fachinformation zu Solifenacin, Arzneimittelwechselwirkungen)

• Strong CYP3A Inducers: Avoid strong CYP3A4 inducers. (Fachinformation zu Sorafenib, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant use of JOURNAVX with strong CYP3A inhibitors is contraindicated [see Warnings and Precautions (5.1) , Drug Interactions (7.1) ] . (Fachinformation zu Suzetrigin, Gegenanzeigen)

Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (Fachinformation zu Tamoxifen, Arzneimittelwechselwirkungen)

• Should not be used in combination with strong inhibitors of CYP3A4. (Fachinformation zu Tamsulosin, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 inducers (e.g., rifampin): Avoid use of HETLIOZ in combination with rifampin or other CYP3A4 inducers, because of decreased exposure ( 7.2 , 12.3 ) (Fachinformation zu Tasimelteon, Arzneimittelwechselwirkungen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Avoid co-administration of strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, ritonavir) and strong CYP3A4 inducers (e.g., rifampin, phenytoin) with TEPADINA due to the potential effects on efficacy and toxicity [see Clinical Pharmacology ( 12.3 ) ] . (Fachinformation zu Thiotepa, Arzneimittelwechselwirkungen)

• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (Fachinformation zu Ticagrelor, Arzneimittelwechselwirkungen)

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

…dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS [see Warnings and Precautions (5.2) ] Unable to sense or respond to thirst Hypovolemic hyponatremia Taking strong CYP3A inhibitors [see Warnings and Precautions (5.5) ] Anuria Hypersensitivity (e.g., anaphylactic shock, rash generalized) to tolvaptan or any components of the product [see Adverse… (Fachinformation zu Tolvaptan, Gegenanzeigen)

Drugs known to prolong the QT interval and strong CYP3A4 inhibitors should be avoided [see Warnings and Precautions (5.1) ] . (Fachinformation zu Toremifen, Boxed Warning (umrahmter Warnhinweis))

CYP3A inhibitors: Avoid concomitant strong CYP3A inhibitors ( 7.1 ) (Fachinformation zu Trabectedin, Arzneimittelwechselwirkungen)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (Fachinformation zu Tramadol, Boxed Warning (umrahmter Warnhinweis))

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (Fachinformation zu Tramadol und Paracetamol, Boxed Warning (umrahmter Warnhinweis))

The use of RALDESY Should be avoided in patients with known QT prolongation or in combination with other drugs that are inhibitors of CYP3A4 (e.g., itraconazole, clarithromycin, voriconazole), or known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic… (Fachinformation zu Trazodon, Warnhinweise und Vorsichtsmaßnahmen)

• Strong CYP3A Inhibitors and Inducers: Avoid coadministration with strong CYP3A inhibitors and inducers. (Fachinformation zu Tretinoin, Arzneimittelwechselwirkungen)

Strong CYP 3A Inhibitors Triazolam is contraindicated in patients receiving strong inhibitors of CYP 3A such as ketoconazole, itraconazole, nefazodone, ritonavir, indinavir, nelfinavir, saquinavir, and lopinavir [see Contraindications (4) , Drug Interactions (7.1) ] . (Fachinformation zu Triazolam, Warnhinweise und Vorsichtsmaßnahmen)

UBRELVY is contraindicated: With concomitant use of strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 )] In patients with a history of serious hypersensitivity to ubrogepant or any component of UBRELVY. (Fachinformation zu Ubrogepant, Gegenanzeigen)

Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3) ] . (Fachinformation zu Ulipristal, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (Fachinformation zu Upadacitinib, Arzneimittelwechselwirkungen)

Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (Fachinformation zu Valbenazin, Arzneimittelwechselwirkungen)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (Fachinformation zu Vepdegestrant, Warnhinweise und Vorsichtsmaßnahmen)

Therefore, the concomitant use of strong CYP3A inhibitors with vincristine sulfate should be avoided. (Fachinformation zu Vincristin, Arzneimittelwechselwirkungen)

…and herbal products that induce CYP2C19, CYP2C9, and/or CYP3A4 and for which significantly reduced voriconazole plasma concentrations may be associated with loss of efficacy [see Drug Interactions (7) ]: • Carbamazepine • Efavirenz Concomitant use with efavirenz dosages of 400 mg every 24 hours or higher is contraindicated [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Voriconazol, Gegenanzeigen)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

John's wort, a CYP3A4 inducer, in combination with zolpidem may decrease blood levels of zolpidem and is not recommended. (Fachinformation zu Zolpidem, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors: Use with caution in combination due to increased exposure of alosetron. (Fachinformation zu Alosetron, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

HMG-CoA reductase inhibitors: Atorvastatin Pravastatin Simvastatin ↓ atorvastatin ↓ pravastatin ↓ simvastatin Plasma concentrations of atorvastatin, pravastatin, and simvastatin decreased. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Use of Cytochrome P450 3A4 Inhibitors Ritonavir and other strong cytochrome P450 3A4 (CYP3A4) inhibitors can significantly increase plasma fluticasone propionate exposure, resulting in significantly reduced serum cortisol concentrations [see Drug Interactions ( 7.2 ) and Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Azelastin und Fluticason, Warnhinweise und Vorsichtsmaßnahmen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Clinically Significant Interactions with Bexagliflozin Tablets UGT Enzyme Inducers Clinical Impact UGT Enzyme Inducers may significantly reduce exposure to bexagliflozin and lead to a decreased efficacy [ see Clinical Pharmacology ( 12.3 )]. (Fachinformation zu Bexagliflozin, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong CYP2D6 REXULTI may be administered without dosage adjustment in patients with MDD when administered with strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine). or CYP3A4 inhibitors Administer half of recommended dosage. (Fachinformation zu Brexpiprazol, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Interactions with Strong Cytochrome P450 3A4 Inhibitors Caution should be exercised when considering the co-administration of PULMICORT FLEXHALER with ketoconazole, and other known strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin) because adverse effects related to… (Fachinformation zu Budesonid, Warnhinweise und Vorsichtsmaßnahmen)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (Fachinformation zu Budesonid und Formoterol, Warnhinweise und Vorsichtsmaßnahmen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Bupropion dose should not exceed the maximum recommended dose. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Other inhibitors and inducers of CYP3A4: Substances that inhibit CYP3A4, such as ketoconazole or ritonavir, may inhibit buspirone metabolism and increase plasma concentrations of buspirone while substances that induce CYP3A4, such as dexamethasone or certain anticonvulsants (phenytoin, phenobarbital, carbamazepine), may increase the rate of buspirone metabolism. (Fachinformation zu Buspiron, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (Fachinformation zu Canagliflozin, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration of CYP2C19 inhibitors, such as omeprazole or fluvoxamine, with carisoprodol could result in increased exposure of carisoprodol and decreased exposure of meprobamate. (Fachinformation zu Carisoprodol, Arzneimittelwechselwirkungen)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (Fachinformation zu Carvedilol, Arzneimittelwechselwirkungen)

Other Inducers of Hepatic CYP Enzymes Adults : When Caspofungin acetate for Injection is co-administered to adult patients with other inducers of hepatic CYP enzymes, such as efavirenz, nevirapine, phenytoin, dexamethasone, or carbamazepine, administration of a daily dose of 70 mg of Caspofungin acetate for Injection should be considered [see Dosage and Administration… (Fachinformation zu Caspofungin, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

In a drug interaction study, co-administration of orally inhaled ciclesonide and oral ketoconazole, a potent inhibitor of cytochrome P450 3A4, increased the exposure (AUC) of des-ciclesonide by approximately 3.6-fold at steady state, while levels of ciclesonide remained unchanged. (Fachinformation zu Ciclesonid, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong and moderate CYP3A4 and CYP2C19 inhibitors: Increase exposure to cilostazol. (Fachinformation zu Cilostazol, Arzneimittelwechselwirkungen)

Co-administration with a strong CYP3A4 inhibitor may increase serum levels of cinacalcet. (Fachinformation zu Cinacalcet, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 and CYP3A5 Inhibitors of CYP3A4 and/or CYP3A5 may increase plasma concentrations of clindamycin [ see Clinical Pharmacology (12.3) ]. (Fachinformation zu Clindamycin, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Antifungals: Itraconazole Ketoconazole ↓ itraconazole ↓ hydroxyitraconazole ↓ ketoconazole Consider alternative antifungal treatment because no dose recommendation for itraconazole or ketoconazole can be made. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 Inhibitors The systemic exposure of darifenacin from darifenacin extended-release tablets is increased in the presence of CYP3A4 inhibitors. (Fachinformation zu Darifenacin, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Desogestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with dexlansoprazole may reduce antiviral effect and promote the development of drug resistance . (Fachinformation zu Dexlansoprazol, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong cytochrome P450 (CYP) 3A inhibitors may increase exposure to doxazosin and increased risk of hypotension. (Fachinformation zu Doxazosin, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Examples Glutethimide and phenobarbital Intervention If a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of doxercalciferol may be necessary. (Fachinformation zu Doxercalciferol, Arzneimittelwechselwirkungen)

Monitor for increased dronabinol-related adverse reactions when dronabinol oral solution is co-administered with inhibitors of CYP2C9 (e.g., amiodarone, fluconazole) and inhibitors of CYP3A4 enzymes (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, erythromycin, grapefruit juice). (Fachinformation zu Dronabinol, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Consider monitoring serum potassium concentration in high-risk patients who take a strong CYP3A4 inhibitor long-term and concomitantly. (Fachinformation zu Drospirenon und Ethinylestradiol, Warnhinweise und Vorsichtsmaßnahmen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antifungals: Itraconazole Ketoconazole ↓ itraconazole ↓ hydroxyitraconazole ↓ ketoconazole Consider alternative antifungal treatment because no dose recommendation for itraconazole or ketoconazole can be made. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with esomeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Esomeprazol, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may increase plasma concentrations of estrogens and may result in side effects. (Fachinformation zu Estradiol, Arzneimittelwechselwirkungen)

Women who take medications that are strong CYP3A4 inducers should not choose Natazia as their oral contraceptive while using these inducers and for at least 28 days after discontinuation of these inducers due to the possibility of increased breakthrough bleeding and/or decreased contraceptive efficacy. (Fachinformation zu Estradiol und Dienogest, Arzneimittelwechselwirkungen)

Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism and decrease or increase the estrogen plasma concentration. (Fachinformation zu Estradiol und Norethisteron, Arzneimittelwechselwirkungen)

The dose of LUNESTA should be reduced in patients who are administered potent inhibitors of CYP3A4, such as ketoconazole, while taking LUNESTA. (Fachinformation zu Eszopiclon, Warnhinweise und Vorsichtsmaßnahmen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Decreased exposure of etonogestrel may be expected. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong CYP 3A4 inducers: Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure. (Fachinformation zu Exemestan, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Anti-infective: Clarithromycin ↓ clarithromycin ↑ 14-OH metabolite Consider alternatives to macrolide antibiotics because of the risk of QT interval prolongation. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

HMG-CoA reductase inhibitors: Atorvastatin Pravastatin Simvastatin ↓ atorvastatin ↓ pravastatin ↓ simvastatin Plasma concentrations of atorvastatin, pravastatin, and simvastatin decreased. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 Interactions: Fosaprepitant is a weak inhibitor of CYP3A4, and aprepitant, the active moiety, is a substrate, inhibitor, and inducer of CYP3A4; see Full Prescribing Information for recommendations regarding contraindications, risk of adverse reactions, and dosage adjustment of FOCINVEZ and concomitant drugs. (Fachinformation zu Fosaprepitant, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

• CYP3A4 Inducer: Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer. (Fachinformation zu Gefitinib, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

…Interactions: Effect of other Drugs on INTUNIV Concomitant Drug Name or Drug Class Clinical Rationale and Magnitude of Drug Interaction Clinical Recommendation Strong and moderate CYP3A4 inhibitors, e.g., ketoconazole, fluconazole Guanfacine is primarily metabolized by CYP3A4 and its plasma concentrations can be significantly affected resulting in an increase… (Fachinformation zu Guanfacin, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant administration of inhibitors of CYP3A4 may lead to increases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions associated with the use of excessive doses. (Fachinformation zu Hydrocortison, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

• CYP3A4 Inducers: Monitor for increased toxicity when used in combination with CYP3A4 inducers. (Fachinformation zu Ifosfamid, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 inducers may decrease Gleevec C max and area under curve (AUC). (Fachinformation zu Imatinib, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Use with CYP3A Inducers Use of KALYDECO with strong CYP3A inducers, such as rifampin, substantially decreases the exposure of ivacaftor, which may reduce the therapeutic effectiveness of KALYDECO. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant administration of itraconazole, a strong CYP3A4 inhibitor, with DUAVEE, resulted in increases in bazedoxifene exposure (40%) and, to a lesser extent, conjugated estrogens exposure (9% for baseline-adjusted total estrone, 5% for total equilin), compared to DUAVEE alone [see Pharmacokinetics (12.3) ] . (Fachinformation zu Konjugierte Estrogene und Bazedoxifen, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with lansoprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Lansoprazol, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding. (Fachinformation zu Levonorgestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (Fachinformation zu Linagliptin, Arzneimittelwechselwirkungen)

Inducers of P-glycoprotein or CYP3A4 Enzymes Clinical Impact Rifampin decreased linagliptin exposure, suggesting that the efficacy of linagliptin may be reduced when administered in combination with a strong P-gp or CYP3A4 inducer. (Fachinformation zu Linagliptin und Metformin, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antimalarials: Artemether/lumefantrine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Consider alternatives to artemether/lumefantrine because of the risk of QT interval prolongation [see Warnings and Precautions (5.16) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Inducers of CYP3A4 (e.g., phenytoin, carbamazepine, dexamethasone, rifampin, and phenobarbital) could increase the rate of elimination of donepezil. (Fachinformation zu Memantin und Donepezil, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Hepatic Enzyme Inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin) : Drugs which induce cytochrome P450 3A4 enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. (Fachinformation zu Methylprednisolon, Arzneimittelwechselwirkungen)

Antifungals: Itraconazole Ketoconazole ↓ itraconazole ↓ hydroxyitraconazole ↓ ketoconazole Consider alternative antifungal treatment because no dose recommendation for itraconazole or ketoconazole can be made. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Cytochrome P450-3A4 Inhibitors: May result in prolonged sedation due to decreased plasma clearance of midazolam. (Fachinformation zu Midazolam, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (Fachinformation zu Mometason, Warnhinweise und Vorsichtsmaßnahmen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

…salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g., methandrostenolone), guanethidine, gymnema sylvestre, glucomannan, thioctic acid, and inhibitors of CYP2C9 (e.g., amiodarone, fluconazole, voriconazole, sulfinpyrazone) or in patients known to be poor metabolizers of CYP2C9 substrates, alcohol. (Fachinformation zu Nateglinid, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Coadministration of P-gp and CYP3A4 inhibitors may increase nintedanib exposure. (Fachinformation zu Nintedanib, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norelgestromin und Ethinylestradiol, Arzneimittelwechselwirkungen)

Some drugs or herbal products that may decrease the effectiveness of HCs include efavirenz, phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, rifabutin, rufinamide, aprepitant, and products containing St. (Fachinformation zu Norethisteron, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norgestimat und Ethinylestradiol, Arzneimittelwechselwirkungen)

Concomitant administration of CYP3A4 inhibitors such as itraconazole, fluconazole, grapefruit juice or ketoconazole may increase plasma hormone concentrations. (Fachinformation zu Norgestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant administration of CYP3A4 inhibitors may inhibit the metabolism of, and increase the mometasone furoate plasma concentration and potentially increase the risk for adverse reactions. (Fachinformation zu Olopatadin und Mometason, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )]. (Fachinformation zu Omeprazol, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Omeprazol und Natriumhydrogencarbonat, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drug Interactions and Decreased Vitamin Absorption ORLISTAT may interact with concomitant drugs including cyclosporine, levothyroxine, warfarin, amiodarone, antiepileptic drugs, and antiretroviral drugs [see Drug Interactions (7) ]. (Fachinformation zu Orlistat, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration with strong cytochrome P450 (CYP) 3A4 inhibitors (e.g., ketoconazole) increases the systemic exposure of oxybutynin. (Fachinformation zu Oxybutynin, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with pantoprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Pantoprazol, Arzneimittelwechselwirkungen)

Exposure of Paricalcitol Injection will increase upon coadministration with strong CYP3A inhibitors [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Paricalcitol, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs that induce CYP3A activity (e.g., phenobarbital, rifampin, rifabutin) would be expected to increase the clearance of EFV resulting in lowered plasma concentrations. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

HMG-CoA reductase inhibitors: Atorvastatin Pravastatin Simvastatin ↓ atorvastatin ↓ pravastatin ↓ simvastatin Plasma concentrations of atorvastatin, pravastatin, and simvastatin decreased. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

HMG-CoA reductase inhibitors: Atorvastatin Pravastatin Simvastatin ↓ atorvastatin ↓ pravastatin ↓ simvastatin Plasma concentrations of atorvastatin, pravastatin, and simvastatin decreased. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP 3A4 inducers (e.g. barbiturates, phenytoin, carbamazepine, and rifampin): Drugs such as barbiturates, phenytoin, ephedrine, and rifampin, which induce hepatic microsomal drug metabolizing enzyme activity may enhance metabolism of prednisolone and require that the dosage of Orapred be increased. (Fachinformation zu Prednisolon, Arzneimittelwechselwirkungen)

CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (Fachinformation zu Prednison, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Antimalarials: Artemether/lumefantrine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Consider alternatives to artemether/lumefantrine because of the risk of QT interval prolongation [see Warnings and Precautions (5.16) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Impact of Other Drugs on Propranolol CYP2D6, CYP1A2 and CYP2C19 Inhibitors: CYP2D6 inhibitors (e.g. bupropion, fluoxetine, paroxetine, quinidine), CYP1A2 inhibitors (e.g., ciprofloxacin, enoxamine, fluvoxamine) and CYP2C19 inhibitors (e.g., fluconazole, fluvoxamine, ticlopidine) increase exposure to propranolol when co-administered with INNOPRAN XL. (Fachinformation zu Propranolol, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antimalarials: Artemether/lumefantrine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Consider alternatives to artemether/lumefantrine because of the risk of QT interval prolongation [see Warnings and Precautions (5.16) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with rabeprazole may reduce antiviral effect and promote the development of drug resistance. (Fachinformation zu Rabeprazol, Arzneimittelwechselwirkungen)

Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (Fachinformation zu Ramelteon, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP2C8 and CYP3A4 Inhibitors Intervention: Repaglinide tablets dose reductions and increased frequency of glucose monitoring may be required when co‑administered. (Fachinformation zu Repaglinid, Arzneimittelwechselwirkungen)

Fixed-Dose Combination of Efavirenz, Emtricitabine, and Tenofovir Once-weekly coadministration of 900 mg PRIFTIN with the antiretroviral fixed-dose combination of efavirenz 600 mg, emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg in HIV-infected patients did not result in any substantial change in steady state exposures of efavirenz, emtricitabine,… (Fachinformation zu Rifapentin, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Coadministration of a selective and potent inhibitor of CYP3A4, ketoconazole (100 mg bid for 2 days with ropivacaine infusion administered 1 hour after ketoconazole) caused a 15% reduction in in vivo plasma clearance of ropivacaine. (Fachinformation zu Ropivacain, Arzneimittelwechselwirkungen)

HMG-CoA reductase inhibitors: Atorvastatin Pravastatin Simvastatin ↓ atorvastatin ↓ pravastatin ↓ simvastatin Plasma concentrations of atorvastatin, pravastatin, and simvastatin decreased. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 Inhibitors: Reduce, interrupt, or discontinue JAKAFI/JAKAFI XR doses as recommended except in patients with acute or chronic graft-versus-host-disease. (Fachinformation zu Ruxolitinib, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin und Metformin, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (Fachinformation zu Selegilin, Arzneimittelwechselwirkungen)

Sertraline ↓ sertraline Increases in sertraline dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure. (Fachinformation zu Sildenafil, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

The possibility of interactions with other drugs administered concurrently should be considered, particularly when their main route of elimination is active renal secretion via the organic cationic transport system (e.g., trimethoprim) [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Monitor QT interval more frequently when SUTENT is concomitantly administered with strong CYP3A4 inhibitors or drugs known to prolong QT interval. (Fachinformation zu Sunitinib, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A inducers: Efficacy may be reduced ( 7.2 ). (Fachinformation zu Suvorexant, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

…Physicians should be aware that CIALIS for once daily use provides continuous plasma tadalafil levels and should consider this when evaluating the potential for interactions with medications (e.g., nitrates, alpha-blockers, anti-hypertensives and potent inhibitors of CYP3A4) and with substantial consumption of alcohol [see Drug Interactions ( 7.1 , 7.2 , 7.3 )] . (Fachinformation zu Tadalafil, Warnhinweise und Vorsichtsmaßnahmen)

Antimalarials: Artemether/lumefantrine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Consider alternatives to artemether/lumefantrine because of the risk of QT interval prolongation [see Warnings and Precautions (5.16) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Narcotic analgesic: Methadone ↓ methadone Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 Substrates (e.g., midazolam) and CYP2B6 Substrates (e.g., bupropion, efavirenz): Efficacy of concomitant drugs may be decreased; monitor patients’ response and consider increasing the dosage of the concomitant drug, if necessary. (Fachinformation zu Telotristat, Arzneimittelwechselwirkungen)

Co-administration with Inducers or Inhibitors of CYP3A Metabolism Agents Inducing CYP3A Metabolism: Strong inducers of CYP3A4/5 such as dexamethasone, carbamazepine, phenytoin, phenobarbital, rifampin, rifabutin, and rifampacin may decrease exposure of the active metabolite, sirolimus. (Fachinformation zu Temsirolimus, Warnhinweise und Vorsichtsmaßnahmen)

Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (Fachinformation zu Terbinafin, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (Fachinformation zu Tinidazol, Arzneimittelwechselwirkungen)

DRUG INTERACTIONS Hepatic microsomal enzyme inducing agents, such as carbamazepine, were found to significantly increase the clearance of thiothixene. (Fachinformation zu Tiotixen, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (Fachinformation zu Torasemid, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (Fachinformation zu Treprostinil, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration of other strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin, cobicistat-containing products) with KENALOG-40 Injection may cause increased plasma concentration of triamcinolone leading to adverse reactions. (Fachinformation zu Triamcinolon, Arzneimittelwechselwirkungen)

The possibility of interactions with other drugs administered concurrently should be considered, particularly when their main route of elimination is active renal secretion via the organic cationic transport system (e.g., trimethoprim) [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drug Interactions with Strong Cytochrome P450 3A4 Inhibitors Caution should be exercised when considering the coadministration of Umeclidinium and Vilanterol ELLIPTA with ketoconazole and other known strong cytochrome P450 3A4 (CYP3A4) inhibitors (including, but not limited to, ritonavir, clarithromycin, conivaptan, indinavir, itraconazole, lopinavir, nefazodone,… (Fachinformation zu Umeclidiniumbromid und Vilanterol, Warnhinweise und Vorsichtsmaßnahmen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.4) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Calcium channel blockers: Diltiazem ↓ diltiazem ↓ desacetyl diltiazem ↓ N-monodesmethyldiltiazem Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 Substrates Clinical Impact Viloxazine is a weak inhibitor of CYP3A4 which increases the exposure of CYP3A4 substrates when coadministered [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Viloxazin, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4: May cause earlier onset and/or increased severity of adverse reactions ( 7.1 ) (Fachinformation zu Vinorelbin, Arzneimittelwechselwirkungen)

Antidepressants: Bupropion ↓ bupropion Increases in bupropion dosage should be guided by clinical response. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Zafirlukast exposure is likely to be increased by other moderate and strong CYP2C9 inhibitors. (Fachinformation zu Zafirlukast, Vorsichtsmaßnahmen)

Multiple-dose administration of the potent CYP3A4 inducer rifampin (600 mg every 24 hours, q24h, for 14 days), however, reduced zaleplon C max and AUC by approximately 80%. (Fachinformation zu Zaleplon, Arzneimittelwechselwirkungen)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between EFV and drugs that prolong the QTc interval. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions (7.5) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Serum parathyroid hormone levels and 1,25 Vitamin D levels were also higher in subjects receiving TDF. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Serum parathyroid hormone levels and 1,25 Vitamin D levels were also higher in subjects receiving TDF. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

The effect of potent CYP3A4 inhibitors on dutasteride has not been studied. (Fachinformation zu Dutasterid, Arzneimittelwechselwirkungen)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (Fachinformation zu Eribulin, Arzneimittelwechselwirkungen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

An in vitro study using human liver microsomes suggests that famciclovir is not an inhibitor of CYP3A4 enzymes. (Fachinformation zu Famciclovir, Arzneimittelwechselwirkungen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Potential for Glycerol Phenylbutyrate to Affect Other Drugs Drugs with narrow therapeutic index that are substrates of CYP3A4 Glycerol phenylbutyrate is a weak inducer of CYP3A4 in humans. (Fachinformation zu Glycerolphenylbutyrat, Arzneimittelwechselwirkungen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

When phenytoin or other hepatic enzyme inducers such as rifampin and phenobarbital have been taken concurrently with mexiletine, lowered mexiletine plasma levels have been reported. (Fachinformation zu Mexiletin, Arzneimittelwechselwirkungen)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Rifaximin, Arzneimittelwechselwirkungen)

Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (Fachinformation zu Riociguat, Arzneimittelwechselwirkungen)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgestimate ↓ active metabolites of norgestimate A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Serum parathyroid hormone levels and 1,25 Vitamin D levels were also higher in subjects receiving TDF. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

However, no formal drug-drug interaction studies between zileuton and CYP3A4 inhibitors, such as ketaconazole, have been conducted. (Fachinformation zu Zileuton, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Micafungin in Sodium Chloride Injection CYP3A4, CYP2C9 and CYP2C19 Inhibitors Co-administration of Micafungin in Sodium Chloride Injection with cyclosporine, itraconazole, voriconazole and fluconazole did not alter the pharmacokinetics of micafungin. (Fachinformation zu Micafungin, Arzneimittelwechselwirkungen)

…adjustment is needed when SINGULAIR is co-administered with theophylline, prednisone, prednisolone, oral contraceptives, fexofenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, and Cytochrome P450 (CYP) enzyme inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Montelukast, Arzneimittelwechselwirkungen)

Drugs without Clinically Significant Interactions No dosage adjustment is recommended when SYMFI is administered with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, and lorazepam. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)