Wechselwirkungen von Ivacaftor

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

• 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)

For patients receiving ELIQUIS at a dose of 2.5 mg twice daily, avoid coadministration with combined P-gp and strong CYP3A4 inhibitors [see Dosage and Administration (2.6) and Clinical Pharmacology (12.3) ] . (Fachinformation zu Apixaban, 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)

Concomitant administration of BIXLENVO with combined P-gp, UGT1A1, and strong CYP3A inhibitors is not recommended. (Fachinformation zu Bictegravir, Emtricitabin und Tenofoviralafenamid, 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)

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

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)

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)

Avoid use of PRADAXA Capsules and P-gp inhibitors in patients with severe renal impairment (CrCl 15-30 mL/min) [see Drug Interactions (7.1) and Use in Specific Populations (8.6) ] . (Fachinformation zu Dabigatran, Warnhinweise und Vorsichtsmaßnahmen)

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

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

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)

Avoid concomitant use of Doxorubicin Hydrochloride Injection with inhibitors of CYP3A4, CYP2D6, or P-gp. (Fachinformation zu Doxorubicin, 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)

• 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)

…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)

Strong CYP3A inhibitor and P-gp inhibitor : Avoid coadministration. (Fachinformation zu Everolimus, Arzneimittelwechselwirkungen)

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)

• 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))

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)

Avoid food or drink containing grapefruit. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

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))

Cytochrome P450 3A4 Interaction The concomitant use of Hydrocodone Bitartrate and Ibuprofen Tablets with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which may cause potentially fatal respiratory depression. (Fachinformation zu Hydrocodon und Ibuprofen, Boxed Warning (umrahmter Warnhinweis))

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))

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

Lumacaftor/Ivacaftor Not recommended 2 weeks before, during, and 2 weeks after 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)

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

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

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

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)

• 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)

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

Strong CYP3A4 inhibitors (ketoconazole, ritonavir) increase exposure to macitentan: avoid co-administration with OPSUMIT ( 7.2 , 12.3 ) . (Fachinformation zu Macitentan, Arzneimittelwechselwirkungen)

SELZENTRY is contraindicated in patients with severe renal impairment or ESRD (creatinine clearance [CrCl] less than 30 mL per minute) who are concomitantly taking potent CYP3A inhibitors or inducers [see Warnings and Precautions ( 5.3 )]. (Fachinformation zu Maraviroc, Gegenanzeigen)

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)

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

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)

…delayed offset of the recently discontinued CYP3A inducer [see Drug Interactions (7.3) ] : • Anticancer drugs: apalutamide, enzalutamide • Anticonvulsant: carbamazepine, phenobarbital, primidone, phenytoin • Antimycobacterials: rifampin, rifapentine • Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor • Herbal products: St. (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)

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))

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))

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))

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)

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

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)

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

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)

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)

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

Effect of Other Drugs on TALZENNA Effect of P-gp Inhibitors Breast Cancer Avoid coadministration of TALZENNA with the following P-gp inhibitors: itraconazole, amiodarone, carvedilol, clarithromycin, itraconazole, and verapamil. (Fachinformation zu Talazoparib, Arzneimittelwechselwirkungen)

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

…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)

Avoid concomitant use HYCAMTIN capsules with P-gp inhibitors or BCRP inhibitors. (Fachinformation zu Topotecan, Arzneimittelwechselwirkungen)

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)

For patients with atopic dermatitis, coadministration of RINVOQ 30 mg once daily with strong CYP3A4 inhibitors is not recommended. (Fachinformation zu Upadacitinib, 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)

Patients with elevated vitamin A levels may be at increased risk. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Patients with elevated vitamin A levels may be at increased risk. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

P-glycoprotein (P-gp) Inhibitors : Co-administration of P-gp inhibitors can increase afatinib exposure. (Fachinformation zu Afatinib, Arzneimittelwechselwirkungen)

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

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Fachinformation zu Amlodipin, Arzneimittelwechselwirkungen)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Fachinformation zu Amlodipin und Atorvastatin, Arzneimittelwechselwirkungen)

CYP3A4 Inhibitors : Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Fachinformation zu Amlodipin und Benazepril, Arzneimittelwechselwirkungen)

• Increased exposure of amlodipine when coadministered with CYP3A inhibitors Olmesartan medoxomil ( 7.2 ): • Nonsteroidal anti-inflammatory drugs (NSAIDS) may lead to increased risk of renal impairment and loss of antihypertensive effect. (Fachinformation zu Amlodipin und Olmesartan, Arzneimittelwechselwirkungen)

Amlodipine Impact of Other Drugs on Amlodipine CYP3A Inhibitors Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Fachinformation zu Amlodipin und Valsartan, 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)

CYP2D6 inhibitors and CYP3A4 Inhibitors : See full prescribing information for ABILIFY MAINTENA dosage modifications when used concomitantly with CYP2D6 inhibitors and/or CYP3A4 inhibitors for greater than 14 days ( 7.1 ) (Fachinformation zu Aripiprazol, 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)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

LIPITOR plasma levels can be significantly increased with concomitant administration of inhibitors of CYP3A4 and transporters. (Fachinformation zu Atorvastatin, Arzneimittelwechselwirkungen)

CYP3A4/5 Inhibitors Co-administration of ketoconazole, a strong inhibitor of CYP3A4/5, increased the plasma exposure of axitinib in healthy volunteers. (Fachinformation zu Axitinib, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Patients with elevated vitamin A levels may be at increased risk. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Strong CYP3A4 Inhibitors: Closely monitor patients with concomitant use. (Fachinformation zu Bortezomib, 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)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (Fachinformation zu Buprenorphin und Naloxon, 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)

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)

Clinically Significant Drug Interactions with VRAYLAR Strong or Moderate CYP3A4 Inhibitors Clinical Impact: Concomitant use of VRAYLAR with a strong or moderate CYP3A4 inhibitor increases the exposures of cariprazine and its major active metabolite, didesmethylcariprazine (DDCAR), compared to use of VRAYLAR alone [see Clinical Pharmacology ( 12.3 ) ]. (Fachinformation zu Cariprazin, 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)

Co-administration of celecoxib with drugs that are known to inhibit CYP2C9 (e.g., fluconazole) may enhance the exposure and toxicity of celecoxib whereas co-administration with CYP2C9 inducers (e.g., rifampin) may lead to compromised efficacy of celecoxib. (Fachinformation zu Celecoxib, 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)

Although a causal relationship between a specific drug and the arrhythmia was not established in this case, erythromycin is a CYP3A4 inhibitor and has been shown to increase quinine plasma levels when used concomitantly. (Fachinformation zu Chinin, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Therefore, caution and appropriate monitoring are recommended when co-administering KALYDECO with sensitive CYP3A and/or P-gp substrates, such as digoxin, cyclosporine, and tacrolimus [ see Clinical Pharmacology (12.3) ]. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4 or CYP2C19 Inhibitors of CYP3A4 Coadministration of strong (e.g., ketoconazole) and moderate (e.g., erythromycin, diltiazem and grapefruit juice) CYP3A4 inhibitors can increase exposure to cilostazol. (Fachinformation zu Cilostazol, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

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

Based on simulations of these results, a reduction of the KALYDECO dosage is recommended for patients aged 6 months and older taking concomitant strong CYP3A inhibitors, such as ketoconazole, itraconazole, posaconazole, voriconazole, telithromycin, and clarithromycin. (Fachinformation zu Ivacaftor, 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)

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)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

CYP2D6 and CYP3A4 Inhibitors Concomitant treatment with CLOZARIL and CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline) can increase clozapine levels and lead to adverse reactions [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Clozapin, 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)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

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

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of dexlansoprazole is expected when used concomitantly with strong inhibitors [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Dexlansoprazol, Arzneimittelwechselwirkungen)

Co-administration of diclofenac with CYP2C9 inhibitors (e.g. voriconazole) may enhance the exposure and toxicity of diclofenac whereas co- administration with CYP2C9 inducers (e.g. rifampin) may lead to compromised efficacy of diclofenac. (Fachinformation zu Diclofenac, Arzneimittelwechselwirkungen)

Co-administration of diclofenac with CYP2C9 inhibitors (e.g., voriconazole) may enhance the exposure and toxicity of diclofenac [see Clinical Pharmacology (12.3) ] whereas co-administration with CYP2C9 inducers (e.g., rifampin) may lead to compromised efficacy of diclofenac. (Fachinformation zu Diclofenac und Misoprostol, Arzneimittelwechselwirkungen)

Co-administration with digoxin, a sensitive P-gp substrate, increased digoxin exposure by 1.3-fold, consistent with weak inhibition of P-gp by ivacaftor. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

…grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular organic cation transport,… (Fachinformation zu Dofetilid, Arzneimittelwechselwirkungen)

Co-administration of PIFELTRO and drugs that are inhibitors of CYP3A may result in increased plasma concentrations of doravirine. (Fachinformation zu Doravirin, Arzneimittelwechselwirkungen)

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

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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)

P-gp Inhibitors Treatment of NVAF Based on clinical experience from the ENGAGE AF-TIMI 48 study, dose reduction in patients concomitantly receiving P-gp inhibitors resulted in edoxaban blood levels that were lower than in patients who were given the full dose. (Fachinformation zu Edoxaban, 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 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)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Coadministration of DESCOVY with other drugs that inhibit P-gp and BCRP may increase the absorption and plasma concentration of TAF. (Fachinformation zu Emtricitabin und Tenofovir, Arzneimittelwechselwirkungen)

Drugs Inducing or Inhibiting CYP3A Enzymes Rilpivirine is primarily metabolized by cytochrome P450 (CYP) 3A, and drugs that induce or inhibit CYP3A may thus affect the clearance of RPV [see Contraindications (4) , Warnings and Precautions (5.7) , and Clinical Pharmacology (12.3) ] . (Fachinformation zu Emtricitabin, Rilpivirin und Tenofovir, Arzneimittelwechselwirkungen)

Therefore, a reduction of the KALYDECO dosage is recommended for patients aged 6 months and older taking concomitant moderate CYP3A inhibitors, such as fluconazole and erythromycin. (Fachinformation zu Ivacaftor, 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)

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)

…exposure at steady state. [See Clinical Pharmacology (12.3).] Substances Increasing the Systemic Exposure of COCs (enzyme inhibitors): Concomitant administration of moderate or strong CYP3A4 inhibitors like azole antifungals (for example, ketoconazole, itraconazole, voriconazole, fluconazole), verapamil, macrolides (for example, clarithromycin, erythromycin), diltiazem,… (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)

Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin concentrations. (Fachinformation zu Etonogestrel und Ethinylestradiol, 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)

Coadministration of CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine) with felodipine may lead to several-fold increases in the plasma levels of felodipine, either due to an increase in bioavailability or due to a decrease in metabolism. (Fachinformation zu Felodipin, Arzneimittelwechselwirkungen)

Concentrations of fidaxomicin and OP-1118 may also be decreased at the site of action (i.e., gastrointestinal tract) via P-gp inhibition; however, concomitant P-gp inhibitor use had no attributable effect on safety or treatment outcome of fidaxomicin-treated adult patients in controlled clinical trials. (Fachinformation zu Fidaxomicin, Arzneimittelwechselwirkungen)

Co-administration with fluconazole, a moderate inhibitor of CYP3A, increased ivacaftor exposure by 3-fold. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (Fachinformation zu Fluvoxamin, Warnhinweise und Vorsichtsmaßnahmen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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)

• CYP3A4 Inhibitor: Monitor adverse reactions if concomitant use with IRESSA. (Fachinformation zu Gefitinib, Arzneimittelwechselwirkungen)

Other therapeutic products for which exposure may be increased by KALYDECO include glimepiride and glipizide; these therapeutic products should be used with caution [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Other therapeutic products for which exposure may be increased by KALYDECO include glimepiride and glipizide; these therapeutic products should be used with caution [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Other therapeutic products for which exposure may be increased by KALYDECO include glimepiride and glipizide; these therapeutic products should be used with caution [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Ivacaftor, 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)

…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)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

The effect of CYP3A4 inhibition and of decreased CYP2D6 enzyme may be additive. (Fachinformation zu Haloperidol, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

• CYP3A4 Inhibitors: Use in combination with CYP3A4 inhibitors could decrease the effectiveness of ifosfamide. (Fachinformation zu Ifosfamid, Arzneimittelwechselwirkungen)

The dose of FANAPT should be reduced in patients co-administered a strong CYP2D6 or CYP3A4 inhibitor. (Fachinformation zu Iloperidon, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Patients with elevated vitamin A levels may be at increased risk. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration with ketoconazole, a strong CYP3A inhibitor, significantly increased ivacaftor exposure [measured as area under the curve (AUC)] by 8.5-fold. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

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)

Strong CYP3A4 or CYP2C9 Inhibitors Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to VIMPAT. (Fachinformation zu Lacosamid, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of lansoprazole is expected when used concomitantly with strong inhibitors [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Lansoprazol, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (Fachinformation zu Levomilnacipran, Arzneimittelwechselwirkungen)

CYP3A inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice The effect of grapefruit juice on CYP3A4 enzymes (e.g., strong vs. moderate inhibition) depends on its brand, concentration, and preparation. , or ketoconazole may increase systemic exposure of the estrogen and/or progestin component of CHCs. (Fachinformation zu Levonorgestrel und Ethinylestradiol, Arzneimittelwechselwirkungen)

Drug Interactions Effects of Other Drugs on Loperamide Concomitant use of loperamide hydrochloride capsules with inhibitors of CYP3A4 (e.g., itraconazole) or CYP2C8 (e.g., gemfibrozil) or inhibitors of P-glycoprotein (e.g., quinidine, ritonavir) can increase exposure to loperamide. (Fachinformation zu Loperamid, 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)

Strong CYP3A4 inhibitors: Recommended dosage is 10.5 mg once daily. (Fachinformation zu Lumateperon, Arzneimittelwechselwirkungen)

Ketoconazole (Potent Inhibitor of CYP3A4) Coadministration of a single 500 mg oral dose of mefloquine with 400 mg of ketoconazole once daily for 10 days in 8 healthy volunteers resulted in an increase in the mean C max and AUC of mefloquine by 64% and 79%, respectively, and an increase in the mean elimination half-life of mefloquine from 322 hours to 448 hours. (Fachinformation zu Mefloquin, Arzneimittelwechselwirkungen)

Thus concomitant usage of CYP2C9 inhibitors (such as amiodarone, fluconazole, and sulphaphenazole) may lead to abnormally high plasma levels of meloxicam due to reduced metabolic clearance [ see Use in Specific Populations ( 8.8 ); and Clinical Pharmacology ( 12.3 , 12.5 ) ]. (Fachinformation zu Meloxicam, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration with oral midazolam, a sensitive CYP3A substrate, increased midazolam exposure 1.5-fold, consistent with weak inhibition of CYP3A by ivacaftor. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Examples phenytoin, carbamazepine, rifampin Strong CYP3A Inhibitors Clinical Impact The concomitant use of strong CYP3A inhibitors with REMERON/REMERONSolTab may increase the plasma concentration of mirtazapine [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Mirtazapin, 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 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)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

P-Glycoprotein (P-gp) Inhibitors Clinical Impact: The concomitant use of P-gp inhibitors can increase the exposure to morphine by two-fold and can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. (Fachinformation zu Morphin, 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)

Moderate (e.g., fluconazole, atazanavir, aprepitant, diltiazem, erythromycin) and Strong (e.g., itraconazole, ketoconazole, clarithromycin, ritonavir, saquinavir) CYP3A Inhibitors Clinical Impact Increase in plasma naldemedine concentrations [see Clinical Pharmacology (12.3) ] Intervention Monitor for potential naldemedine-related adverse reactions [see Adverse… (Fachinformation zu Naldemedin, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, 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)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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)

…as ketoconazole, fluconazole, itraconazole, clarithromycin, erythromycin (Azithromycin, although structurally related to the class of macrolide antibiotic is void of clinically relevant CYP3A4 inhibition), grapefruit, nefazodone, fluoxetine, saquinavir, indinavir, nelfinavir, and ritonavir may result in increased exposure to nifedipine when co-administered. (Fachinformation zu Nifedipin, 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)

Substances increasing the systemic concentrations of HCs: Co-administration of certain HCs and strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase the systemic concentrations of progestins, including norethindrone. (Fachinformation zu Norethisteron, Arzneimittelwechselwirkungen)

CYP3A4 inhibitors such as itraconazole or ketoconazole may increase plasma hormone levels. (Fachinformation zu Norethisteron und Ethinylestradiol, 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)

Risk of Use in Patients with Decreased Cytochrome P450 2D6 Function or Concomitant Use or Discontinuation with Cytochrome P450 3A4 Inhibitors and Inducers Risk of Increased Oliceridine Plasma Concentrations Increased plasma concentrations of oliceridine, which may result in prolonged opioid adverse reactions and exacerbated respiratory depression, may occur when… (Fachinformation zu Oliceridin, Warnhinweise und Vorsichtsmaßnahmen)

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (Fachinformation zu Olmesartan, Amlodipin und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Omeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (Fachinformation zu Omeprazol und Natriumhydrogencarbonat, 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)

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

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

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

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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 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 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)

Strong CYP3A4 Inhibitors: Reduce NUPLAZID dose to 10 mg once daily. (Fachinformation zu Pimavanserin, Arzneimittelwechselwirkungen)

Other therapeutic products for which exposure may be increased by KALYDECO include glimepiride and glipizide; these therapeutic products should be used with caution [see Clinical Pharmacology (12.3) ] . (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Based on simulations of these results, a reduction of the KALYDECO dosage is recommended for patients aged 6 months and older taking concomitant strong CYP3A inhibitors, such as ketoconazole, itraconazole, posaconazole, voriconazole, telithromycin, and clarithromycin. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Published clinical reports indicate primaquine may inhibit CYP3A4 enzyme activity and thus may lead to increased exposure of oral CYP3A4 substrate drugs when co-administered with Primaquine phosphate Tablets. (Fachinformation zu Primaquin, 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 use of strong CYP3A4 inhibitors: Reduce quetiapine dose to one‑sixth when coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) ( 2.5 , 7.1 , 12.3 ) (Fachinformation zu Quetiapin, Arzneimittelwechselwirkungen)

Ketoconazole (strong CYP3A4 inhibitor): Increases AUC for ramelteon; administer with caution. (Fachinformation zu Ramelteon, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, 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)

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 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 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 P-glycoprotein (P-gp) inhibitors (e.g., cyclosporine): Caution should be exercised when concomitant use of XIFAXAN and a P-glycoprotein inhibitor is needed. (Fachinformation zu Rifaximin, Warnhinweise und Vorsichtsmaßnahmen)

Coadministration of EDURANT or EDURANT PED and drugs that inhibit CYP3A may result in increased plasma concentrations of rilpivirine. (Fachinformation zu Rilpivirin, 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)

Use with inhibitors of CYP3A4 or dual inhibitors of CYP3A4 and CYP1A2 (e.g., erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine) will increase roflumilast systemic exposure and may result in increased adverse reactions. (Fachinformation zu Roflumilast, Arzneimittelwechselwirkungen)

• Monitor for toxicities related to increased romidepsin exposure when co-administering romidepsin with strong CYP3A4 inhibitors ( 7.2 ). (Fachinformation zu Romidepsin, 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)

Rosuvastatin plasma levels can be significantly increased with concomitant administration of inhibitors of CYP2C9 and transporters. (Fachinformation zu Rosuvastatin, Arzneimittelwechselwirkungen)

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)

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

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Therefore, caution and appropriate monitoring are recommended when co-administering KALYDECO with sensitive CYP3A and/or P-gp substrates, such as digoxin, cyclosporine, and tacrolimus [ see Clinical Pharmacology (12.3) ]. (Fachinformation zu Ivacaftor, 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)

CYP3A4 Inhibitors Co-administration of a 180 mg daily dose of diltiazem with 5 mg amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. (Fachinformation zu Telmisartan und Amlodipin, 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)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Simultaneous administration of drugs that inhibit the activity of liver microsomal enzymes, i.e., CYP3A4 inhibitors such as cimetidine and ketoconazole, may prolong the half-life and decrease the plasma clearance of tinidazole, increasing the plasma concentrations of tinidazole. (Fachinformation zu Tinidazol, Arzneimittelwechselwirkungen)

Table 7: Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate… (Fachinformation zu Tofacitinib, Arzneimittelwechselwirkungen)

Drug Interactions CYP3A4 Inhibitors Ketoconazole, an inhibitor of the drug metabolizing enzyme CYP3A4, significantly increased plasma concentrations of tolterodine when coadministered to subjects who were poor metabolizers (see CLINICAL PHARMACOLOGY, Variability in Metabolism and Drug-Drug Interactions ). (Fachinformation zu Tolterodin, 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)

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

Although other risk factors were present in some cases (such as corticosteroid use and/or exposure to radiation), a possible risk attributable to KALYDECO cannot be excluded. (Fachinformation zu Ivacaftor, Warnhinweise und Vorsichtsmaßnahmen)

Increase in Plasma Concentrations of ella Associated with Co-Administered Drugs CYP3A4 inhibitors such as itraconazole or ketoconazole increase plasma concentrations of ella [see Pharmacokinetics (12.3) ] . (Fachinformation zu Ulipristal, 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)

In patients taking a strong CYP2D6 or CYP3A4 inhibitor, or who are CYP2D6 poor metabolizers, INGREZZA and INGREZZA SPRINKLE concentrations may be higher and QT prolongation clinically significant [see Clinical Pharmacology ( 12.2 )] . (Fachinformation zu Valbenazin, Warnhinweise und Vorsichtsmaßnahmen)

Potential for Drug Interactions with Strong or Moderate CYP3A4 Inhibitors Concomitant administration with strong CYP3A4 inhibitors (such as ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (such as erythromycin) increases plasma concentrations of vardenafil. (Fachinformation zu Vardenafil, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant use of CYP3A4 inhibitors and venlafaxine may increase levels of venlafaxine and ODV. (Fachinformation zu Venlafaxin, Arzneimittelwechselwirkungen)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

CYP3A4 Inhibitors: The VIIBRYD dose should not exceed 20 mg once daily when co-administered with strong CYP3A4 inhibitors ( 2.4 , 7 ). (Fachinformation zu Vilazodon, 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)

Based on simulations of these results, a reduction of the KALYDECO dosage is recommended for patients aged 6 months and older taking concomitant strong CYP3A inhibitors, such as ketoconazole, itraconazole, posaconazole, voriconazole, telithromycin, and clarithromycin. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Potential for ivacaftor to affect other drugs 7.4 CYP2C9 Substrates Ivacaftor may inhibit CYP2C9; therefore, monitoring of the international normalized ratio (INR) during co-administration of KALYDECO with warfarin is recommended. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

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

Drugs That Inhibit CYP3A4 CYP3A4 is a minor metabolic pathway for the elimination of zaleplon because the sum of desethylzaleplon (formed via CYP3A4 in vitro) and its metabolites, 5-oxo-desethylzaleplon and 5-oxo-desethylzaleplon glucuronide, account for only 9% of the urinary recovery of a zaleplon dose. (Fachinformation zu Zaleplon, Arzneimittelwechselwirkungen)

Ketoconazole Ketoconazole, a potent inhibitor of CYP3A4, at a dose of 400 mg QD for 5 days, increased the AUC and C max of ziprasidone by about 35 to 40%. (Fachinformation zu Ziprasidon, Arzneimittelwechselwirkungen)

CYP3A4 Inhibitors Ketoconazole Ketoconazole, a potent CYP3A4 inhibitor, increased the exposure to and pharmacodynamic effects of zolpidem. (Fachinformation zu Zolpidem, Arzneimittelwechselwirkungen)

However, at high concentrations in vitro , clopidogrel inhibits CYP2C9. (Fachinformation zu Clopidogrel, Arzneimittelwechselwirkungen)

Dapagliflozin or dapagliflozin 3-O-glucuronide did not meaningfully inhibit P-gp, OCT2, OAT1, or OAT3 active transporters. (Fachinformation zu Dapagliflozin, Arzneimittelwechselwirkungen)

Although potent inhibitors of cytochrome P450 3A4 (e.g., ketoconazole) have not been studied clinically, in vitro studies have shown that erythromycin and oleandomycin inhibit the metabolism of disopyramide. (Fachinformation zu Disopyramid, Arzneimittelwechselwirkungen)

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)

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

Additionally, in vitro studies have shown ketoconazole, a potent inhibitor of CYP3A4 activity, to be at least 100 times more potent than fluoxetine or norfluoxetine as an inhibitor of the metabolism of several substrates for this enzyme, including astemizole, cisapride, and midazolam. (Fachinformation zu Fluoxetin, Arzneimittelwechselwirkungen)

Effect of Other Drugs on the Metabolism of Donepezil Inhibitors of CYP3A4 (e.g., ketoconazole) and CYP2D6 (e.g., quinidine), inhibit donepezil metabolism in vitro . (Fachinformation zu Memantin und Donepezil, Arzneimittelwechselwirkungen)

Inhibitors of CYP3A4, CYP2B6, CYP2C19, CYP2C9, or CYP2D6 Clinical Impact: Methadone undergoes hepatic N-demethylation by several cytochrome P450 (CYP) isoforms, including CYP3A4, CYP2B6, CYP2C19, CYP2C9, and CYP2D6. (Fachinformation zu Methadon, Arzneimittelwechselwirkungen)

Drugs Metabolized by CYP3A — In vitro studies utilizing human liver microsomes suggest that olanzapine has little potential to inhibit CYP3A. (Fachinformation zu Olanzapin und Fluoxetin, Arzneimittelwechselwirkungen)

Therefore, co-administration with strong CYP3A inducers, such as rifampin, rifabutin, phenobarbital, carbamazepine, phenytoin, and St. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Clinically Significant Interactions Affecting Other Drugs CYP3A Substrates Where Small Concentration Changes May Lead to Serious Adverse Reactions Clinical Impact Ritlecitinib is a CYP3A inhibitor. (Fachinformation zu Ritlecitinib, Arzneimittelwechselwirkungen)

Fluconazole is an inhibitor of CYP2C9 and CYP3A enzymes. (Fachinformation zu Terbinafin, Arzneimittelwechselwirkungen)

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

Ciprofloxacin Co-administration of KALYDECO with ciprofloxacin had no effect on the exposure of ivacaftor. (Fachinformation zu Ivacaftor, Arzneimittelwechselwirkungen)

Inhibitors of Cytochrome P450 3A4 In controlled clinical studies co-administration of desloratadine with ketoconazole, erythromycin, or azithromycin resulted in increased plasma concentrations of desloratadine and 3 hydroxydesloratadine, but there were no clinically relevant changes in the safety profile of desloratadine. [See Clinical Pharmacology (12.3) .]… (Fachinformation zu Desloratadin, Arzneimittelwechselwirkungen)