Dexamethasone interactions
Dexamethasone (Decadron, Hemady), a corticosteroid has 278 documented interactions across the FDA labels and fact sheets we index: 83 major, 161 moderate, 33 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (83)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Adalimumab label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use. (Apixaban label, Drug interactions)
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 ) (Apremilast label, Warnings and precautions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (Aripiprazole label, Drug interactions)
Concomitant administration of BIXLENVO is contraindicated with: dofetilide due to the potential for increased dofetilide plasma concentrations and associated serious and/or life-threatening events. strong CYP3A inducers due to decreased plasma concentrations of BIC and LEN, which may result in the loss of therapeutic effect and development of resistance to BIXLENVO. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Contraindications)
Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (Buprenorphine label, Drug interactions)
Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (Cariprazine label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Avoid coadministration of cholestyramine and HEMADY and consider alternative agents. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Concomitant use of Strong CYP3A4 Inducers is not recommended. (Clozapine label, Drug interactions)
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. (Codeine label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Moderate or Strong CYP3A4 inducers: Avoid concomitant use. (Daridorexant label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (Elexacaftor, tezacaftor, and ivacaftor label, Warnings and precautions)
…Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline Epinephrine should not be used to counteract circulatory collapse or hypotension caused by phenothiazines, as a reversal of the pressor effects of epinephrine… (Epinephrine label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Etanercept label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (Fentanyl label, Boxed warning)
Preventing or Managing DI The concomitant use of ADDYI with CYP3A4 inducers is not recommended. (Flibanserin label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Use of a LABA, including formoterol fumarate inhalation solution, without an inhaled corticosteroid is contraindicated in patients with asthma [see Warnings and Precautions (5.1) ]. (Formoterol label, Contraindications)
In addition, discontinuation of a concomitantly used Cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentrations. (Hydrocodone and acetaminophen label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Infliximab label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
- IvabradineMajor
Avoid concomitant use of CYP3A4 inducers when using Corlanor. (Ivabradine label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Strong or moderate CYP3A inducers: Avoid concomitant use. (Lemborexant label, Drug interactions)
When concomitant administration of corticosteroids and levothyroxine is required, administration of corticosteroid should precede the initiation of levothyroxine therapy to avoid adrenal crisis. (Dexamethasone label, Warnings and precautions)
When concomitant administration of corticosteroids and levothyroxine is required, administration of corticosteroid should precede the initiation of levothyroxine therapy to avoid adrenal crisis. (Dexamethasone label, Warnings and precautions)
Moreover, cholesterol and other products of the cholesterol biosynthesis pathway are essential components for fetal development, including synthesis of steroids and cell membranes. (Lovastatin label, Contraindications)
CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (Lumateperone label, Drug interactions)
Strong CYP3A4 inducers (e.g., rifampin, avasimibe, St. (Lurasidone label, Contraindications)
- MacitentanMajor
Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (Macitentan label, Drug interactions)
In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in meperidine plasma concentration. (Meperidine label, Boxed warning)
When concomitant administration of corticosteroids and levothyroxine is required, administration of corticosteroid should precede the initiation of levothyroxine therapy to avoid adrenal crisis. (Dexamethasone label, Warnings and precautions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
None of the cases were considered life-threatening and all resolved either without treatment or with medication (antihistamines or glucocorticoids). (Moexipril label, Warnings)
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. (Naldemedine label, Drug interactions)
Avoid co-administration of nifedipine with phenytoin or any known CYP3A4 inducer or consider an alternative antihypertensive therapy. (Nifedipine label, Drug interactions)
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 ) (Norethindrone and ethinyl estradiol label, Drug interactions)
If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (Oliceridine label, Drug interactions)
In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone plasma concentration. (Oxycodone label, Boxed warning)
In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone plasma concentration. (Oxycodone and acetaminophen label, Boxed warning)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
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. (Paliperidone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (Pimavanserin label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
When concomitant administration of corticosteroids and levothyroxine is required, administration of corticosteroid should precede the initiation of levothyroxine therapy to avoid adrenal crisis. (Dexamethasone label, Warnings and precautions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
- RimegepantMajor
• Strong and Moderate CYP3A Inducers: Avoid concomitant administration. (Rimegepant label, Drug interactions)
Avoid concomitant use of XARELTO with drugs that are known combined P-gp and strong CYP3A inducers [see Drug Interactions (7.3) ] . (Rivaroxaban label, Warnings and precautions)
• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (Roflumilast label, Warnings and precautions)
WARNING: ASTHMA-RELATED DEATH Long-acting beta 2 -adrenergic agonists (LABA), such as salmeterol, the active ingredient in SEREVENT DISKUS, as monotherapy (without inhaled corticosteroids [ICS]) increase the risk of asthma-related death. (Salmeterol label, Boxed warning)
In a multicenter clinical study, de novo renal transplant patients treated with sirolimus, mycophenolate mofetil (MMF), steroids, and an IL-2 receptor antagonist had significantly higher acute rejection rates and numerically higher death rates compared to patients treated with cyclosporine, MMF, steroids, and IL-2 receptor antagonist. (Sirolimus label, Warnings and precautions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (Tamoxifen label, Drug interactions)
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 ) (Tasimelteon label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Tocilizumab label, Boxed warning)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Tofacitinib label, Boxed warning)
The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (Tramadol label, Boxed warning)
Two of the four cases were life-threatening and resolved without treatment or with medication (corticosteroids). (Trandolapril label, Warnings)
At first signs or symptoms of this syndrome, immediately initiate high-dose corticosteroid therapy and hemodynamic monitoring until resolution of signs and symptoms. (Tretinoin label, Boxed warning)
- UbrogepantMajor
Strong CYP3A4 Inducers: Should be avoided as concomitant use will result in reduction of ubrogepant exposure. (Ubrogepant label, Drug interactions)
• use of a long-acting beta 2 -adrenergic agonist (LABA), including vilanterol, one of the active ingredients in Umeclidinium and Vilanterol ELLIPTA, without an inhaled corticosteroid (ICS), in patients with asthma [see Warnings and Precautions ( 5.1 )] . (Umeclidinium and vilanterol label, Contraindications)
Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. (Upadacitinib label, Boxed warning)
Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (Valbenazine label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (Dexamethasone label, Drug interactions)
John's wort, a CYP3A4 inducer, in combination with zolpidem may decrease blood levels of zolpidem and is not recommended. (Zolpidem label, Drug interactions)
Moderate interactions (161)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Sympathomimetics, Methylxanthines, Steroids In clinical studies, concurrent administration of aclidinium bromide and other drugs commonly used in the treatment of COPD including sympathomimetics (short-acting beta 2 agonists), methylxanthines, and oral and inhaled steroids showed no increases in adverse drug reactions. (Aclidinium label, Drug interactions)
- AlbendazoleModerate
Dexamethasone: Steady-state trough concentrations of albendazole sulfoxide were about 56% higher when dexamethasone was coadministered with each dose of albendazole. (Albendazole label, Drug interactions)
If the patient needs more doses of Albuterol Sulfate HFA than usual, this may be a marker of destabilization of asthma and requires reevaluation of the patient and treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids. (Albuterol label, Warnings and precautions)
…osteonecrosis of the jaw include invasive dental procedures (e.g., tooth extraction, dental implants, boney surgery), diagnosis of cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders (e.g., periodontal and/or other pre-existing dental disease, anemia, coagulopathy, infection, ill-fitting… (Alendronate label, Warnings and precautions)
Patients who experience these effects, even without respiratory distress, require prolonged observation and appropriate monitoring measures since treatment with antihistamines and corticosteroids may not be sufficient to prevent respiratory involvement. (Aliskiren label, Warnings and precautions)
• Use with CYP3A Inducers: Increase the risk of reduced efficacy of alprazolam. (Alprazolam label, Drug interactions)
Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine label, Drug interactions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Blood pressure should be monitored when amlodipine is coadministered with CYP3A4 inducers (e.g. rifampicin, St. (Amlodipine and benazepril label, Drug interactions)
Monitor for toxicity when aspirin is used in conjunction with HEMADY in hypoprothrombinemia. (Dexamethasone label, Drug interactions)
- Aspirin and dipyridamoleantiplatelet agentModerate
Monitor for toxicity when aspirin is used in conjunction with HEMADY in hypoprothrombinemia. (Dexamethasone label, Drug interactions)
- BenralizumabModerate
• Reduction in Corticosteroid Dosage: Do not discontinue systemic or inhaled corticosteroids abruptly upon initiation of therapy with FASENRA. (Benralizumab label, Warnings and precautions)
- Bismuth subsalicylatesalicylateModerate
The clearance of salicylates may be increased with concurrent use of corticosteroids. (Dexamethasone label, Drug interactions)
- BrexpiprazoleantipsychoticModerate
Strong CYP3A4 inducers Double the recommended dosage and further adjust based on clinical response. (Brexpiprazole label, Drug interactions)
- Budesonide and formoterolcorticosteroidModerate
In this situation, the patient requires immediate re-evaluation with reassessment of the treatment regimen, giving special consideration to the possible need for replacing the current strength of budesonide and formoterol fumarate dihydrate with a higher strength, adding additional inhaled corticosteroid, or initiating systemic corticosteroids. (Budesonide and formoterol label, Warnings and precautions)
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Buprenorphine and naloxone label, Warnings and precautions)
…risk of seizure: concomitant use of other medications that lower the seizure threshold (e.g., other bupropion products, antipsychotics, tricyclic antidepressants, theophylline, and systemic corticosteroids), metabolic disorders (e.g., hypoglycemia, hyponatremia, severe hepatic impairment, and hypoxia), or use of illicit drugs (e.g., cocaine) or abuse or misuse… (Bupropion label, Warnings and precautions)
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. (Buspirone label, Drug interactions)
- ButorphanolopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Butorphanol label, Warnings)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Cannabidiol (prescription)anticonvulsantModerate
• Strong inducer of CYP3A4 or CYP2C19: Consider dose increase of EPIDIOLEX. (Cannabidiol (prescription) label, Drug interactions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is increased in patients over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. (Ciprofloxacin label, Warnings and precautions)
Inducers of CYP3A4 and CYP3A5 Inducers of CYP3A4 and/or CYP3A5 may reduce plasma concentrations of clindamycin. (Clindamycin label, Drug interactions)
- Conjugated estrogensestrogenModerate
( 7.1 ) • Concomitant therapies such as erythropoietin stimulating agents or estrogen containing therapies may have an increased risk of thromboembolism. (Dexamethasone label, Drug interactions)
- DabigatrananticoagulantModerate
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Deferasiroxiron supplementModerate
The risk of GI hemorrhage may be increased when administering Exjade in combination with drugs that have ulcerogenic or hemorrhagic potential, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, oral bisphosphonates, or anticoagulants. (Deferasirox label, Warnings and precautions)
- DenosumabModerate
Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (Denosumab label, Warnings and precautions)
- Dexlansoprazoleproton pump inhibitorModerate
Clinically Relevant Interactions Affecting DEXILANT When Coadministered with Other Drugs and Substances CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of dexlansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (Dexlansoprazole label, Drug interactions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Anticholinergic drugs in the presence of increased intraocular pressure may be hazardous when taken concurrently with agents such as corticosteroids. (Dicyclomine label, Drug interactions)
Digitalis Glycosides Patients on digitalis glycosides may be at increased risk of arrhythmias due to hypokalemia [ see Warnings and Precautions ( 5.3 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (Divalproex (valproate) label, Drug interactions)
- DofetilideantiarrhythmicModerate
Concomitant medications were 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… (Dofetilide label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveModerate
( 7.1 ) • Concomitant therapies such as erythropoietin stimulating agents or estrogen containing therapies may have an increased risk of thromboembolism. (Dexamethasone label, Drug interactions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- DupilumabModerate
Eosinophilic Conditions: Be alert to vasculitic rash, worsening pulmonary symptoms, cardiac complications, kidney injury and/or neuropathy, especially upon reduction of oral corticosteroids. (Dupilumab label, Warnings and precautions)
- EdoxabananticoagulantModerate
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Empagliflozin and metforminSGLT2 inhibitorModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- EnoxaparinanticoagulantModerate
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
Table 4: Clinically Relevant Interactions Affecting Esomeprazole When Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Esomeprazole label, Drug interactions)
( 7.1 ) • Concomitant therapies such as erythropoietin stimulating agents or estrogen containing therapies may have an increased risk of thromboembolism. (Dexamethasone label, Drug interactions)
Drugs that Induce CYP3A4 (Rifampicin) Racemic zopiclone exposure was decreased 80% by concomitant use of rifampicin, a potent inducer of CYP3A4. (Eszopiclone label, Drug interactions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- ExenatideGLP-1 receptor agonistModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- FesoterodineanticholinergicModerate
CYP3A4 Inducers No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. (Fesoterodine label, Drug interactions)
- FingolimodimmunosuppressantModerate
In both cases, the patients were taking a 1.25 mg dose of fingolimod (higher than the recommended 0.5 mg dose) and had received high-dose corticosteroid therapy to treat suspected MS relapses. (Fingolimod label, Warnings and precautions)
- FlecainideantiarrhythmicModerate
Limited data in patients receiving known enzyme inducers ( phenytoin, phenobarbital, carbamazepine ) indicate only a 30% increase in the rate of flecainide elimination. (Flecainide label, Drug interactions)
- FluocinonidecorticosteroidModerate
Use of more than one corticosteroid-containing product at the same time may increase the total systemic absorption of topical corticosteroids. (Fluocinonide label, Warnings and precautions)
In this situation, the patient requires immediate reevaluation with reassessment of the treatment regimen, giving special consideration to the possible need for replacing the current strength of Fluticasone Propionate/Salmeterol MDPI with a higher strength, adding additional inhaled corticosteroid, or initiating systemic corticosteroids. (Fluticasone and salmeterol label, Warnings and precautions)
- FondaparinuxanticoagulantModerate
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Glyburide and metforminsulfonylureaModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
…and its plasma concentrations can be significantly affected resulting in an increase in exposure Consider dose reduction [see Dosage and administration (2.7) ] Strong and moderate CYP3A4 inducers, e.g., rifampin, efavirenz Guanfacine is primarily metabolized by CYP3A4 and its plasma concentrations can be significantly affected resulting in a decrease in exposure… (Guanfacine label, Drug interactions)
- HalobetasolcorticosteroidModerate
Use of more than one corticosteroid-containing product at the same time may increase the total systemic exposure to topical corticosteroids. (Halobetasol label, Warnings and precautions)
CYP3A4 Inducers Clinical Impact CYP3A4 inducers decrease haloperidol exposure (haloperidol is a CYP3A4 substrate) [see Clinical Pharmacology (12.3) ]. (Haloperidol label, Drug interactions)
- HeparinanticoagulantModerate
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
Long-term treatment with steroids may be necessary (see PRECAUTIONS, Laboratory Tests ). (Hydralazine label, Warnings)
Concomitant administration of inducers of CYP3A4 may lead to decreases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions, including adrenal crisis. (Hydrocortisone label, Drug interactions)
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Hydromorphone label, Warnings and precautions)
- IbandronatebisphosphonateModerate
…osteonecrosis of the jaw include invasive dental procedures (e.g., tooth extraction, dental implants, boney surgery), diagnosis of cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders (e.g., periodontal and/or other pre-existing dental disease, anemia, coagulopathy, infection, ill-fitting… (Ibandronate label, Warnings and precautions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Insulin degludecinsulinModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Insulin detemirinsulinModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Insulin regular (human)insulinModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- IvermectinModerate
Oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids have been used to treat postural hypotension. (Ivermectin label, Warnings)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Clinically Relevant Interactions Affecting PREVACID or PREVACID SoluTab When Coadministered with Other Drugs CYP2C19 OR CYP3A4 Inducers Clinical Impact: Decreased exposure of lansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (Lansoprazole label, Drug interactions)
- Levalbuterolbeta-adrenergic agonistModerate
If the patient needs more doses of XOPENEX HFA than usual, this may be a marker of destabilization of asthma and requires reevaluation of the patient and treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids. (Levalbuterol label, Warnings and precautions)
The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is increased in patients usually over 60 years of age, in those taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. (Levofloxacin label, Warnings and precautions)
- LevonorgestrelprogestinModerate
Estrogens, Including Oral Contraceptives Estrogens may decrease the hepatic metabolism of certain corticosteroids and increase exposures, which may increase the risk of adverse reactions [see Warnings and Precautions ( 5 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
( 7.1 ) • Concomitant therapies such as erythropoietin stimulating agents or estrogen containing therapies may have an increased risk of thromboembolism. (Dexamethasone label, Drug interactions)
- LevorphanolopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Levorphanol label, Warnings)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
Even in those instances where swelling of only the tongue is involved, without respiratory distress, patients may require prolonged observation since treatment with antihistamines and corticosteroids may not be sufficient. (Lisinopril and hydrochlorothiazide label, Warnings)
Estrogens, Including Oral Contraceptives Estrogens may decrease the hepatic metabolism of certain corticosteroids and increase exposures, which may increase the risk of adverse reactions [see Warnings and Precautions ( 5 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- MegestrolprogestinModerate
Estrogens, Including Oral Contraceptives Estrogens may decrease the hepatic metabolism of certain corticosteroids and increase exposures, which may increase the risk of adverse reactions [see Warnings and Precautions ( 5 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- Menthol and methyl salicylatesalicylateModerate
The clearance of salicylates may be increased with concurrent use of corticosteroids. (Dexamethasone label, Drug interactions)
- MepolizumabModerate
Decrease corticosteroids gradually, if appropriate. (Mepolizumab label, Warnings and precautions)
- MesalaminesalicylateModerate
The clearance of salicylates may be increased with concurrent use of corticosteroids. (Dexamethasone label, Drug interactions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Methadone label, Warnings and precautions)
NSAIDs, Aspirin, and Steroids: May elevate and prolong serum methotrexate levels and increase gastrointestinal toxicity. (Methotrexate label, Drug interactions)
- MethyldopaantihypertensiveModerate
If not, corticosteroids may be given and other causes of anemia should be considered. (Methyldopa label, Warnings)
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. (Methylprednisolone label, Drug interactions)
Corticosteroids Or ACTH May increase the risk of hypokalemia and increase salt and water retention. (Metolazone label, Drug interactions)
John's Wort, tramadol, tryptophan, buspirone Strong CYP3A Inducers Clinical Impact The concomitant use of strong CYP3A inducers with REMERON/REMERONSolTab decreases the plasma concentration of mirtazapine [see Clinical Pharmacology (12.3) ] . (Mirtazapine label, Drug interactions)
Lung function (FEV 1 or PEF), beta-agonist use, and asthma symptoms should be carefully monitored during withdrawal of oral or other systemic corticosteroids. (Mometasone label, Warnings and precautions)
Inhaled corticosteroid may be reduced gradually. (Montelukast label, Warnings and precautions)
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Morphine label, Warnings and precautions)
- MoxifloxacinfluoroquinoloneModerate
The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is increased in patients over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. (Moxifloxacin label, Warnings and precautions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- NalbuphineopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Nalbuphine label, Warnings)
- Naltrexone and bupropionopioid antagonistModerate
…hypoglycemia concomitant administration of medications that may lower the seizure threshold, including other bupropion products, antipsychotics, tricyclic antidepressants, theophylline, systemic steroids Recommendations for Reducing the Risk of Seizure: Clinical experience with bupropion suggests that the risk of seizure may be minimized by adhering to the recommended… (Naltrexone and bupropion label, Warnings and precautions)
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- NatalizumabimmunosuppressantModerate
In Studies MS1 and MS2, an increase in infections was seen in patients concurrently receiving short courses of corticosteroids. (Natalizumab label, Warnings and precautions)
- NintedanibModerate
Use OFEV with caution when treating patients with recent abdominal surgery, previous history of diverticular disease or receiving concomitant corticosteroids or NSAIDs. (Nintedanib label, Warnings and precautions)
- NorethindroneprogestinModerate
Estrogens, Including Oral Contraceptives Estrogens may decrease the hepatic metabolism of certain corticosteroids and increase exposures, which may increase the risk of adverse reactions [see Warnings and Precautions ( 5 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- Norgestimate and ethinyl estradioloral contraceptiveModerate
( 7.1 ) • Concomitant therapies such as erythropoietin stimulating agents or estrogen containing therapies may have an increased risk of thromboembolism. (Dexamethasone label, Drug interactions)
- OcrelizumabimmunosuppressantModerate
In multiple sclerosis (MS) clinical trials, all adult and pediatric patients who were treated with OCREVUS received premedication with methylprednisolone (or an equivalent steroid), and may have also received an antihistamine (all pediatric patients) and/or an analgesic/antipyretic to reduce the risk of infusion reactions prior to each infusion. (Ocrelizumab label, Warnings and precautions)
- OfloxacinfluoroquinoloneModerate
The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is increased in patients over 60 years of age, in those taking corticosteroid drugs, and in patients with kidney, heart or lung transplants. (Ofloxacin label, Warnings)
- OmalizumabModerate
Corticosteroid Reduction: Do not abruptly discontinue corticosteroids upon initiation of OMLYCLO therapy. (Omalizumab label, Warnings and precautions)
Table 4: Clinically Relevant Interactions Affecting Omeprazole When Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (Omeprazole label, Drug interactions)
Phenytoin, Carbamazepine, and Rifampin In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. (Ondansetron label, Drug interactions)
- OxymorphoneopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Oxymorphone label, Warnings and precautions)
- Pentazocine and naloxoneopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Pentazocine and naloxone label, Warnings)
- PhenylephrinedecongestantModerate
Agonistic Effects (increase in BIORPHEN blood pressure effect) can occur with monoamine oxidase inhibitors (MAOI), oxytocin and oxytocic drugs, tricyclic antidepressants, angiotensin and aldosterone, atropine, steroids, norepinephrine transporter inhibitors, ergot alkaloids. (Phenylephrine label, Drug interactions)
Phenytoin In post-marketing experience, there have been reports of both increases and decreases in phenytoin levels with dexamethasone coadministration, leading to alterations in seizure control. (Dexamethasone label, Drug interactions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Pioglitazone and metforminthiazolidinedioneModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- PitolisantQT-prolonging drugModerate
Strong CYP3A4 Inducers: Decreased exposure of WAKIX; consider dosage adjustment of WAKIX ( 2.6 , 7.1 ) (Pitolisant label, Drug interactions)
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. (Prednisolone label, Drug interactions)
CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (Prednisone label, Drug interactions)
- ProgesteroneprogestinModerate
Estrogens, Including Oral Contraceptives Estrogens may decrease the hepatic metabolism of certain corticosteroids and increase exposures, which may increase the risk of adverse reactions [see Warnings and Precautions ( 5 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
- PropofolCNS depressantModerate
The following appear to be major risk factors for the development of these events: decreased oxygen delivery to tissues; serious neurological injury and/or sepsis; high dosages of one or more of the following pharmacological agents: vasoconstrictors, steroids, inotropes and/or prolonged, high-dose infusions of propofol (> 5 mg/kg/hour for > 48 hours). (Propofol label, Warnings and precautions)
• Concomitant use of strong CYP3A4 inducers: Increase quetiapine dose up to 5 fold when used in combination with a chronic treatment (more than 7-14 days) of potent CYP3A4 inducers (e.g., phenytoin, rifampin, St. (Quetiapine label, Drug interactions)
- Ramelteonsedative-hypnoticModerate
Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (Ramelteon label, Drug interactions)
- RepaglinidemeglitinideModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
…Calcium Channel Blockers Diltiazem Decrease exposure Nifedipine Rifampin 1200 mg administered as a single oral dose 8 hours before administering a single oral dose of nifedipine 10 mg Decrease exposure Verapamil Decrease exposure Corticosteroids Numerous cases in the literature describe a decrease in glucocorticoid effect when used concomitantly with rifampin. (Rifampin label, Drug interactions)
- RisedronatebisphosphonateModerate
…the jaw include invasive dental procedures (for example, tooth extraction, dental implants, boney surgery), diagnosis of cancer, concomitant therapies (for example, chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders (for example, periodontal and/or other pre-existing dental disease, anemia, coagulopathy, infection,… (Risedronate label, Warnings and precautions)
Carbamazepine and other enzyme inducers decrease plasma concentrations of risperidone. (Risperidone label, Drug interactions)
- RufinamideanticonvulsantModerate
Effects of Other AEDs on BANZEL Potent cytochrome P450 enzyme inducers, such as carbamazepine, phenytoin, primidone, and phenobarbital, appear to increase the clearance of BANZEL (see Table 6). (Rufinamide label, Drug interactions)
- SelegilineMAO inhibitorModerate
Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (Selegiline label, Drug interactions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Sitagliptin and metforminDPP-4 inhibitorModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- SulfasalazinesulfonamideModerate
The clearance of salicylates may be increased with concurrent use of corticosteroids. (Dexamethasone label, Drug interactions)
- Sumatriptan and naproxentriptanModerate
Nonsteroidal Anti-Inflammatory Agents (NSAIDS) Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects [see Warnings and Precautions ( 5.7 ) and Adverse Reactions ( 6 )] . (Dexamethasone label, Drug interactions)
Risk of Rejection with Strong CYP3A Inducers and Risk of Serious Adverse Reactions with Strong CYP3A Inhibitors The concomitant use of strong CYP3A inducers may increase the metabolism of tacrolimus, leading to lower whole blood trough concentrations and greater risk of rejection. (Tacrolimus label, Warnings and precautions)
CYP3A4 inhibitors (e.g. ketoconazole, ritonavir) increase CIALIS exposure ( 2.7 , 5.10 , 7.2 ) requiring dose adjustment: CIALIS for use as needed: no more than 10 mg every 72 hours CIALIS for once daily use: dose not to exceed 2.5 mg CYP3A4 inducers (e.g. rifampin) decrease CIALIS exposure ( 7.2 ). (Tadalafil label, Drug interactions)
- TapentadolopioidModerate
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids. (Tapentadol label, Warnings and precautions)
Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (Terbinafine label, Drug interactions)
- Terbutalinebeta-adrenergic agonistModerate
If the patient needs more doses of terbutaline sulfate tablets than usual, this may be a marker of destabilization of asthma and requires reevaluation of the patient and the treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids. (Terbutaline label, Warnings)
Abuse of Testosterone and Monitoring of Serum Testosterone : If testosterone use at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids is suspected, check serum testosterone concentration ( 5.5 ). (Testosterone label, Warnings and precautions)
Dosage Increases: Increases in the dose of theophylline should not be made in response to an acute exacerbation of symptoms of chronic lung disease since theophylline provides little added benefit to inhaled beta2 -selective agonists and systemically administered corticosteroids in this circumstance and increases the risk of adverse effects. (Theophylline label, Warnings)
- TiagabineanticonvulsantModerate
Use of tiagabine HCl without enzyme-inducing antiepileptic drugs results in blood levels about twice those attained in the studies on which current dosing recommendations are based (see DOSAGE AND ADMINISTRATION ). (Tiagabine label, Warnings)
- TinidazoleantibioticModerate
CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (Tinidazole label, Drug interactions)
Concomitant Respiratory Medications SPIRIVA RESPIMAT has been used concomitantly with short-acting and long-acting sympathomimetic (beta-agonists) bronchodilators, methylxanthines, oral and inhaled steroids, antihistamines, mucolytics, leukotriene modifiers, cromones, and anti-IgE treatment without increases in adverse reactions. (Tiotropium label, Drug interactions)
- TirzepatideGLP-1 receptor agonistModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
Corticosteroids and ACTH: Increased risk of hypokalemia. (Torsemide label, Drug interactions)
CYP3A4 Inducers: Increase in RALDESY dosage may be necessary ( 2.5 , 7 ). (Trazodone label, Drug interactions)
- Treprostinilprostaglandin analogModerate
Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (Treprostinil label, Warnings and precautions)
Hepatic enzyme inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin): Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. (Triamcinolone label, Drug interactions)
Other Considerations Concurrent use of hydrochlorothiazide with amphotericin B or corticosteroids or corticotropin (ACTH) may intensify electrolyte imbalance, particularly hypokalemia, although the presence of triamterene minimizes the hypokalemic effect. (Triamterene and hydrochlorothiazide label, Drug interactions)
- TriazolambenzodiazepineModerate
Strong Inducers of CYP 3A Clinical implication Coadministration of triazolam with strong inducers of CYP3A4 can significantly decrease the plasma concentration of triazolam and may decrease effectiveness of triazolam. (Triazolam label, Drug interactions)
- Valproic acidanticonvulsantModerate
Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (Valproic acid label, Drug interactions)
CYP3A4 Inducers: Consider increasing VIIBRYD dosage by 2-fold, up to 80 mg once-daily over 1 to 2 weeks when used concomitantly with strong CYP3A4 inducers for greater than 14 days ( 2.4 , 7 ). (Vilazodone label, Drug interactions)
( 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (Dexamethasone label, Warnings and precautions)
- Zaleplonsedative-hypnoticModerate
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%. (Zaleplon label, Drug interactions)
Pharmacokinetic Interactions Carbamazepine Carbamazepine is an inducer of CYP3A4; administration of 200 mg twice daily for 21 days resulted in a decrease of approximately 35% in the AUC of ziprasidone. (Ziprasidone label, Drug interactions)
CYP3A4 Inducers If co-administration with a potent CYP3A4 inducer is necessary, the patient should be closely monitored and the dose of ZONISAMIDE and other drugs that CYP3A4 substrates may need to be adjusted [see Clinical Pharmacology ( 12.3 )] . (Zonisamide label, Drug interactions)
Minor mentions (33)
Interference with Laboratory Tests Amphetamines can cause a significant elevation in plasma corticosteroid levels. (Amphetamine and dextroamphetamine label, Drug interactions)
- Ampicillinpenicillin antibioticMinor
OXYGEN, INTRAVENOUS STEROIDS, AND AIRWAY MANAGEMENT, INCLUDING INTUBATION, SHOULD ALSO BE ADMINISTERED AS INDICATED. (Ampicillin label, Warnings)
- Bempedoic acidOATP1B1 inhibitorMinor
Tendon rupture may occur more frequently in patients over 60 years of age, in those taking corticosteroid or fluoroquinolone drugs, in patients with renal failure, and in patients with previous tendon disorders. (Bempedoic acid label, Warnings and precautions)
- Bisoprolol and hydrochlorothiazidebeta blockerMinor
Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)
- Calcitriolvitamin D analogMinor
Corticosteroids A relationship of functional antagonism exists between vitamin D analogues, which promote calcium absorption, and corticosteroids, which inhibit calcium absorption. (Calcitriol label, Drug interactions)
…clozapine, cyclosporin, delavirdine, desipramine, diazepam, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, ethosuximide, everolimus, felbamate, glucocorticoids, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, lorazepam, methadone, methsuxamide, mianserin, midazolam, mirtazapine, nefazodone, olanzapine, oral… (Carbamazepine label, Drug interactions)
- CefadroxilcephalosporinMinor
SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS, INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED. (Cefadroxil label, Warnings and precautions)
SERIOUS ACUTE HYPERSENSITIVITY REACTIONS MAY REQUIRE TREATMENT WITH EPINEPHRINE AND OTHER EMERGENCY MEASURES, INCLUDING OXYGEN, INTRAVENOUS FLUIDS, INTRAVENOUS ANTIHISTAMINES, CORTICOSTEROIDS, PRESSOR AMINES, AND AIRWAY MANAGEMENT, AS CLINICALLY INDICATED. (Cefdinir label, Warnings)
- Clomipheneselective estrogen receptor modulatorMinor
Elevated urinary steroid levels, varying degrees of electrolyte imbalance, hypovolemia, hemoconcentration, and hypoproteinemia may occur. (Clomiphene label, Warnings)
The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (Clonazepam label, Drug interactions)
Anticholinesterases Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Dexamethasone label, Drug interactions)
Drugs Metabolized by CYP3A Results of in vitro studies demonstrate that duloxetine does not inhibit or induce CYP3A activity. (Duloxetine label, Drug interactions)
- Emtricitabine and tenofovirantiretroviralMinor
TAF is not an inhibitor or inducer of CYP3A in vivo . (Emtricitabine and tenofovir label, Drug interactions)
- Ethacrynic acidloop diureticMinor
Care should also be exercised in patients receiving potassium-depleting steroids. (Ethacrynic acid label, Warnings)
Most patients improved promptly with discontinuation of fluoxetine and/or adjunctive treatment with antihistamines or steroids, and all patients experiencing these reactions were reported to recover completely. (Fluoxetine label, Warnings and precautions)
- Galantaminecholinesterase inhibitorMinor
Anticholinesterases Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Dexamethasone label, Drug interactions)
- GlucagonMinor
In the reported cases NME resolved with discontinuation of the glucagon, and treatment with corticosteroids was not effective. (Glucagon label, Warnings and precautions)
- GuselkumabimmunosuppressantMinor
TREMFYA was subsequently discontinued, and the liver test abnormalities resolved following administration of corticosteroids [see Adverse Reactions (6.1) ] . (Guselkumab label, Warnings and precautions)
ATROVENT HFA has been used concomitantly with other drugs, including sympathomimetic bronchodilators, methylxanthines, oral and inhaled steroids commonly used in the treatment of COPD. (Ipratropium label, Drug interactions)
- Midodrinealpha-adrenergic agonistMinor
Midodrine hydrochloride tablets have been used in patients concomitantly treated with salt-retaining steroid therapy (i.e., fludrocortisone acetate), with or without salt supplementation. (Midodrine label, Drug interactions)
Both cases required hospitalization, and resolved after treatment with antibiotics and corticosteroids. (Naltrexone label, Warnings and precautions)
- Penicillin Gpenicillin antibioticMinor
Oxygen, intravenous steroids, and airway management, including intubation, should also be administered as indicated. (Penicillin G label, Warnings)
OXYGEN, INTRAVENOUS STEROIDS, AND AIRWAY MANAGEMENT, INCLUDING INTUBATION, SHOULD ALSO BE ADMINISTERED AS INDICATED. (Penicillin V label, Warnings)
- Pyridostigminecholinesterase inhibitorMinor
Anticholinesterases Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Dexamethasone label, Drug interactions)
- Raloxifeneselective estrogen receptor modulatorMinor
Other Concomitant Medications EVISTA can be concomitantly administered with ampicillin, amoxicillin, antacids, corticosteroids, and digoxin [see Clinical Pharmacology ( 12.3 )] . (Raloxifene label, Drug interactions)
- RifaximinantibioticMinor
CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (Rifaximin label, Drug interactions)
- RiociguatvasodilatorMinor
Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (Riociguat label, Drug interactions)
- RituximabimmunosuppressantMinor
Institute medical management (e.g., glucocorticoids, epinephrine, bronchodilators, or oxygen) for infusion-related reactions as needed. (Rituximab label, Warnings and precautions)
- Rivastigminecholinesterase inhibitorMinor
Anticholinesterases Concomitant use of anticholinesterase agents and corticosteroids may produce severe weakness in patients with myasthenia gravis. (Dexamethasone label, Drug interactions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistMinor
Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia, may occur. (Spironolactone and hydrochlorothiazide label, Drug interactions)
- TobramycinaminoglycosideMinor
In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)
- UstekinumabimmunosuppressantMinor
Patients improved with discontinuation of therapy and in certain cases administration of corticosteroids. (Ustekinumab label, Warnings and precautions)
Corticosteroids such as prednisone reduce calcium absorption and impair vitamin D metabolism, contributing to bone loss. (NIH Office of Dietary Supplements, Vitamin D)
No significant interaction reported (1)
- AsenapineantipsychoticNo interaction
Drugs Having No Clinically Important Interactions with SAPHRIS No dosage adjustment of SAPHRIS is necessary when administered concomitantly with paroxetine (see Table 12 in Drug Interactions ( 7.1 ) for paroxetine dosage adjustment), imipramine, cimetidine, valproate, lithium, or a CYP3A4 inducer (e.g., carbamazepine, phenytoin, rifampin). (Asenapine label, Drug interactions)
Check Dexamethasone against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.