Interacciones de Efavirenz

CYP3A4 Inducers: Avoid concomitant strong CYP3A4 inducers during YONSA treatment. (etiqueta de Abiraterona, Interacciones medicamentosas)

• CYP3A Inhibitors: Avoid co-administration with strong CYP3A inhibitors. (etiqueta de Acalabrutinib, Interacciones medicamentosas)

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs alone or in combination with other antiretrovirals [See Warnings and Precautions (5. (etiqueta de Adefovir, Advertencia en recuadro)

…(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… (etiqueta de Alfuzosina, Contraindicaciones)

Concomitant use of almotriptan tablets and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment [see Clinical Pharmacology ( 12.3 )] . (etiqueta de Almotriptán, Interacciones medicamentosas)

CYP3A4 Inducers : Avoid coadministration of VIJOICE with a strong CYP3A4 inducer. (etiqueta de Alpelisib, Interacciones medicamentosas)

• 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) ] . (etiqueta de Alprazolam, Contraindicaciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

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 ) (etiqueta de Apremilast, Advertencias y precauciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (etiqueta de Aripiprazol, Interacciones medicamentosas)

Treatment-experienced patients: Coadministration of efavirenz and atazanavir is not recommended. (etiqueta de Efavirenz, Interacciones medicamentosas)

Do not use avanafil in patients taking strong CYP3A4 inhibitors [see Warnings and Precautions ( 5.2 ) and Dosage and Administration ( 2.3 )]. (etiqueta de Avanafilo, Interacciones medicamentosas)

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

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong CYP3A4 Inducers: Avoid concomitant use. (etiqueta de Bortezomib, Interacciones medicamentosas)

Co-administration of such combinations of a CYP2C9 inhibitor plus a strong or moderate CYP3A inhibitor with TRACLEER is not recommended. (etiqueta de Bosentán, Interacciones medicamentosas)

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (etiqueta de Bosutinib, Interacciones medicamentosas)

Concomitant use of strong CYP3A4 inhibitors (e.g., azole antimycotics, HIV protease inhibitors) with CYCLOSET should be avoided. (etiqueta de Bromocriptina, Interacciones medicamentosas)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (etiqueta de Buprenorfina, Interacciones medicamentosas)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (etiqueta de Butalbital, ácido acetilsalicílico, cafeína y codeína, Advertencia en recuadro)

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. (etiqueta de Butalbital, paracetamol, cafeína y codeína, Advertencia en recuadro)

Coadministration with other antiretroviral medications for PrEP is not recommended. (etiqueta de Cabotegravir, Interacciones medicamentosas)

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… (etiqueta de Cabozantinib, Interacciones medicamentosas)

Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (etiqueta de Cariprazina, Interacciones medicamentosas)

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

Antiviral and antiretroviral drugs: Avoid concomitant use. (etiqueta de Cladribina, Interacciones medicamentosas)

CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole. (etiqueta de Clopidogrel, Advertencias y precauciones)

• Concomitant use of Strong CYP3A4 Inducers is not recommended. (etiqueta de Clozapina, Interacciones medicamentosas)

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. (etiqueta de Codeína, Advertencia en recuadro)

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) ] . (etiqueta de Colchicina, Contraindicaciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong CYP3A4 inhibitors: Avoid concomitant use. (etiqueta de Daridorexant, Interacciones medicamentosas)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

Avoid concomitant use of strong CYP3A4 inhibitors. (etiqueta de Dasatinib, Interacciones medicamentosas)

Avoid use of moderate or strong CYP3A4 inducers with EMFLAZA, as they may reduce efficacy ( 7.1 ) (etiqueta de Deflazacort, Interacciones medicamentosas)

• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (etiqueta de Dexametasona, Interacciones medicamentosas)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (etiqueta de Dextrometorfano y quinidina, Advertencias y precauciones)

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. (etiqueta de Dihidroergotamina, Advertencia en recuadro)

Concomitant use of Docetaxel Injection and drugs that inhibit CYP3A4 may increase exposure to docetaxel and should be avoided. (etiqueta de Docetaxel, Interacciones medicamentosas)

HIV Antiviral Agents efavirenz etravirine nevirapine ↓ doravirine Use with efavirenz, etravirine, or nevirapine is not recommended. (etiqueta de Doravirina, Interacciones medicamentosas)

• Avoid concomitant use of doxorubicin hydrochloride with inhibitors and inducers of CYP3A4, CYP2D6, and/or P-gp ( 7.1 ) (etiqueta de Doxorubicina, Interacciones medicamentosas)

• CYP3A inducers: Avoid concomitant use. (etiqueta de Dronedarona, Interacciones medicamentosas)

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) ]. (etiqueta de Dutasterida y tamsulosina, Advertencias y precauciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (etiqueta de Efavirenz, lamivudina y tenofovir, Advertencias y precauciones)

• 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) ]. (etiqueta de Eletriptán, Contraindicaciones)

Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (etiqueta de Elexacaftor, tezacaftor e ivacaftor, Advertencias y precauciones)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Therapy with BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also receiving highly active antiretroviral therapy (HAART) [see Warnings and Precautions (5.2) ] . (etiqueta de Entecavir, Advertencia en recuadro)

…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)… (etiqueta de Eplerenona, Contraindicaciones)

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. (etiqueta de Ergotamina y cafeína, Advertencia en recuadro)

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). (etiqueta de Erlotinib, Interacciones medicamentosas)

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

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) ] . (etiqueta de Ezetimiba y simvastatina, Contraindicaciones)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (etiqueta de Fentanilo, Advertencia en recuadro)

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) ]. (etiqueta de Fesoterodina, Interacciones medicamentosas)

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) ] . (etiqueta de Flibanserina, Advertencia en recuadro)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (etiqueta de Fluticasona, Interacciones medicamentosas)

Avoid strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): May increase risk of systemic corticosteroid and cardiovascular effects. (etiqueta de Fluticasona y salmeterol, Interacciones medicamentosas)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Hidrocodona, Advertencia en recuadro)

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. (etiqueta de Hidrocodona e ibuprofeno, Advertencia en recuadro)

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. (etiqueta de Hidrocodona y clorfenamina, Advertencia en recuadro)

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. (etiqueta de Hidrocodona y homatropina, Advertencia en recuadro)

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. (etiqueta de Hidrocodona y paracetamol, Advertencia en recuadro)

Increased Toxicity with Concomitant Use of Antiretroviral Drugs Pancreatitis Pancreatitis (including fatal cases) have occurred in patients with HIV infection during therapy with hydroxyurea and didanosine, with or without stavudine. (etiqueta de Hidroxicarbamida (hidroxiurea), Interacciones medicamentosas)

La hierba de San Juan (hipérico) puede reducir los niveles en sangre de algunos medicamentos contra el VIH lo suficiente como para causar el fracaso del tratamiento. (NCCIH, St. John's Wort)

• Strong CYP3A4 Inducers: Do not administer strong CYP3A4 inducers with CAMPTOSAR. (etiqueta de Irinotecán, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

…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 ) (etiqueta de Ivabradina, Contraindicaciones)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

Avoid strong CYP3A4 inhibitors. (etiqueta de Lapatinib, Interacciones medicamentosas)

Strong CYP3A4 Inhibitors: Avoid coadministration of strong CYP3A4 inhibitors with VITRAKVI. (etiqueta de Larotrectinib, Interacciones medicamentosas)

Velpatasvir/ Sofosbuvir ↓ velpatasvir Coadministration of efavirenz and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong or moderate CYP3A inhibitors: Avoid concomitant use. (etiqueta de Lemborexant, Interacciones medicamentosas)

…Agents: atazanavir/cobicistat Drug-drug interaction study was conducted. atazanavir/ritonavir ↑ lenacapavir (atazanavir/cobicistat, atazanavir/ritonavir) Concomitant administration of efavirenz, nevirapine, or tipranavir/ritonavir may result in loss of therapeutic effect and development of resistance. efavirenz nevirapine tipranavir/ritonavir ↓ lenacapavir (efavirenz,… (etiqueta de Lenacapavir, Interacciones medicamentosas)

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) ]. (etiqueta de Lomitapida, Contraindicaciones)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

• Strong CYP3A Inhibitors : Avoid concomitant use; reduce LORBRENA dose if concomitant use cannot be avoided. (etiqueta de Lorlatinib, Interacciones medicamentosas)

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 ). (etiqueta de Lovastatina, Contraindicaciones)

CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (etiqueta de Lumateperona, Interacciones medicamentosas)

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole, mibefradil, etc.) [see Drug Interactions ( 7.1 )]. (etiqueta de Lurasidona, Contraindicaciones)

Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (etiqueta de Macitentán, Interacciones medicamentosas)

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 )]. (etiqueta de Maraviroc, Contraindicaciones)

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. (etiqueta de Metilergometrina, Interacciones medicamentosas)

CYP3A inducers: Do not use mifepristone with CYP3A inducers ( 7.3 ). (etiqueta de Mifepristona, Interacciones medicamentosas)

Strong CYP3A Inhibitors and Inducers: Avoid concomitant use. (etiqueta de Mitapivat, Interacciones medicamentosas)

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. (etiqueta de Naldemedina, Interacciones medicamentosas)

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… (etiqueta de Naloxegol, Contraindicaciones)

CYP2B6 Inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) may reduce efficacy by reducing bupropion exposure, avoid concomitant use. (etiqueta de Naltrexona y bupropión, Interacciones medicamentosas)

Co-administration of nevirapine and efavirenz is not recommended as this combination has been associated with an increase in adverse reactions and no improvement in efficacy. (etiqueta de Nevirapina, Advertencias y precauciones)

John’s Wort reduce the bioavailability and efficacy of nifedipine; therefore nifedipine should not be used in combination with strong CYP3A inducers such as rifampin (See CONTRAINDICATIONS ). (etiqueta de Nifedipino, Interacciones medicamentosas)

Avoid use of concomitant drugs known to prolong the QT interval and strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 , 7.2 )] . (etiqueta de Nilotinib, Advertencia en recuadro)

Therefore, the concomitant administration of NYMALIZE and strong CYP3A4 inhibitors should generally be avoided [ see Warnings and Precautions (5.3) ]. (etiqueta de Nimodipino, Interacciones medicamentosas)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Nisoldipino, Interacciones medicamentosas)

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 ) (etiqueta de Noretisterona y etinilestradiol, Interacciones medicamentosas)

If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (etiqueta de Oliceridina, Interacciones medicamentosas)

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. (etiqueta de Oxicodona, Advertencia en recuadro)

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. (etiqueta de Oxicodona y paracetamol, Advertencia en recuadro)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etiqueta de Palbociclib, Interacciones medicamentosas)

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. (etiqueta de Paliperidona, Interacciones medicamentosas)

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. (etiqueta de Paracetamol y codeína, Advertencia en recuadro)

Strong CYP3A4 Inhibitors : Avoid coadministration of VOTRIENT with strong CYP3A4 inhibitors. (etiqueta de Pazopanib, Interacciones medicamentosas)

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. (etiqueta de Petidina (meperidina), Advertencia en recuadro)

Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (etiqueta de Pimavanserina, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

Anthelmintic: Praziquantel ↓ praziquantel Coadministration with efavirenz is not recommended due to significant decrease in plasma concentrations of praziquantel, with risk of treatment failure due to increased hepatic metabolism by efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Prometazina y codeína, Advertencia en recuadro)

• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 (CYP2D6) inhibitor and a 3A4 inhibitor (CYP3A4). (etiqueta de Propafenona, Advertencias y precauciones)

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

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (etiqueta de Rifabutina, Advertencias)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

• Strong CYP3A4 Inhibitors: Avoid concomitant administration. (etiqueta de Rimegepant, Interacciones medicamentosas)

• Certain CYP3A inducers: Coadministration with strong inducers of CYP3A is not recommended. (etiqueta de Ritlecitinib, Interacciones medicamentosas)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (etiqueta de Efavirenz, Interacciones medicamentosas)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (etiqueta de Roflumilast, Advertencias y precauciones)

Intervention: Avoid the use of VARUBI in patients who require chronic administration of strong CYP3A4 inducers. (etiqueta de Rolapitant, Interacciones medicamentosas)

• Avoid use with rifampin and strong CYP3A4 inducers ( 7.3 ). (etiqueta de Romidepsina, Interacciones medicamentosas)

• Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (etiqueta de Salmeterol, Interacciones medicamentosas)

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… (etiqueta de Silodosina, Contraindicaciones)

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) ] . (etiqueta de Simvastatina, Contraindicaciones)

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) ]. (etiqueta de Sirolimus, Advertencias y precauciones)

Velpatasvir/ Sofosbuvir ↓ velpatasvir Coadministration of efavirenz and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (etiqueta de Efavirenz, Interacciones medicamentosas)

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 )] . (etiqueta de Solifenacina, Interacciones medicamentosas)

• Strong CYP3A Inducers: Avoid strong CYP3A4 inducers. (etiqueta de Sorafenib, Interacciones medicamentosas)

Concomitant use of JOURNAVX with strong CYP3A inhibitors is contraindicated [see Warnings and Precautions (5.1) , Drug Interactions (7.1) ] . (etiqueta de Suzetrigina, Contraindicaciones)

Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (etiqueta de Tamoxifeno, Interacciones medicamentosas)

• Should not be used in combination with strong inhibitors of CYP3A4. (etiqueta de Tamsulosina, Advertencias y precauciones)

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 ) (etiqueta de Tasimelteón, Interacciones medicamentosas)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (etiqueta de Efavirenz, Advertencias y precauciones)

• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (etiqueta de Ticagrelor, Interacciones medicamentosas)

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 ) ] . (etiqueta de Tiotepa, Interacciones medicamentosas)

…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… (etiqueta de Tolvaptán, Contraindicaciones)

Drugs known to prolong the QT interval and strong CYP3A4 inhibitors should be avoided [see Warnings and Precautions (5.1) ] . (etiqueta de Toremifeno, Advertencia en recuadro)

CYP3A inhibitors: Avoid concomitant strong CYP3A inhibitors ( 7.1 ) (etiqueta de Trabectedina, Interacciones medicamentosas)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (etiqueta de Tramadol, Advertencia en recuadro)

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. (etiqueta de Tramadol y paracetamol, Advertencia en recuadro)

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… (etiqueta de Trazodona, Advertencias y precauciones)

• Strong CYP3A Inhibitors and Inducers: Avoid coadministration with strong CYP3A inhibitors and inducers. (etiqueta de Tretinoína, Interacciones medicamentosas)

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) ] . (etiqueta de Triazolam, Advertencias y precauciones)

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. (etiqueta de Ubrogepant, Contraindicaciones)

Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3) ] . (etiqueta de Ulipristal, Advertencias y precauciones)

Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (etiqueta de Upadacitinib, Interacciones medicamentosas)

Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (etiqueta de Valbenazina, Interacciones medicamentosas)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (etiqueta de Vepdegestrant, Advertencias y precauciones)

Therefore, the concomitant use of strong CYP3A inhibitors with vincristine sulfate should be avoided. (etiqueta de Vincristina, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (etiqueta de Efavirenz, Interacciones medicamentosas)

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including zidovudine and other antiretrovirals. (etiqueta de Zidovudina, Advertencia en recuadro)

John's wort, a CYP3A4 inducer, in combination with zolpidem may decrease blood levels of zolpidem and is not recommended. (etiqueta de Zolpidem, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients receiving efavirenz should be alerted to the potential for additive central nervous system effects when efavirenz is used concomitantly with alcohol or psychoactive drugs. (etiqueta de Efavirenz, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 inhibitors: Use with caution in combination due to increased exposure of alosetron. (etiqueta de Alosetrón, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Clinically Significant Interactions with Bexagliflozin Tablets UGT Enzyme Inducers Clinical Impact UGT Enzyme Inducers may significantly reduce exposure to bexagliflozin and lead to a decreased efficacy [ see Clinical Pharmacology ( 12.3 )]. (etiqueta de Bexagliflozina, Interacciones medicamentosas)

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. (etiqueta de Brexpiprazol, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (etiqueta de Budesonida y formoterol, Advertencias y precauciones)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Bupropion dose should not exceed the maximum recommended dose. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Buspirona, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Table 7: Clinically Significant Drug Interactions with INVOKANA UGT Enzyme Inducers Clinical Impact: UGT enzyme inducers decrease canagliflozin exposure which may reduce the effectiveness of INVOKANA. (etiqueta de Canagliflozina, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Co-administration of CYP2C19 inhibitors, such as omeprazole or fluvoxamine, with carisoprodol could result in increased exposure of carisoprodol and decreased exposure of meprobamate. (etiqueta de Carisoprodol, Interacciones medicamentosas)

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) ]. (etiqueta de Carvedilol, Interacciones medicamentosas)

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

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. (etiqueta de Celecoxib, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong and moderate CYP3A4 and CYP2C19 inhibitors: Increase exposure to cilostazol. (etiqueta de Cilostazol, Interacciones medicamentosas)

Co-administration with a strong CYP3A4 inhibitor may increase serum levels of cinacalcet. (etiqueta de Cinacalcet, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Inhibitors of CYP3A4 and CYP3A5 Inhibitors of CYP3A4 and/or CYP3A5 may increase plasma concentrations of clindamycin [ see Clinical Pharmacology (12.3) ]. (etiqueta de Clindamicina, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 Inhibitors The systemic exposure of darifenacin from darifenacin extended-release tablets is increased in the presence of CYP3A4 inhibitors. (etiqueta de Darifenacina, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etiqueta de Desogestrel y etinilestradiol, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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

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. (etiqueta de Diclofenaco, Interacciones medicamentosas)

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. (etiqueta de Diclofenaco y misoprostol, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Non-nucleoside reverse transcriptase inhibitor: Efavirenz a ↓Dolutegravir Adjust dose of TIVICAY to twice daily for treatment-naïve and treatment-experienced, INSTI-naïve adult patients. (etiqueta de Dolutegravir, Interacciones medicamentosas)

Strong cytochrome P450 (CYP) 3A inhibitors may increase exposure to doxazosin and increased risk of hypotension. (etiqueta de Doxazosina, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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). (etiqueta de Dronabinol, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Consider monitoring serum potassium concentration in high-risk patients who take a strong CYP3A4 inhibitor long-term and concomitantly. (etiqueta de Drospirenona y etinilestradiol, Advertencias y precauciones)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

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

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. (etiqueta de Estradiol, Interacciones medicamentosas)

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

Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism and decrease or increase the estrogen plasma concentration. (etiqueta de Estradiol y noretisterona, Interacciones medicamentosas)

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) ] . (etiqueta de Estrógenos conjugados y bazedoxifeno, Interacciones medicamentosas)

The dose of LUNESTA should be reduced in patients who are administered potent inhibitors of CYP3A4, such as ketoconazole, while taking LUNESTA. (etiqueta de Eszopiclona, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Decreased exposure of etonogestrel may be expected. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Concomitant use of Etravirine with efavirenz or nevirapine may cause a significant decrease in the plasma concentrations of etravirine and loss of therapeutic effect of Etravirine. (etiqueta de Etravirina, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong CYP 3A4 inducers: Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure. (etiqueta de Exemestano, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Potential for Other Drugs to Affect Efavirenz Drugs that induce CYP3A activity (e.g., phenobarbital, rifampin, rifabutin) would be expected to increase the clearance of efavirenz resulting in lowered plasma concentrations [ see Dosage and Administration ( 2.2 ) ]. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Phenobarbital Clinical Impact: Chronic administration of phenobarbital, a known enzyme inducer, may be associated with a decrease in the plasma half-life of fenoprofen. (etiqueta de Fenoprofeno, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Anti-infective: Clarithromycin ↓ clarithromycin * ↑ 14-OH metabolite * Consider alternatives to macrolide antibiotics because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 Interactions: Fosaprepitant is a weak inhibitor of CYP3A4, and aprepitant, the active moiety, is a substrate, inhibitor, and inducer of CYP3A4; see Full Prescribing Information for recommendations regarding contraindications, risk of adverse reactions, and dosage adjustment of FOCINVEZ and concomitant drugs. (etiqueta de Fosaprepitant, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

• CYP3A4 Inducer: Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer. (etiqueta de Gefitinib, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

…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… (etiqueta de Guanfacina, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Concomitant administration of inhibitors of CYP3A4 may lead to increases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions associated with the use of excessive doses. (etiqueta de Hidrocortisona, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

• CYP3A4 Inducers: Monitor for increased toxicity when used in combination with CYP3A4 inducers. (etiqueta de Ifosfamida, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 inducers may decrease Gleevec C max and area under curve (AUC). (etiqueta de Imatinib, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Ivacaftor, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding. (etiqueta de Levonorgestrel y etinilestradiol, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (etiqueta de Linagliptina, Interacciones medicamentosas)

Inducers of P-glycoprotein or CYP3A4 Enzymes Clinical Impact Rifampin decreased linagliptin exposure, suggesting that the efficacy of linagliptin may be reduced when administered in combination with a strong P-gp or CYP3A4 inducer. (etiqueta de Linagliptina y metformina, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

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 ) ]. (etiqueta de Meloxicam, Interacciones medicamentosas)

Inducers of CYP3A4 (e.g., phenytoin, carbamazepine, dexamethasone, rifampin, and phenobarbital) could increase the rate of elimination of donepezil. (etiqueta de Memantina y donepezilo, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Metilprednisolona, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antifungals: Voriconazole Itraconazole Ketoconazole Posaconazole ↓ voriconazole * ↑ efavirenz * ↓ itraconazole * ↓ hydroxyitraconazole * ↓ ketoconazole ↓ posaconazole * Efavirenz and voriconazole should not be coadministered at standard doses. (etiqueta de Efavirenz, Interacciones medicamentosas)

Cytochrome P450-3A4 Inhibitors: May result in prolonged sedation due to decreased plasma clearance of midazolam. (etiqueta de Midazolam, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (etiqueta de Mometasona, Advertencias y precauciones)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (etiqueta de Naproxeno y esomeprazol, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

…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. (etiqueta de Nateglinida, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Coadministration of P-gp and CYP3A4 inhibitors may increase nintedanib exposure. (etiqueta de Nintedanib, Interacciones medicamentosas)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etiqueta de Norelgestromina y etinilestradiol, Interacciones medicamentosas)

Some drugs or herbal products that may decrease the effectiveness of HCs include efavirenz, phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, rifabutin, rufinamide, aprepitant, and products containing St. (etiqueta de Noretisterona, Interacciones medicamentosas)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etiqueta de Norgestimato y etinilestradiol, Interacciones medicamentosas)

Concomitant administration of CYP3A4 inhibitors such as itraconazole, fluconazole, grapefruit juice or ketoconazole may increase plasma hormone concentrations. (etiqueta de Norgestrel y etinilestradiol, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (etiqueta de Omeprazol y bicarbonato de sodio, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Drug Interactions and Decreased Vitamin Absorption ORLISTAT may interact with concomitant drugs including cyclosporine, levothyroxine, warfarin, amiodarone, antiepileptic drugs, and antiretroviral drugs [see Drug Interactions (7) ]. (etiqueta de Orlistat, Advertencias y precauciones)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Co-administration with strong cytochrome P450 (CYP) 3A4 inhibitors (e.g., ketoconazole) increases the systemic exposure of oxybutynin. (etiqueta de Oxibutinina, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

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

Exposure of Paricalcitol Injection will increase upon coadministration with strong CYP3A inhibitors [see Clinical Pharmacology (12.3) ] . (etiqueta de Paricalcitol, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Prednisolona, Interacciones medicamentosas)

CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (etiqueta de Prednisona, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (etiqueta de Efavirenz, Advertencias y precauciones)

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

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

Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (etiqueta de Ramelteón, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP2C8 and CYP3A4 Inhibitors Intervention: Repaglinide tablets dose reductions and increased frequency of glucose monitoring may be required when co‑administered. (etiqueta de Repaglinida, Interacciones medicamentosas)

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

Coadministration of EDURANT or EDURANT PED and drugs that induce CYP3A may result in decreased plasma concentrations of rilpivirine and loss of virologic response and possible resistance to rilpivirine or to the class of NNRTIs. (etiqueta de Rilpivirina, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

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. (etiqueta de Ropivacaína, Interacciones medicamentosas)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

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

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (etiqueta de Saxagliptina, Interacciones medicamentosas)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (etiqueta de Saxagliptina y metformina, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (etiqueta de Selegilina, Interacciones medicamentosas)

Increases in sertraline dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure. (etiqueta de Sildenafilo, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Monitor QT interval more frequently when SUTENT is concomitantly administered with strong CYP3A4 inhibitors or drugs known to prolong QT interval. (etiqueta de Sunitinib, Advertencias y precauciones)

Strong CYP3A inducers: Efficacy may be reduced ( 7.2 ). (etiqueta de Suvorexant, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

…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 )] . (etiqueta de Tadalafilo, Advertencias y precauciones)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (etiqueta de Efavirenz, Interacciones medicamentosas)

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

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

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. (etiqueta de Temsirolimus, Advertencias y precauciones)

Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (etiqueta de Terbinafina, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (etiqueta de Tinidazol, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

DRUG INTERACTIONS Hepatic microsomal enzyme inducing agents, such as carbamazepine, were found to significantly increase the clearance of thiothixene. (etiqueta de Tiotixeno, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (etiqueta de Torasemida, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (etiqueta de Treprostinilo, Advertencias y precauciones)

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

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,… (etiqueta de Umeclidinio y vilanterol, Advertencias y precauciones)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Calcium channel blockers: Diltiazem Others (e.g., felodipine, nicardipine, nifedipine, verapamil) ↓ diltiazem * ↓ desacetyl diltiazem * ↓ N-monodesmethyl diltiazem * ↓ calcium channel blocker Diltiazem dose adjustments should be guided by clinical response (refer to the full prescribing information for diltiazem). (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

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) ]. (etiqueta de Viloxazina, Interacciones medicamentosas)

Inhibitors of CYP3A4: May cause earlier onset and/or increased severity of adverse reactions ( 7.1 ) (etiqueta de Vinorelbina, Interacciones medicamentosas)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (etiqueta de Efavirenz, Interacciones medicamentosas)

Zafirlukast exposure is likely to be increased by other moderate and strong CYP2C9 inhibitors. (etiqueta de Zafirlukast, Precauciones)

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%. (etiqueta de Zaleplón, Interacciones medicamentosas)

QT Prolonging Drugs There is limited information available on the potential for a pharmacodynamic interaction between efavirenz and drugs that prolong the QTc interval. (etiqueta de Efavirenz, Interacciones medicamentosas)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (etiqueta de Efavirenz, Advertencias y precauciones)

Analysis of long-term data from Study 006 (median follow-up 180 weeks, 102 weeks, and 76 weeks for patients treated with efavirenz + zidovudine + lamivudine, efavirenz + indinavir, and indinavir + zidovudine + lamivudine, respectively) showed that, beyond 24 weeks of therapy, the incidences of new-onset nervous system symptoms among efavirenz-treated patients… (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

The effect of potent CYP3A4 inhibitors on dutasteride has not been studied. (etiqueta de Dutasterida, Interacciones medicamentosas)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (etiqueta de Eribulina, Interacciones medicamentosas)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

An in vitro study using human liver microsomes suggests that famciclovir is not an inhibitor of CYP3A4 enzymes. (etiqueta de Famciclovir, Interacciones medicamentosas)

Potential for Glycerol Phenylbutyrate to Affect Other Drugs Drugs with narrow therapeutic index that are substrates of CYP3A4 Glycerol phenylbutyrate is a weak inducer of CYP3A4 in humans. (etiqueta de Fenilbutirato de glicerol, Interacciones medicamentosas)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (etiqueta de Efavirenz, Advertencias y precauciones)

Analysis of long-term data from Study 006 (median follow-up 180 weeks, 102 weeks, and 76 weeks for patients treated with efavirenz + zidovudine + lamivudine, efavirenz + indinavir, and indinavir + zidovudine + lamivudine, respectively) showed that, beyond 24 weeks of therapy, the incidences of new-onset nervous system symptoms among efavirenz-treated patients… (etiqueta de Efavirenz, Advertencias y precauciones)

Analysis of long-term data from Study 006 (median follow-up 180 weeks, 102 weeks, and 76 weeks for patients treated with efavirenz + zidovudine + lamivudine, efavirenz + indinavir, and indinavir + zidovudine + lamivudine, respectively) showed that, beyond 24 weeks of therapy, the incidences of new-onset nervous system symptoms among efavirenz-treated patients… (etiqueta de Efavirenz, Advertencias y precauciones)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

When phenytoin or other hepatic enzyme inducers such as rifampin and phenobarbital have been taken concurrently with mexiletine, lowered mexiletine plasma levels have been reported. (etiqueta de Mexiletina, Interacciones medicamentosas)

Hormonal contraceptives: Oral Ethinyl estradiol/ Norgsetimate Implant Etonogestrel ↑ active metabolites of norgestimate * ↓ etonogestrel A reliable method of barrier contraception should be used in addition to hormonal contraceptives. (etiqueta de Efavirenz, Interacciones medicamentosas)

CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (etiqueta de Rifaximina, Interacciones medicamentosas)

Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (etiqueta de Riociguat, Interacciones medicamentosas)

However, no formal drug-drug interaction studies between zileuton and CYP3A4 inhibitors, such as ketaconazole, have been conducted. (etiqueta de Zileutón, Interacciones medicamentosas)

…Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine), paroxetine, and raltegravir. (etiqueta de Efavirenz, Interacciones medicamentosas)

Drugs Without Clinically Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir… (etiqueta de Efavirenz, Interacciones medicamentosas)

Drugs Without Clinically Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir… (etiqueta de Efavirenz, Interacciones medicamentosas)

…Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine),… (etiqueta de Efavirenz, Interacciones medicamentosas)

…Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine),… (etiqueta de Efavirenz, Interacciones medicamentosas)

…Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine), paroxetine, and raltegravir. (etiqueta de Efavirenz, Interacciones medicamentosas)

Drugs Without Clinically Significant Interactions with Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir… (etiqueta de Efavirenz, Interacciones medicamentosas)

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

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

…Efavirenz No dosage adjustment is recommended when efavirenz is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine), paroxetine, and raltegravir. (etiqueta de Efavirenz, Interacciones medicamentosas)