Étravirine : interactions médicamenteuses

CYP3A4 Inducers: Avoid concomitant strong CYP3A4 inducers during YONSA treatment. (notice Abiratérone, Interactions médicamenteuses)

• CYP3A Inducers: Avoid co-administration with strong CYP3A inducers. (notice Acalabrutinib, Interactions médicamenteuses)

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. (notice Adéfovir, Mise en garde encadrée)

CYP3A4 Inducers : Avoid coadministration of VIJOICE with a strong CYP3A4 inducer. (notice Alpélisib, Interactions médicamenteuses)

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

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 ) (notice Aprémilast, Mises en garde et précautions)

CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (notice Aripiprazole, Interactions médicamenteuses)

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure… (notice Étravirine, Interactions médicamenteuses)

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. (notice Axitinib, Interactions médicamenteuses)

Concomitant administration of BIXLENVO is contraindicated with: dofetilide due to the potential for increased dofetilide plasma concentrations and associated serious and/or life-threatening events. strong CYP3A inducers due to decreased plasma concentrations of BIC and LEN, which may result in the loss of therapeutic effect and development of resistance to BIXLENVO. (notice Bictégravir, emtricitabine et ténofovir alafénamide, Contre-indications)

Strong CYP3A4 Inducers: Avoid concomitant use. (notice Bortézomib, Interactions médicamenteuses)

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

• Strong CYP3A Inducers: Avoid concomitant use with BOSULIF. (notice Bosutinib, Interactions médicamenteuses)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (notice Buprénorphine, Interactions médicamenteuses)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (notice Butalbital, aspirine, caféine et codéine, Mise en garde encadrée)

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. (notice Butalbital, paracétamol, caféine et codéine, Mise en garde encadrée)

Coadministration with other antiretroviral medications for PrEP is not recommended. (notice Cabotégravir, Interactions médicamenteuses)

Avoid chronic co-administration of strong CYP3A4 inducers (e.g., phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, St. (notice Cabozantinib, Interactions médicamenteuses)

Etravirine should not be used in combination with carbamazepine, phenobarbital, or phenytoin as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (notice Cariprazine, Interactions médicamenteuses)

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 ),… (notice Citalopram, Mises en garde et précautions)

Antiviral and antiretroviral drugs: Avoid concomitant use. (notice Cladribine, Interactions médicamenteuses)

CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole. (notice Clopidogrel, Mises en garde et précautions)

• Concomitant use of Strong CYP3A4 Inducers is not recommended. (notice Clozapine, Interactions médicamenteuses)

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. (notice Codéine, Mise en garde encadrée)

P-glycoprotein The concomitant use of colchicine capsules and inhibitors of P-glycoprotein (e.g. clarithromycin, ketoconazole, cyclosporine, etc.) should be avoided due to the potential for serious and life-threatening toxicity [see Warnings and Precautions (5.3) and Clinical Pharmacology (12) ] . (notice Colchicine, Interactions médicamenteuses)

Avoid use of PRADAXA Capsules and P-gp inhibitors in patients with severe renal impairment (CrCl 15-30 mL/min) [see Drug Interactions (7.1) and Use in Specific Populations (8.6) ] . (notice Dabigatran, Mises en garde et précautions)

Moderate or Strong CYP3A4 inducers: Avoid concomitant use. (notice Daridorexant, Interactions médicamenteuses)

…atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure (AUC) of etravirine was reduced when Etravirine was co-administered with darunavir/ritonavir. (notice Étravirine, Interactions médicamenteuses)

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure… (notice Étravirine, Interactions médicamenteuses)

If concomitant administration of a strong CYP3A4 inducer cannot be avoided, consider a dose increase [see Dosage and Administration ( 2.3 )] . (notice Dasatinib, Interactions médicamenteuses)

Avoid use of moderate or strong CYP3A4 inducers with EMFLAZA, as they may reduce efficacy ( 7.1 ) (notice Déflazacort, Interactions médicamenteuses)

Concomitant Drug Class: Drug Name Effect on Concentration of Dolutegravir and/or Concomitant Drug Clinical Comment HIV-1 Antiviral Agents Non-nucleoside reverse transcriptase inhibitor: Etravirine a ↓Dolutegravir Use of TIVICAY or TIVICAY PD with etravirine without coadministration of atazanavir/ritonavir, darunavir/ritonavir, or lopinavir/ritonavir is not recommended. (notice Dolutégravir, Interactions médicamenteuses)

HIV Antiviral Agents efavirenz etravirine nevirapine ↓ doravirine Use with efavirenz, etravirine, or nevirapine is not recommended. (notice Doravirine, Interactions médicamenteuses)

• Avoid concomitant use of doxorubicin hydrochloride with inhibitors and inducers of CYP3A4, CYP2D6, and/or P-gp ( 7.1 ) (notice Doxorubicine, Interactions médicamenteuses)

• CYP3A inducers: Avoid concomitant use. (notice Dronédarone, Interactions médicamenteuses)

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. (notice Éfavirenz, lamivudine et ténofovir, Mises en garde et précautions)

Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (notice Élexacaftor, tézacaftor et ivacaftor, Mises en garde et précautions)

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure… (notice Étravirine, Interactions médicamenteuses)

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including FTC, alone or in combination with other antiretrovirals. (notice Emtricitabine, Mises en garde et précautions)

Etravirine and delavirdine should not be co-administered. rilpivirine ↓ rilpivirine ↔ etravirine Combining two NNRTIs has not been shown to be beneficial. (notice Étravirine, Interactions médicamenteuses)

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) ] . (notice Entécavir, Mise en garde encadrée)

Strong CYP3A inhibitor and P-gp inhibitor : Avoid coadministration. (notice Évérolimus, Interactions médicamenteuses)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (notice Fentanyl, Mise en garde encadrée)

Preventing or Managing DI The concomitant use of ADDYI with CYP3A4 inducers is not recommended. (notice Flibansérine, Interactions médicamenteuses)

…unknown Co-administration of Etravirine with darunavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to darunavir. fosamprenavir (without ritonavir) ↑ amprenavir Concomitant use of Etravirine with fosamprenavir without low-dose ritonavir may cause a significant alteration in the plasma concentration… (notice Étravirine, Interactions médicamenteuses)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (notice Hydrocodone, Mise en garde encadrée)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (notice Hydrocodone et chlorphénamine, Mise en garde encadrée)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (notice Hydrocodone et homatropine, Mise en garde encadrée)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (notice Hydrocodone et ibuprofène, Mise en garde encadrée)

In addition, discontinuation of a concomitantly used Cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentrations. (notice Hydrocodone et paracétamol, Mise en garde encadrée)

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. (notice Hydroxycarbamide, Interactions médicamenteuses)

• Strong CYP3A4 Inducers: Do not administer strong CYP3A4 inducers with CAMPTOSAR. (notice Irinotécan, Interactions médicamenteuses)

Avoid concomitant use of CYP3A4 inducers when using Corlanor. (notice Ivabradine, Interactions médicamenteuses)

Therefore, administration of potent enzyme inducers of CYP3A4 with ketoconazole tablets is not recommended. (notice Kétoconazole, Interactions médicamenteuses)

Avoid strong CYP3A4 inducers. (notice Lapatinib, Interactions médicamenteuses)

Strong CYP3A4 Inducers: Avoid coadministration of strong CYP3A4 inducers with VITRAKVI. (notice Larotrectinib, Interactions médicamenteuses)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (notice Lédipasvir et sofosbuvir, Interactions médicamenteuses)

Strong or moderate CYP3A inducers: Avoid concomitant use. (notice Lemborexant, Interactions médicamenteuses)

Concomitant administration of SUNLENCA with strong CYP3A inducers is contraindicated due to decreased lenacapavir plasma concentrations, which may result in the loss of therapeutic effect and development of resistance to SUNLENCA [see Drug Interactions (7.1) ] . (notice Lénacapavir, Contre-indications)

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure… (notice Étravirine, Interactions médicamenteuses)

Effect of Other Drugs on LORBRENA Strong CYP3A Inducers LORBRENA is contraindicated in patients taking strong CYP3A inducers [see Contraindication (4) ] . (notice Lorlatinib, Interactions médicamenteuses)

CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (notice Lumatépérone, Interactions médicamenteuses)

Strong CYP3A4 inducers (e.g., rifampin, avasimibe, St. (notice Lurasidone, Contre-indications)

Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (notice Macitentan, Interactions médicamenteuses)

CYP3A inducers: Do not use mifepristone with CYP3A inducers ( 7.3 ). (notice Mifépristone, Interactions médicamenteuses)

Le millepertuis peut abaisser les taux sanguins de certains médicaments contre le VIH au point de provoquer un échec du traitement. (NCCIH, St. John's Wort)

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. (notice Naldémédine, Interactions médicamenteuses)

Strong CYP3A4 inducers (e.g., rifampin) : Decreased concentrations of naloxegol; concomitant use is not recommended. (notice Naloxégol, Interactions médicamenteuses)

Female gender and higher CD4 + cell counts at initiation of therapy place patients at increased risk; women with CD4 + cell counts greater than 250 cells/mm 3 , including pregnant women receiving nevirapine in combination with other antiretrovirals for the treatment of HIV-1 infection, are at the greatest risk. (notice Névirapine, Mise en garde encadrée)

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 ). (notice Nifédipine, Interactions médicamenteuses)

Strong CYP3A Inducers: Avoid concomitant use with CAVHANZA. (notice Nilotinib, Interactions médicamenteuses)

HIV-antiviral agents: protease inhibitors (PIs) atazanavir (without ritonavir) ↓ atazanavir Co-administration of Etravirine and atazanavir without low-dose ritonavir is not recommended. atazanavir/ritonavir ↓ atazanavir ↔ etravirine Concomitant use of Etravirine with atazanavir/ritonavir decreased atazanavir C min but it is not considered clinically relevant. (notice Étravirine, Interactions médicamenteuses)

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 ) (notice Noréthistérone et éthinylestradiol, Interactions médicamenteuses)

If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (notice Olicéridine, Interactions médicamenteuses)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone plasma concentration. (notice Oxycodone, Mise en garde encadrée)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone plasma concentration. (notice Oxycodone et paracétamol, Mise en garde encadrée)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (notice Palbociclib, Interactions médicamenteuses)

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. (notice Palipéridone, Interactions médicamenteuses)

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. (notice Paracétamol et codéine, Mise en garde encadrée)

VOTRIENT is not recommended if chronic use of strong CYP3A4 inducers cannot be avoided. (notice Pazopanib, Interactions médicamenteuses)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in meperidine plasma concentration. (notice Péthidine, Mise en garde encadrée)

Etravirine should not be used in combination with carbamazepine, phenobarbital, or phenytoin as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Etravirine should not be used in combination with carbamazepine, phenobarbital, or phenytoin as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Etravirine should not be used in combination with carbamazepine, phenobarbital, or phenytoin as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (notice Pimavansérine, Interactions médicamenteuses)

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

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. (notice Prométhazine et codéine, Mise en garde encadrée)

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) (notice Ranolazine, Contre-indications)

If Etravirine is co-administered with darunavir/ritonavir, lopinavir/ritonavir or saquinavir/ritonavir, then rifabutin should not be co-administered due to the potential for significant reductions in etravirine exposure. (notice Étravirine, Interactions médicamenteuses)

Etravirine should not be used with rifampin or rifapentine as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Etravirine should not be used with rifampin or rifapentine as co-administration may cause significant decreases in etravirine plasma concentrations and loss of therapeutic effect of Etravirine. (notice Étravirine, Interactions médicamenteuses)

Etravirine and delavirdine should not be co-administered. rilpivirine ↓ rilpivirine ↔ etravirine Combining two NNRTIs has not been shown to be beneficial. (notice Étravirine, Interactions médicamenteuses)

• Strong and Moderate CYP3A Inducers: Avoid concomitant administration. (notice Rimégépant, Interactions médicamenteuses)

• Certain CYP3A inducers: Coadministration with strong inducers of CYP3A is not recommended. (notice Ritlécitinib, Interactions médicamenteuses)

Etravirine and atazanavir/ritonavir can be co-administered without dose adjustments. atazanavir/cobicistat ↓ atazanavir ↓ cobicistat Co-administration of Etravirine with atazanavir/cobicistat is not recommended because it may result in loss of therapeutic effect and development of resistance to atazanavir. darunavir/ritonavir ↓ etravirine The mean systemic exposure… (notice Étravirine, Interactions médicamenteuses)

Avoid concomitant use of XARELTO with drugs that are known combined P-gp and strong CYP3A inducers [see Drug Interactions (7.3) ] . (notice Rivaroxaban, Mises en garde et précautions)

• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (notice Roflumilast, Mises en garde et précautions)

Intervention: Avoid the use of VARUBI in patients who require chronic administration of strong CYP3A4 inducers. (notice Rolapitant, Interactions médicamenteuses)

• Avoid use with rifampin and strong CYP3A4 inducers ( 7.3 ). (notice Romidepsine, Interactions médicamenteuses)

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) ]. (notice Sirolimus, Mises en garde et précautions)

• Strong CYP3A Inducers: Avoid strong CYP3A4 inducers. (notice Sorafénib, Interactions médicamenteuses)

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

Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (notice Tamoxifène, Interactions médicamenteuses)

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 ) (notice Tasimeltéon, Interactions médicamenteuses)

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including TDF, alone or in combination with other antiretrovirals. (notice Ténofovir, Mises en garde et précautions)

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 ) ] . (notice Thiotépa, Interactions médicamenteuses)

• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (notice Ticagrélor, Interactions médicamenteuses)

Avoid concomitant use of SAMSCA with strong CYP3A inducers. (notice Tolvaptan, Interactions médicamenteuses)

Avoid concomitant use HYCAMTIN capsules with P-gp inhibitors or BCRP inhibitors. (notice Topotécan, Interactions médicamenteuses)

Coadministration with a strong CYP3A4 inducer may result in a relevant decrease in FARESTON exposure and should be avoided. (notice Torémifène, Interactions médicamenteuses)

CYP3A inducers: Avoid concomitant strong CYP3A inducers ( 7.1 ) (notice Trabectédine, Interactions médicamenteuses)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (notice Tramadol, Mise en garde encadrée)

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. (notice Tramadol et paracétamol, Mise en garde encadrée)

Avoid concomitant use with strong CYP3A inducers if possible. (notice Trétinoïne, Interactions médicamenteuses)

Strong CYP3A4 Inducers: Should be avoided as concomitant use will result in reduction of ubrogepant exposure. (notice Ubrogépant, Interactions médicamenteuses)

Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3) ] . (notice Ulipristal, Mises en garde et précautions)

Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (notice Upadacitinib, Interactions médicamenteuses)

Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (notice Valbénazine, Interactions médicamenteuses)

Strong CYP3A Inducers : Avoid concomitant use with strong CYP3A inducers. (notice Vepdégestrant, Interactions médicamenteuses)

Therefore, the concomitant use of P-gp inhibitors or inducers should be avoided. (notice Vincristine, Interactions médicamenteuses)

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. (notice Zidovudine, Mise en garde encadrée)

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

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (notice Acide valproïque, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

P-glycoprotein (P-gp) Inhibitors : Co-administration of P-gp inhibitors can increase afatinib exposure. (notice Afatinib, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (notice Amlodipine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Blood pressure should be monitored when amlodipine is coadministered with CYP3A4 inducers (e.g. rifampicin, St. (notice Amlodipine et bénazépril, Interactions médicamenteuses)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (notice Amlodipine et olmésartan, Interactions médicamenteuses)

Blood pressure should be closely monitored when amlodipine is coadministered with CYP3A inducers (e.g. rifampicin, St. (notice Amlodipine et valsartan, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Phosphodiesterase type 5 (PDE-5) inhibitors : sildenafil tadalafil vardenafil ↓ sildenafil ↓ N-desmethyl-sildenafil Etravirine and sildenafil can be co-administered without dose adjustments, however, the dose of sildenafil may need to be altered based on clinical effect. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Alternatives to clarithromycin, such as azithromycin, should be considered for the treatment of MAC. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

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 )]. (notice Bexagliflozine, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Strong CYP3A4 inducers Double the recommended dosage and further adjust based on clinical response. (notice Brexpiprazole, Interactions médicamenteuses)

Therefore, potent inhibitors or inducers of CYP3A4 may increase or reduce the circulating levels of CYCLOSET, respectively. (notice Bromocriptine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

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. (notice Buspirone, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

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. (notice Canagliflozine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

• Strong inducer of CYP3A4 or CYP2C19: Consider dose increase of EPIDIOLEX. (notice Cannabidiol (sur ordonnance), Interactions médicamenteuses)

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

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) ]. (notice Carvédilol, Interactions médicamenteuses)

Inducers of Hepatic CYP Enzymes Rifampin : Rifampin is a potent CYP3A4 inducer and concomitant administration with caspofungin acetate for injection is expected to reduce the plasma concentrations of caspofungin acetate for injection. (notice Caspofungine, Interactions médicamenteuses)

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. (notice Célécoxib, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Antiinfective : clarithromycin ↑ etravirine ↓ clarithromycin ↑ 14-OH-clarithromycin Clarithromycin exposure was decreased by Etravirine; however, concentrations of the active metabolite, 14-hydroxy-clarithromycin, were increased. (notice Étravirine, Interactions médicamenteuses)

Inducers of CYP3A4 and CYP3A5 Inducers of CYP3A4 and/or CYP3A5 may reduce plasma concentrations of clindamycin. (notice Clindamycine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

…several closely related tricyclic antidepressants have been reported to be increased by the concomitant administration of methylphenidate or hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decreased by the concomitant administration of hepatic enzyme inducers (e.g., barbiturates, phenytoin), and such an effect may be anticipated with CMI as well. (notice Clomipramine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Antifungals : fluconazole ↑ etravirine ↔ fluconazole Co-administration of etravirine and fluconazole significantly increased etravirine exposures. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

…nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir]) /HCV protease inhibitors (decrease [e.g., boceprevir and telaprevir]) or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., nevirapine] or increase [e.g., etravirine]). (notice Désogestrel et éthinylestradiol, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Systemic dexamethasone should be used with caution or alternatives should be considered, particularly for long-term use. (notice Étravirine, Interactions médicamenteuses)

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 . (notice Dexlansoprazole, Interactions médicamenteuses)

The serum digoxin concentrations should be monitored and used for titration of the digoxin dose to obtain the desired clinical effect. amiodarone bepridil disopyramide flecainide lidocaine (systemic) mexiletine propafenone quinidine ↓ antiarrhythmics Concentrations of these antiarrhythmics may be decreased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

A decrease in diazepam dose may be needed. (notice Étravirine, Interactions médicamenteuses)

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. (notice Diclofénac, Interactions médicamenteuses)

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. (notice Diclofénac et misoprostol, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (notice Divalproate de sodium (valproate), Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Examples Glutethimide and phenobarbital Intervention If a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of doxercalciferol may be necessary. (notice Doxercalciférol, Interactions médicamenteuses)

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). (notice Dronabinol, Interactions médicamenteuses)

Antifungals : fluconazole ↑ etravirine ↔ fluconazole Co-administration of etravirine and fluconazole significantly increased etravirine exposures. (notice Étravirine, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

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. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Coadministration of DESCOVY with other drugs that inhibit P-gp and BCRP may increase the absorption and plasma concentration of TAF. (notice Emtricitabine et ténofovir, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

CYP3A4 Inducers Pre-treatment with a CYP3A4 inducer prior to erlotinib decreased erlotinib exposure [see Clinical Pharmacology (12.3) ]. (notice Erlotinib, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

CYP2C19 Substrates APTIOM can inhibit CYP2C19, which can cause increased plasma concentrations of drugs that are metabolized by this isoenzyme (e.g., phenytoin, clobazam, and omeprazole) [see Clinical Pharmacology ( 12.3 )]. (notice Eslicarbazépine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

• 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) ] . (notice Ésoméprazole, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

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. (notice Estradiol et diénogest, Interactions médicamenteuses)

Drugs that Induce CYP3A4 (Rifampicin) Racemic zopiclone exposure was decreased 80% by concomitant use of rifampicin, a potent inducer of CYP3A4. (notice Eszopiclone, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

…ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir]) /HCV protease inhibitors (decrease [e.g., boceprevir and telaprevir]) or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., efavirenz, nevirapine] or increase [e.g., etravirine]). (notice Étonogestrel et éthinylestradiol, Interactions médicamenteuses)

Strong CYP 3A4 inducers: Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure. (notice Exémestane, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Phenobarbital Clinical Impact: Chronic administration of phenobarbital, a known enzyme inducer, may be associated with a decrease in the plasma half-life of fenoprofen. (notice Fénoprofène, Interactions médicamenteuses)

CYP3A4 Inducers No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. (notice Fésotérodine, Interactions médicamenteuses)

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

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Antifungals : fluconazole ↑ etravirine ↔ fluconazole Co-administration of etravirine and fluconazole significantly increased etravirine exposures. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

• CYP3A4 Inducer: Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer. (notice Géfitinib, Interactions médicamenteuses)

…and its plasma concentrations can be significantly affected resulting in an increase in exposure Consider dose reduction [see Dosage and administration (2.7) ] Strong and moderate CYP3A4 inducers, e.g., rifampin, efavirenz Guanfacine is primarily metabolized by CYP3A4 and its plasma concentrations can be significantly affected resulting in a decrease in exposure… (notice Guanfacine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Drugs that May Decrease Haloperidol Plasma Concentrations Coadministration of haloperidol with potent enzyme inducers of CYP3A4 may gradually decrease the plasma concentrations of haloperidol to such an extent that efficacy may be reduced. (notice Halopéridol, Interactions médicamenteuses)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

• CYP3A4 Inducers: Monitor for increased toxicity when used in combination with CYP3A4 inducers. (notice Ifosfamide, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

The plasma concentration of imipramine may increase when the drug is given concomitantly with hepatic enzyme inhibitors (e.g., cimetidine, fluoxetine) and decrease by concomitant administration with hepatic enzyme inducers (e.g., barbiturates, phenytoin), and adjustment of the dosage of imipramine may therefore be necessary. (notice Imipramine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Concomitant systemic use of itraconazole or ketoconazole and Etravirine may increase plasma concentrations of etravirine. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Strong CYP3A4 or CYP2C9 Inhibitors Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to VIMPAT. (notice Lacosamide, Interactions médicamenteuses)

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. (notice Lansoprazole, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

In contrast, significant increases in systemic exposure of the estrogen and/or progestin have been noted when CHCs are co-administered with certain other HIV protease inhibitors (e.g., indinavir and atazanavir/ritonavir) and with other non-nucleoside reverse transcriptase inhibitors (e.g., etravirine). (notice Lévonorgestrel et éthinylestradiol, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

The serum digoxin concentrations should be monitored and used for titration of the digoxin dose to obtain the desired clinical effect. amiodarone bepridil disopyramide flecainide lidocaine (systemic) mexiletine propafenone quinidine ↓ antiarrhythmics Concentrations of these antiarrhythmics may be decreased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (notice Linagliptine, Interactions médicamenteuses)

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. (notice Linagliptine et metformine, Interactions médicamenteuses)

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

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

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 ) ]. (notice Méloxicam, Interactions médicamenteuses)

Inducers of CYP3A4 (e.g., phenytoin, carbamazepine, dexamethasone, rifampin, and phenobarbital) could increase the rate of elimination of donepezil. (notice Mémantine et donépézil, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

CYP3A4 inducers Drugs (e.g. nevirapine, rifampin) that are strong inducers of CYP3A4 are likely to decrease the pharmacological action of methylergonovine maleate. (notice Méthylergométrine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Antifungals : fluconazole ↑ etravirine ↔ fluconazole Co-administration of etravirine and fluconazole significantly increased etravirine exposures. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

John's Wort, tramadol, tryptophan, buspirone Strong CYP3A Inducers Clinical Impact The concomitant use of strong CYP3A inducers with REMERON/REMERONSolTab decreases the plasma concentration of mirtazapine [see Clinical Pharmacology (12.3) ] . (notice Mirtazapine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

• 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) ]. (notice Naproxène et ésoméprazole, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

…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. (notice Natéglinide, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Possible Reduced Efficacy with Strong CYP3A4 Inducers Concomitant use of strong CYP3A4 inducers (e.g., carbamazepine, phenobarbital, phenytoin, rifampin, St. (notice Nimodipine, Mises en garde et précautions)

Coadministration with oral doses of a P-gp and CYP3A4 inducer, rifampicin, decreased exposure to nintedanib by 50%. (notice Nintédanib, Interactions médicamenteuses)

…with HIV protease inhibitors (decrease [e.g., nelfinavir, ritonavir, darunavir/ritonavir, (fos)amprenavir/ritonavir, lopinavir/ritnoavir, and tipranavir/ritonavir] or increase [e.g., indinavir and atazanavir/ritonavir])/HCV protease inhibitors or with non-nucleoside reverse transcriptase inhibitors (decrease [e.g., nevirapine] or increase [e.g., etravirine]). (notice Norelgestromine et éthinylestradiol, Interactions médicamenteuses)

In contrast, significant increases in systemic exposure of the progestin have been noted in cases of co-administration with certain other HIV protease inhibitors (e.g., indinavir and atazanavir/ritonavir) and with other non-nucleoside reverse transcriptase inhibitors (e.g., etravirine). (notice Noréthistérone, Interactions médicamenteuses)

…immunodeficiency virus (HIV)/Hepatitis C virus (HCV) protease inhibitors, non-nucleoside reverse transcriptase inhibitors , and HIV/AIDS medications containing strong inhibitors or inducers of CYP3A Significant changes (increase or decrease) in the plasma concentrations of estrogen and/or progestin have been noted in some cases of co-administration with HIV protease… (notice Norgestimate et éthinylestradiol, Interactions médicamenteuses)

…progestin have been noted when COCs are co-administered with some HIV protease inhibitors (decrease [e.g., nelfinavir, ritonavir, darunavir/ritonavir, (fos) amprenavir/ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir], or increase [e.g., indinavir and atazanavir/ritonavir] HCV protease inhibitors (decrease [e.g., nevirapine] or increase [e.g., etravirine]). (notice Norgestrel et éthinylestradiol, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (notice Olmésartan, amlodipine et hydrochlorothiazide, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

• 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 )]. (notice Oméprazole, Interactions médicamenteuses)

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 )] . (notice Oméprazole et bicarbonate de sodium, Interactions médicamenteuses)

Phenytoin, Carbamazepine, and Rifampin In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. (notice Ondansétron, Interactions médicamenteuses)

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) ]. (notice Orlistat, Mises en garde et précautions)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

• 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. (notice Pantoprazole, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Strong CYP3A4 Inducers: Decreased exposure of WAKIX; consider dosage adjustment of WAKIX ( 2.6 , 7.1 ) (notice Pitolisant, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for itraconazole, ketoconazole or posaconazole may be necessary depending on the other co-administered drugs. (notice Étravirine, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

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. (notice Propranolol, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

• Concomitant use of strong CYP3A4 inducers: Increase quetiapine dose up to 5 fold when used in combination with a chronic treatment (more than 7-14 days) of potent CYP3A4 inducers (e.g., phenytoin, rifampin, St. (notice Quétiapine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

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. (notice Rabéprazole, Interactions médicamenteuses)

Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (notice Rameltéon, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

CYP2C8 and CYP3A4 Inducers Intervention: Repaglinide tablets dose increases and increased frequency of glucose monitoring may be required when co‑administered. (notice Répaglinide, Interactions médicamenteuses)

• Concomitant P-glycoprotein (P-gp) inhibitors (e.g., cyclosporine): Caution should be exercised when concomitant use of XIFAXAN and a P-glycoprotein inhibitor is needed. (notice Rifaximine, Mises en garde et précautions)

Carbamazepine and other enzyme inducers decrease plasma concentrations of risperidone. (notice Rispéridone, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Effects of Other AEDs on BANZEL Potent cytochrome P450 enzyme inducers, such as carbamazepine, phenytoin, primidone, and phenobarbital, appear to increase the clearance of BANZEL (see Table 6). (notice Rufinamide, Interactions médicamenteuses)

Strong CYP3A4 Inducers Concomitant use of JAKAFI/JAKAFI XR with strong CYP3A4 inducers may decrease ruxolitinib exposure [ see Clinical Pharmacology ( 12.3 )] , which may reduce efficacy of JAKAFI/JAKAFI XR. (notice Ruxolitinib, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (notice Sélégiline, Interactions médicamenteuses)

Phosphodiesterase type 5 (PDE-5) inhibitors : sildenafil tadalafil vardenafil ↓ sildenafil ↓ N-desmethyl-sildenafil Etravirine and sildenafil can be co-administered without dose adjustments, however, the dose of sildenafil may need to be altered based on clinical effect. (notice Étravirine, Interactions médicamenteuses)

Dose adjustments for these HMG-CoA reductase inhibitors may be necessary. (notice Étravirine, Interactions médicamenteuses)

Other agents Antiarrhythmics : digoxin ↔ etravirine ↑ digoxin For patients who are initiating a combination of Etravirine and digoxin, the lowest dose of digoxin should initially be prescribed. (notice Étravirine, Interactions médicamenteuses)

• CYP3A4 Inducers : Consider dose increase of SUTENT when administered with strong CYP3A4 inducers. (notice Sunitinib, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Phosphodiesterase type 5 (PDE-5) inhibitors : sildenafil tadalafil vardenafil ↓ sildenafil ↓ N-desmethyl-sildenafil Etravirine and sildenafil can be co-administered without dose adjustments, however, the dose of sildenafil may need to be altered based on clinical effect. (notice Étravirine, Interactions médicamenteuses)

Antimalarial : artemether/lumefantrine ↔ etravirine ↓ artemether ↓ dihydroartemisinin ↓ lumefantrine Caution is warranted when co-administering Etravirine and artemether/lumefantrine as it is unknown whether the decrease in exposure of artemether or its active metabolite, dihydroartemisinin, could result in decreased antimalarial efficacy. (notice Étravirine, Interactions médicamenteuses)

Narcotic analgesics/treatment of opioid dependence: buprenorphine buprenorphine/naloxone methadone ↔ etravirine ↓ buprenorphine ↔ norbuprenorphine ↔ methadone Etravirine and buprenorphine (or buprenorphine/naloxone) can be co-administered without dose adjustments, however, clinical monitoring for withdrawal symptoms is recommended as buprenorphine (or buprenorphine/naloxone)… (notice Étravirine, Interactions médicamenteuses)

Patients should be monitored for adequate clinical effect when amlodipine is co-administered with CYP3A4 inducers. (notice Telmisartan et amlodipine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

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. (notice Temsirolimus, Mises en garde et précautions)

Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (notice Terbinafine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Use of tiagabine HCl without enzyme-inducing antiepileptic drugs results in blood levels about twice those attained in the studies on which current dosing recommendations are based (see DOSAGE AND ADMINISTRATION ). (notice Tiagabine, Mises en garde)

CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (notice Tinidazole, Interactions médicamenteuses)

DRUG INTERACTIONS Hepatic microsomal enzyme inducing agents, such as carbamazepine, were found to significantly increase the clearance of thiothixene. (notice Tiotixène, Interactions médicamenteuses)

Platelet aggregation inhibitors: clopidogrel ↓ clopidogrel (active) metabolite Activation of clopidogrel to its active metabolite may be decreased when clopidogrel is co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (notice Torasémide, Interactions médicamenteuses)

CYP3A4 Inducers: Increase in RALDESY dosage may be necessary ( 2.5 , 7 ). (notice Trazodone, Interactions médicamenteuses)

Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (notice Tréprostinil, Mises en garde et précautions)

Corticosteroid : dexamethasone (systemic) ↓ etravirine Systemic dexamethasone induces CYP3A and can decrease etravirine plasma concentrations. (notice Étravirine, Interactions médicamenteuses)

Benzodiazepine: diazepam ↑ diazepam Concomitant use of Etravirine with diazepam may increase plasma concentrations of diazepam. (notice Étravirine, Interactions médicamenteuses)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (notice Étravirine, Interactions médicamenteuses)

Phosphodiesterase type 5 (PDE-5) inhibitors : sildenafil tadalafil vardenafil ↓ sildenafil ↓ N-desmethyl-sildenafil Etravirine and sildenafil can be co-administered without dose adjustments, however, the dose of sildenafil may need to be altered based on clinical effect. (notice Étravirine, Interactions médicamenteuses)

CCR5 antagonists maraviroc ↔ etravirine ↓ maraviroc When Etravirine is co-administered with maraviroc in the absence of a potent CYP3A inhibitor (e.g., ritonavir boosted protease inhibitor), the recommended dose of maraviroc is 600 mg twice daily. (notice Étravirine, Interactions médicamenteuses)

CYP3A4 Inducers: Consider increasing VIIBRYD dosage by 2-fold, up to 80 mg once-daily over 1 to 2 weeks when used concomitantly with strong CYP3A4 inducers for greater than 14 days ( 2.4 , 7 ). (notice Vilazodone, Interactions médicamenteuses)

The amount of safety data at these increased etravirine exposures is limited, therefore, etravirine and voriconazole should be co-administered with caution. (notice Étravirine, Interactions médicamenteuses)

The international normalized ratio (INR) should be monitored when warfarin is combined with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Zafirlukast exposure is likely to be increased by other moderate and strong CYP2C9 inhibitors. (notice Zafirlukast, Précautions)

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%. (notice Zaléplone, Interactions médicamenteuses)

Pharmacokinetic Interactions Carbamazepine Carbamazepine is an inducer of CYP3A4; administration of 200 mg twice daily for 21 days resulted in a decrease of approximately 35% in the AUC of ziprasidone. (notice Ziprasidone, Interactions médicamenteuses)

CYP3A4 Inducers If co-administration with a potent CYP3A4 inducer is necessary, the patient should be closely monitored and the dose of ZONISAMIDE and other drugs that CYP3A4 substrates may need to be adjusted [see Clinical Pharmacology ( 12.3 )] . (notice Zonisamide, Interactions médicamenteuses)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (notice Étravirine, Mises en garde et précautions)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (notice Étravirine, Mises en garde et précautions)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Dapagliflozin or dapagliflozin 3-O-glucuronide did not meaningfully inhibit P-gp, OCT2, OAT1, or OAT3 active transporters. (notice Dapagliflozine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

• Cytochrome P450 3A4 inducers, inhibitors, or substrates: May alter docetaxel metabolism. (notice Docétaxel, Interactions médicamenteuses)

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs. (notice Drospirénone et éthinylestradiol, Interactions médicamenteuses)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (notice Éribuline, Interactions médicamenteuses)

Inducers of CYP3A4 such as St. (notice Estradiol, Interactions médicamenteuses)

Inducers of CYP3A4 such as St. (notice Estradiol et noréthistérone, Interactions médicamenteuses)

Inducers of CYP3A4, such as St. (notice Estrogènes conjugués et bazédoxifène, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (notice Étravirine, Mises en garde et précautions)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (notice Étravirine, Mises en garde et précautions)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

P-glycoprotein Substrates Lomitapide is an inhibitor of P-glycoprotein (P-gp). (notice Lomitapide, Interactions médicamenteuses)

Counsel patients to use a back-up method or alternative method of contraception when enzyme inducers are used with MPA Injectable Suspension, USP. (notice Médroxyprogestérone, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

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. (notice Phénylbutyrate de glycérol, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Stevens-Johnson syndrome was reported in 1.1% (2/177) of pediatric patients less than 18 years of age receiving Etravirine in combination with other HIV-1 antiretroviral agents in an observational study. (notice Étravirine, Mises en garde et précautions)

Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (notice Riociguat, Interactions médicamenteuses)

Strong P-glycoprotein (P-gp) Inhibitors In vitro studies indicated that silodosin is a P‑gp substrate. (notice Silodosine, Interactions médicamenteuses)

Antiretrovirals: atazanavir lopinavir ↑ voxilaprevir Coadministration of VOSEVI with atazanavir- or lopinavir-containing regimens is not recommended. tipranavir/ritonavir ↓ sofosbuvir ↓ velpatasvir Coadministration is not recommended. (notice Sofosbuvir et velpatasvir, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

Potential for Etravirine to Affect Other Drugs Etravirine is an inducer of CYP3A and inhibitor of CYP2C9, CYP2C19 and P-glycoprotein (P-gp). (notice Étravirine, Interactions médicamenteuses)

CYP2C9 Venlafaxine did not inhibit CYP2C9 in vitro . (notice Venlafaxine, Interactions médicamenteuses)

Anticonvulsants : carbamazepine phenobarbital phenytoin ↓ etravirine Carbamazepine, phenobarbital and phenytoin are inducers of CYP450 enzymes. (notice Étravirine, Interactions médicamenteuses)

Drugs Having No Clinically Important Interactions with SAPHRIS No dosage adjustment of SAPHRIS is necessary when administered concomitantly with paroxetine (see Table 12 in Drug Interactions ( 7.1 ) for paroxetine dosage adjustment), imipramine, cimetidine, valproate, lithium, or a CYP3A4 inducer (e.g., carbamazepine, phenytoin, rifampin). (notice Asénapine, Interactions médicamenteuses)

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. (notice Micafungine, Interactions médicamenteuses)

…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) ]. (notice Montélukast, Interactions médicamenteuses)

…to the drugs included in Table 4, the interaction between Etravirine and the following drugs were evaluated in clinical studies and no dose adjustment is needed for either drug [see Clinical Pharmacology (12.3) ] : didanosine, enfuvirtide (ENF), ethinylestradiol/norethindrone, omeprazole, paroxetine, raltegravir, ranitidine, and tenofovir disoproxil fumarate. (notice Étravirine, Interactions médicamenteuses)

…to the drugs included in Table 4, the interaction between Etravirine and the following drugs were evaluated in clinical studies and no dose adjustment is needed for either drug [see Clinical Pharmacology (12.3) ] : didanosine, enfuvirtide (ENF), ethinylestradiol/norethindrone, omeprazole, paroxetine, raltegravir, ranitidine, and tenofovir disoproxil fumarate. (notice Étravirine, Interactions médicamenteuses)