Rifabutine : interactions médicamenteuses

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

• Concomitant administration of rifampin or rifabutin reduces atovaquone concentrations; concomitant use with MEPRON oral suspension is not recommended. (notice Atovaquone, Interactions médicamenteuses)

• Administration with rifampin or rifabutin is known to reduce atovaquone concentrations; concomitant use with MALARONE is not recommended. (notice Atovaquone et proguanil, Interactions médicamenteuses)

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

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

Rifabutin capsules are contraindicated in patients being treated with cabotegravir/rilpivirine prolonged-release injectable suspension (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Contre-indications)

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

• 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)

Voriconazole 400 mg twice a day for 7 days (maintenance dose) 300 mg once a day for 7 days Healthy male subjects (12) ↑ AUC by 331%, ↑ C max by 195% ↑ AUC by ~100%, ↑ C max by ~100% compared to voriconazole 200 mg twice a day alone CONTRAINDICATED ANTI-PCP (Pneumocystis carinii pneumonia) Dapsone 50 mg once a day 300 mg once a day HIV-infected patients (16) (notice Rifabutine, Interactions médicamenteuses)

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

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

Co-administration of rifabutin with elvitegravir/ cobicistat is not recommended due to an expected decrease in elvitegravir exposure. (notice Rifabutine, 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

• 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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

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)

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

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

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

Rifabutin capsules are contraindicated in patients being treated with cabotegravir/rilpivirine prolonged-release injectable suspension (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Contre-indications)

Rifabutin should not be co-administered with etravirine and boosted PIs due to potential for decreased effectiveness of etravirine. (notice Rifabutine, 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

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

Itraconazole 200 mg once a day 300 mg once a day HIV-Infected patients (6) ↑ data from a case report ↓ AUC by 70%, ↓ C max by 75%, If co-administration of these two drugs cannot be avoided, patients should be monitored for adverse events associated with rifabutin administration, and lack of itraconazole efficacy. (notice Rifabutine, 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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

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

ND 36% ↓ in C max and 24% ↓ AUC Co-administration of rifabutin with sofosbuvir (alone or in combination) is not recommended. (notice Rifabutine, Interactions médicamenteuses)

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

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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

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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

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

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)

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

Posaconazole 200 mg once a day for 10 days 300 mg once a day for 17 days Healthy subjects (8) ↑ AUC by 72%, ↑ C max by 31% ↓ AUC by 49%, ↓ C max by 43% If co-administration of these two drugs cannot be avoided, patients should be monitored for adverse events associated with rifabutin administration, and lack of posaconazole efficacy. (notice Rifabutine, 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

Rifabutin capsules are contraindicated in patients being treated with cabotegravir/rilpivirine prolonged-release injectable suspension (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Contre-indications)

• 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)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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)

Strong Inducers and Strong Inhibitors of CYP3A4 and P-gp Avoid concomitant use of sirolimus with strong inducers (e.g., rifampin, rifabutin) and strong inhibitors (e.g., ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, clarithromycin) of CYP3A4 and P-gp. (notice Sirolimus, Interactions médicamenteuses)

ND 36% ↓ in C max and 24% ↓ AUC Co-administration of rifabutin with sofosbuvir (alone or in combination) is not recommended. (notice Rifabutine, Interactions médicamenteuses)

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

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

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)

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)

Voriconazole 400 mg twice a day for 7 days (maintenance dose) 300 mg once a day for 7 days Healthy male subjects (12) ↑ AUC by 331%, ↑ C max by 195% ↑ AUC by ~100%, ↑ C max by ~100% compared to voriconazole 200 mg twice a day alone CONTRAINDICATED ANTI-PCP (Pneumocystis carinii pneumonia) Dapsone 50 mg once a day 300 mg once a day HIV-infected patients (16) (notice Rifabutine, Interactions médicamenteuses)

Therefore, co-administration with antiretroviral and anti-HCV drugs metabolized by CYP3A is not recommended or there may be a need to increase the dose of antiretroviral or anti-HCV drugs (see PRECAUTIONS-Drug Interactions ). (notice Rifabutine, Mises en garde)

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

• Use with CYP3A Inducers: Increase the risk of reduced efficacy of alprazolam. (notice Alprazolam, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

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

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

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

CYP3A4/5 Inducers Co-administration of rifampin, a strong inducer of CYP3A4/5, reduced the plasma exposure of axitinib in healthy volunteers. (notice Axitinib, Interactions médicamenteuses)

ND ↓ AUC by 27 – 40% Sulfamethoxazole-Trimethoprim 800/160 mg 300 mg once a day HIV-infected patients (12) ↔ ↓ AUC by 15–20% ANTI-MAC (Mycobacterium avium intracellulare complex) Azithromycin 500 mg once a day for 1 day, then 250 mg once a day for 9 days 300 mg once a day Healthy subjects (6) ↔ ↔ Clarithromycin 500 mg twice a day 300 mg once a day HIV-infected… (notice Rifabutine, 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)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), protease inhibitors (e.g., ritonavir) CYP3A4 Inducers Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inducers can decrease the plasma concentration of buprenorphine [see Clinical Pharmacology (12.3) ] , potentially resulting in decreased efficacy… (notice Buprénorphine et naloxone, 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)

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)

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

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

MAC Treatment with Clarithromycin When rifabutin is used concomitantly with clarithromycin for MAC treatment, a decreased dose of rifabutin is recommended due to the increase in plasma concentrations of rifabutin (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Mises en garde)

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

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

ANTIFUNGALS Fluconazole 200 mg once a day for 2 weeks 300 mg once a day for 2 weeks HIV-infected patients (12) ↑ AUC by 82%, ↑ C max by 88% ↔ Monitor for rifabutin associated adverse events. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. (notice Désogestrel et éthinylestradiol, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Clinically Relevant Interactions Affecting DEXILANT When Coadministered with Other Drugs and Substances CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of dexlansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (notice Dexlansoprazole, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, 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)

Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (notice Dofétilide, 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)

ANTIFUNGALS Fluconazole 200 mg once a day for 2 weeks 300 mg once a day for 2 weeks HIV-infected patients (12) ↑ AUC by 82%, ↑ C max by 88% ↔ Monitor for rifabutin associated adverse events. (notice Rifabutine, 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)

Uveitis Due to the possible occurrence of uveitis, patients should also be carefully monitored when rifabutin is given in combination with clarithromycin (or other macrolides) and/or fluconazole and related compounds (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Mises en garde)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Table 4: Clinically Relevant Interactions Affecting Esomeprazole When Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (notice Ésoméprazole, Interactions médicamenteuses)

While no in vivo drug-drug interaction studies were conducted between estazolam and inducers of CYP3A, compounds that are potent CYP3A inducers (such as carbamazepine, phenytoin, rifampin, and barbiturates) would be expected to decrease estazolam concentrations. (notice Estazolam, Mises en garde)

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)

Alternative treatment for clarithromycin should be considered when treating patients receiving rifabutin ANTI-TB (Tuberculosis) Ethambutol 1200 mg 300 mg once a day for 7 days Healthy subjects (10) (notice Rifabutine, Interactions médicamenteuses)

Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include: phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. (notice Étonogestrel et éthinylestradiol, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

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

Uveitis Due to the possible occurrence of uveitis, patients should also be carefully monitored when rifabutin is given in combination with clarithromycin (or other macrolides) and/or fluconazole and related compounds (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Mises en garde)

Limited data in patients receiving known enzyme inducers ( phenytoin, phenobarbital, carbamazepine ) indicate only a 30% increase in the rate of flecainide elimination. (notice Flécaïnide, Interactions médicamenteuses)

Uveitis Due to the possible occurrence of uveitis, patients should also be carefully monitored when rifabutin is given in combination with clarithromycin (or other macrolides) and/or fluconazole and related compounds (see PRECAUTIONS-Drug Interactions, Table 2 ). (notice Rifabutine, Mises en garde)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

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

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

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)

Concomitant administration of inducers of CYP3A4 may lead to decreases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions, including adrenal crisis. (notice Hydrocortisone, Interactions médicamenteuses)

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

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, 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)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Clinically Relevant Interactions Affecting PREVACID or PREVACID SoluTab When Coadministered with Other Drugs CYP2C19 OR CYP3A4 Inducers Clinical Impact: Decreased exposure of lansoprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ] . (notice Lansoprazole, Interactions médicamenteuses)

Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding. (notice Lévonorgestrel et éthinylestradiol, 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)

Rifampin (Potent Inducer of CYP3A4) Coadministration of a single 500 mg oral dose of mefloquine and 600 mg of rifampin once daily for 7 days in 7 healthy Thai volunteers resulted in a decrease in the mean C max and AUC of mefloquine by 19% and 68%, respectively, and a decrease in the mean elimination half-life of mefloquine from 305 hours to 113 hours. (notice Méfloquine, 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)

…agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir), fluconazole, fluvoxamine, some selective serotonin reuptake inhibitors (SSRIs) (e.g., sertraline, fluvoxamine) Inducers of CYP3A4, CYP2B6, CYP2C19, or CYP2C9 Clinical Impact: The concomitant use of methadone and CYP3A4, CYP2B6, CYP2C19, or CYP2C9 inducers can decrease the plasma concentration… (notice Méthadone, 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)

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

ANTIFUNGALS Fluconazole 200 mg once a day for 2 weeks 300 mg once a day for 2 weeks HIV-infected patients (12) ↑ AUC by 82%, ↑ C max by 88% ↔ Monitor for rifabutin associated adverse events. (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, 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)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (notice Naproxène et ésoméprazole, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, 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)

Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. (notice Norelgestromine et éthinylestradiol, Interactions médicamenteuses)

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

Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate, rifabutin, rufinamide, aprepitant, and products containing St. (notice Norgestimate et éthinylestradiol, Interactions médicamenteuses)

Some drugs or herbal products that may decrease the effectiveness of hormonal contraceptives include phenytoin, barbiturates, carbamazepine, bosentan, felbamate, griseofulvin, oxcarbazepine, rifampicin, topiramate rifabutin, rufinamide, aprepitant, and products containing St. (notice Norgestrel et éthinylestradiol, Interactions médicamenteuses)

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

Table 4: Clinically Relevant Interactions Affecting Omeprazole When Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (notice Oméprazole, Interactions médicamenteuses)

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (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 Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

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

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

CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (notice Prednisone, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

Antiepileptics (AEDs) (Carbamazepine, Phenobarbital, and Phenytoin) Carbamazepine, phenobarbital, and phenytoin are CYP3A4 inducers and may decrease quinine plasma concentrations if used concurrently with quinine sulfate. (notice Quinine, Interactions médicamenteuses)

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

ND ↔ Other drugs The structurally similar drug, rifampin, is known to reduce the plasma concentrations of a number of other drugs (see prescribing information for rifampin). (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

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

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

ND ↓ AUC by 27 – 40% Sulfamethoxazole-Trimethoprim 800/160 mg 300 mg once a day HIV-infected patients (12) ↔ ↓ AUC by 15–20% ANTI-MAC (Mycobacterium avium intracellulare complex) Azithromycin 500 mg once a day for 1 day, then 250 mg once a day for 9 days 300 mg once a day Healthy subjects (6) ↔ ↔ Clarithromycin 500 mg twice a day 300 mg once a day HIV-infected… (notice Rifabutine, Interactions médicamenteuses)

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

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, Interactions médicamenteuses)

Risk of Rejection with Strong CYP3A Inducers and Risk of Serious Adverse Reactions with Strong CYP3A Inhibitors The concomitant use of strong CYP3A inducers may increase the metabolism of tacrolimus, leading to lower whole blood trough concentrations and greater risk of rejection. (notice Tacrolimus, Mises en garde et précautions)

CYP3A4 inhibitors (e.g. ketoconazole, ritonavir) increase CIALIS exposure ( 2.7 , 5.10 , 7.2 ) requiring dose adjustment: CIALIS for use as needed: no more than 10 mg every 72 hours CIALIS for once daily use: dose not to exceed 2.5 mg CYP3A4 inducers (e.g. rifampin) decrease CIALIS exposure ( 7.2 ). (notice Tadalafil, Interactions médicamenteuses)

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

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)

…exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Strong CYP3A4 Inducers (e.g., rifampin) Clinical Impact Decreased exposure to tofacitinib and may result in loss of or reduced clinical response Intervention Concomitant use with XELJANZ/XELJANZ… (notice Tofacitinib, Interactions médicamenteuses)

Drug Interactions Effect of Rifabutin on the Pharmacokinetics of Other Drugs Rifabutin induces CYP3A enzymes and therefore may reduce the plasma concentrations of drugs metabolized by those enzymes. (notice Rifabutine, 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)

Hepatic enzyme inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin): Drugs which induce hepatic microsomal drug metabolizing enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased. (notice Triamcinolone, Interactions médicamenteuses)

Strong Inducers of CYP 3A Clinical implication Coadministration of triazolam with strong inducers of CYP3A4 can significantly decrease the plasma concentration of triazolam and may decrease effectiveness of triazolam. (notice Triazolam, Interactions médicamenteuses)

ND ↓ AUC by 27 – 40% Sulfamethoxazole-Trimethoprim 800/160 mg 300 mg once a day HIV-infected patients (12) ↔ ↓ AUC by 15–20% ANTI-MAC (Mycobacterium avium intracellulare complex) Azithromycin 500 mg once a day for 1 day, then 250 mg once a day for 9 days 300 mg once a day Healthy subjects (6) ↔ ↔ Clarithromycin 500 mg twice a day 300 mg once a day HIV-infected… (notice Rifabutine, Interactions médicamenteuses)

Effect of Other Drugs on Rifabutin Pharmacokinetics Some drugs that inhibit CYP3A may significantly increase the plasma concentration of rifabutin. (notice Rifabutine, 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)

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)

The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (notice Clonazépam, Interactions médicamenteuses)

Drug Interactions If phenytoin or other hepatic enzyme inducers are taken concurrently with Norpace or Norpace CR, lower plasma levels of disopyramide may occur. (notice Disopyramide, 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)

ND ↔ Ethinylestradiol (EE)/ Norethindrone (NE) 35 mg EE / 1 mg NE for 21 days 300 mg once a day for 10 days Healthy female subjects (22) (notice Rifabutine, Interactions médicamenteuses)

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

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

CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (notice Rifaximine, Interactions médicamenteuses)

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

Concurrent use of strong CYP3A inducers (e.g., St. (notice Vincristine, Interactions médicamenteuses)

…lomefloxacin mebendazole medroxyprogesterone methylprednisolone metronidazole metoprolol nadolol nifedipine nizatidine norfloxacin ofloxacin omeprazole prednisone, prednisolone ranitidine rifabutin roxithromycin sorbitol (purgative doses do not inhibit theophylline absorption) sucralfate terbutaline, systemic terfenadine tetracycline tocainide The Effect of Other Drugs… (notice Aminophylline, 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)

Zidovudine and Rifabutin No dosage adjustment for zidovudine and rifabutin is needed when megestrol acetate is coadministered with these drugs [See Clinical Pharmacology ( 12.3 )] . (notice Mégestrol, Interactions médicamenteuses)

CYP2C19 and CYP3A4 Inducer Co-administration of Micafungin in Sodium Chloride Injection with rifampin and ritonavir 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)

…cefaclor nizatidine co-trimoxazole (trimethoprim and sulfamethoxazole) norfloxacin ofloxacin diltiazem omeprazole dirithromycin prednisone, prednisolone enflurane ranitidine famotidine rifabutin felodipine roxithromycin finasteride Sorbitol (purgative doses do not inhibit hydrocortisone theophylline absorption) isoflurane sucralfate isoniazid terbutaline, systemic… (notice Théophylline, Interactions médicamenteuses)