Rolapitant : interactions médicamenteuses

If concomitant use of DYANAVEL XR with other serotonergic drugs or CYP2D6 inhibitors is clinically warranted, initiate DYANAVEL XR with lower doses, monitor patients for the emergence of serotonin syndrome during drug initiation or titration, and inform patients of the increased risk for serotonin syndrome. (notice Amphétamine, Mises en garde et précautions)

If serotonin syndrome occurs, discontinue ADDERALL XR and the CYP2D6 inhibitor [see Warnings and Precautions ( 5.8 ), Overdosage ( 10 )] . (notice Amphétamine et dexamfétamine, Interactions médicamenteuses)

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

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

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

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

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

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

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

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

If serotonin syndrome occurs, discontinue dextroamphetamine sulfate and the CYP2D6 inhibitor [see Warnings , Overdosage ]. (notice Dexamfétamine, Interactions médicamenteuses)

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

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

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

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

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

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

Avoid the use of Hydrocodone Polistirex and Chlorpheniramine Polistirex while taking a CYP3A4 or CYP2D6 inhibitor. (notice Hydrocodone et chlorphénamine, Interactions médicamenteuses)

Avoid the use of hydrocodone bitartrate and homatropine methylbromide while taking a CYP3A4 or CYP2D6 inhibitor. (notice Hydrocodone et homatropine, Interactions médicamenteuses)

Co-administration with eliglustat is contraindicated in poor or intermediate metabolizers of CYP2D6 and in subjects taking strong or moderate CYP2D6 inhibitors. (notice Itraconazole, Mise en garde encadrée)

If concomitant use of VYVANSE with other serotonergic drugs or CYP2D6 inhibitors is clinically warranted, initiate VYVANSE with lower doses, monitor patients for the emergence of serotonin syndrome during drug initiation or titration, and inform patients of the increased risk for serotonin syndrome. (notice Lisdexamfétamine, 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)

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

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The concomitant use of METHADOSE with all cytochrome P450 3A4, 2B6, 2C19, 2C9 or 2D6 inhibitors may result in an increase in methadone plasma concentrations, which could cause potentially fatal respiratory depression. (notice Méthadone, Mise en garde encadrée)

If serotonin syndrome occurs, discontinue methamphetamine hydrochloride tablets, USP and the CYP2D6 inhibitor [see Warnings and Precautions 5.8]. (notice Méthamphétamine, Interactions médicamenteuses)

CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (notice Métoprolol, Interactions médicamenteuses)

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

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

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

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

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

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

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

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

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

VARUBI is contraindicated in patients taking CYP2D6 substrates with a narrow therapeutic index, such as thioridazine and pimozide. (notice Rolapitant, Contre-indications)

Intervention: Avoid the use of VARUBI in patients who require chronic administration of strong CYP3A4 inducers. (notice Rolapitant, 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, requiring careful consideration of the effects on the parent drug, codeine, and the active metabolite, morphine. (notice Prométhazine et codéine, Mise en garde encadrée)

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

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

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

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

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

VARUBI is contraindicated in patients taking CYP2D6 substrates with a narrow therapeutic index, such as thioridazine and pimozide. (notice Rolapitant, Contre-indications)

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

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

Strong CYP2D6 Inhibitors Prevention or Management With concomitant use of atomoxetine oral solution and a strong CYP2D6 inhibitor 1 , increase the titration interval [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ] . (notice Atomoxétine, Interactions médicamenteuses)

Strong CYP2D6 REXULTI may be administered without dosage adjustment in patients with MDD when administered with strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine). or CYP3A4 inhibitors Administer half of recommended dosage. (notice Brexpiprazole, Interactions médicamenteuses)

CYP2D6 inhibitors may potentiate systemic beta-blockade. (notice Brimonidine et timolol, Interactions médicamenteuses)

Exposure to dextromethorphan, a CYP2D6 substrate, following a single dose of rolapitant increased about 3-fold on Days 8 and Day 22. (notice Rolapitant, Mises en garde et précautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (notice Carvédilol, Interactions médicamenteuses)

Concomitant use of strong CYP2D6 inhibitors: Maximum recommended dose of AUSTEDO XR or AUSTEDO is 36 mg per day ( 2.3 , 7.1 ) (notice Deutétrabénazine, Interactions médicamenteuses)

Exposure to dextromethorphan, a CYP2D6 substrate, following a single dose of rolapitant increased about 3-fold on Days 8 and Day 22. (notice Rolapitant, Mises en garde et précautions)

Exposure to dextromethorphan, a CYP2D6 substrate, following a single dose of rolapitant increased about 3-fold on Days 8 and Day 22. (notice Rolapitant, Mises en garde et précautions)

P-gp Substrates with a Narrow Therapeutic Index (e.g. digoxin) Clinical Impact: Increased plasma concentrations of P-gp substrates (e.g., digoxin) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ]. (notice Rolapitant, Interactions médicamenteuses)

CYP2D6 inhibitors may potentiate systemic beta-blockade. (notice Dorzolamide et timolol, Interactions médicamenteuses)

Use caution in combination with moderate CYP3A4 inhibitors (e.g., erythromycin) or strong (e.g., paroxetine) or moderate CYP2D6 inhibitors, a combination of both CYP3A4 and CYP2D6 inhibitors, or known poor metabolizers of CYP2D6. (notice Dutastéride et tamsulosine, Mises en garde et précautions)

In poor metabolizers for CYP2D6, representing a maximum CYP2D6 inhibition, C max and AUC of the active metabolite are increased 1.7- and 2-fold, respectively. (notice Fésotérodine, Interactions médicamenteuses)

The haloperidol plasma concentrations increased when a CYP3A4 and/or CYP2D6 inhibitor was coadministered with haloperidol. (notice Halopéridol, Interactions médicamenteuses)

These effects could be more pronounced with concomitant use of hydrocodone bitartrate and acetaminophen tablets and both CYP3A4 and CYP2D6 inhibitors, particularly when an inhibitor is added after a stable dose of hydrocodone bitartrate and acetaminophen tablets is achieved [see WARNINGS ]. (notice Hydrocodone et paracétamol, Interactions médicamenteuses)

Table 7: Clinically Important Drug Interactions with FANAPT Strong CYP2D6 Inhibitors Clinical Impact Coadministration of fluoxetine with iloperidone increased exposure (area under curve, [AUC]) of iloperidone and its metabolite P88, by about 2- to 3- fold, and decreased the AUC of its metabolite P95 by one-half [see Clinical Pharmacology (12.3 , 12.5) ] . (notice Ilopéridone, Interactions médicamenteuses)

BCRP Substrates with a Narrow Therapeutic Index (e.g., methotrexate, topotecan, or irinotecan) Clinical Impact: Increased plasma concentrations of BCRP substrates (e.g., methotrexate, topotecan, or irinotecan) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ]. (notice Rolapitant, Interactions médicamenteuses)

CYP2D6 Inhibitors : Concomitant use of paroxetine resulted in increased plasma levels of Lofexidine tablets. (notice Lofexidine, Interactions médicamenteuses)

BCRP Substrates with a Narrow Therapeutic Index (e.g., methotrexate, topotecan, or irinotecan) Clinical Impact: Increased plasma concentrations of BCRP substrates (e.g., methotrexate, topotecan, or irinotecan) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ]. (notice Rolapitant, Interactions médicamenteuses)

• Strong CYP2D6 inhibitors (e.g., quinidine, bupropion, fluoxetine, and paroxetine) : See Full Prescribing Information for recommended dosage reductions. (notice Métoclopramide, Interactions médicamenteuses)

CYP2D6 inhibitors: Increased metoprolol concentration. (notice Métoprolol et hydrochlorothiazide, Interactions médicamenteuses)

Use with CYP2D6 Inhibitors Nebivolol exposure increases with inhibition of CYP2D6 [see Drug Interactions ( 7 ) ] . (notice Nébivolol, Mises en garde et précautions)

…nefazodone and its major metabolites are not altered in these “poor metabolizers.” Plasma concentrations of one minor metabolite (mCPP) are increased in this population; the adjustment of nefazodone dosage is not required when administered to “poor metabolizers.” Nefazodone and its metabolites have been shown in vitro to be extremely weak inhibitors of CYP2D6. (notice Néfazodone, Interactions médicamenteuses)

Inhibitors of CYP2D6 Fluoxetine: Fluoxetine (60 mg single dose or 60 mg daily dose for 8 days) causes a small (mean 16%) increase in the maximum concentration of olanzapine and a small (mean 16%) decrease in olanzapine clearance. (notice Olanzapine, Interactions médicamenteuses)

The Effect of Other Drugs on Olanzapine — Fluoxetine, an inhibitor of CYP2D6, decreases olanzapine clearance a small amount [see Clinical Pharmacology ( 12.3 )]. (notice Olanzapine et fluoxétine, Interactions médicamenteuses)

…prolonged opioid adverse reactions and exacerbated respiratory depression, may occur when OLINVYK is used under the following conditions: In patients with decreased Cytochrome P450 (CYP) 2D6 function (poor metabolizers of CYP2D6 or normal metabolizers taking moderate or strong CYP2D6 inhibitors) [See Drug Interactions ( 7 ); Use in Specific Populations ( 8.8 )]. (notice Olicéridine, Mises en garde et précautions)

Strong CYP2D6 Inhibitors: Increased exposure of WAKIX; reduce the maximum recommended dose of WAKIX by half ( 2.6 , 7.1 ) (notice Pitolisant, Interactions médicamenteuses)

Effects of Other Drugs on the Pharmacokinetics of Primaquine Strong CYP2D6 Inhibitors Published clinical and non-clinical reports indicate reduced CYP2D6 activity may decrease the formation of active metabolites of primaquine, which may reduce antimalarial efficacy of Primaquine phosphate Tablets (see CLINICAL PHARMACOLOGY, Pharmacogenomics ). (notice Primaquine, Interactions médicamenteuses)

Exposure to dextromethorphan, a CYP2D6 substrate, following a single dose of rolapitant increased about 3-fold on Days 8 and Day 22. (notice Rolapitant, Mises en garde et précautions)

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)

Fluoxetine and Paroxetine Fluoxetine (20 mg once daily) and paroxetine (20 mg once daily), CYP 2D6 inhibitors, have been shown to increase the plasma concentration of risperidone 2.5–2.8 fold and 3–9 fold respectively. (notice Rispéridone, Interactions médicamenteuses)

Use the lowest effective dose of rosuvastatin (see prescribing information for additional information on recommended dosing). (notice Rolapitant, Interactions médicamenteuses)

Use with caution in combination with moderate inhibitors of CYP3A4, with strong or moderate inhibitors of CYP2D6, in patients known to be CYP2D6 poor metabolizers, or in combination with other cytochrome P450 inhibitors. (notice Tamsulosine, Mises en garde et précautions)

• Do not exceed 50 mg/day and the maximum single dose should not exceed 25 mg if administered in conjunction with a strong CYP2D6 inhibitor (e.g., fluoxetine, paroxetine). (notice Tétrabénazine, Mises en garde et précautions)

CYP2D6 Inhibitors Potentiated systemic beta-blockade (e.g., decreased heart rate) has been reported during combined treatment with CYP2D6 inhibitors (e.g., quinidine) and timolol. (notice Timolol, Interactions médicamenteuses)

BCRP Substrates with a Narrow Therapeutic Index (e.g., methotrexate, topotecan, or irinotecan) Clinical Impact: Increased plasma concentrations of BCRP substrates (e.g., methotrexate, topotecan, or irinotecan) may result in potential adverse reactions [see Clinical Pharmacology (12.3) ]. (notice Rolapitant, Interactions médicamenteuses)

For patients who are CYP2D6 poor metabolizers or are taking a strong CYP2D6 inhibitor, dose reduction may be necessary. (notice Valbénazine, Mises en garde et précautions)

Therefore, the potential exists for a drug interaction between drugs that inhibit CYP2D6-mediated metabolism of venlafaxine, reducing the metabolism of venlafaxine to ODV, resulting in increased plasma concentrations of venlafaxine and decreased concentrations of the active metabolite. (notice Venlafaxine, Interactions médicamenteuses)

CYP2D6 Substrates Clinical Impact Viloxazine is a weak inhibitor of CYP2D6, and increases the exposure of CYP2D6 substrates when coadministered [see Clinical Pharmacology (12.3) ] . (notice Viloxazine, Interactions médicamenteuses)

• Strong inhibitors of CYP2D6: Reduce TRINTELLIX dose by half when coadministered ( 2.5 , 7.1 ). (notice Vortioxétine, Interactions médicamenteuses)

Warfarin Clinical Impact: Although co-administration of intravenous rolapitant (VARBI is not approved for intravenous use), which has a higher C max than oral VARUBI, with warfarin did not substantially increase the systemic exposure to S-warfarin, the active enantiomer, the effects on INR and prothrombin time were not studied [see Clinical Pharmacology (12.3)… (notice Rolapitant, Interactions médicamenteuses)

CYP2D6 substrates Clinical Impact: In vitro studies indicate that celecoxib, although not a substrate, is an inhibitor of CYP2D6. (notice Célécoxib, Interactions médicamenteuses)

Drugs which inhibit CYP2D6 and CYP3A3/4 also inhibit the metabolism of cevimeline. (notice Céviméline, 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)

In vitro data suggest that fluvoxamine is a relatively weak inhibitor of CYP2D6. (notice Fluvoxamine, Interactions médicamenteuses)

Because ritonavir is a CYP2D6 inhibitor, clinically significant interactions with drugs metabolized by CYP2D6 are possible when coadministered with fosamprenavir calcium plus ritonavir. (notice Fosamprénavir, Interactions médicamenteuses)

• CYP2D6 inhibitors: As meclizine is metabolized by CYP2D6, there is a potential for drug-drug interactions between meclizine hydrochloride and CYP2D6 inhibitors ( 7.2 ). (notice Méclozine, Interactions médicamenteuses)

Potential for PAXLOVID to Affect Other Drugs PAXLOVID (nirmatrelvir co-packaged with ritonavir) is a strong inhibitor of CYP3A, and an inhibitor of CYP2D6, P-gp and OATP1B1. (notice Nirmatrelvir et ritonavir, Interactions médicamenteuses)

Drugs Metabolized by CYP2D6 Clinical Impact: Sertraline hydrochloride capsules are a CYP2D6 inhibitor [see Clinical Pharmacology ( 12.3 )] . (notice Sertraline, Interactions médicamenteuses)

Strong Inhibitors of CYP2D6 The impact on the efficacy of tamoxifen with co-administration of strong CYP2D6 inhibitors (e.g., paroxetine) is not well established. (notice Tamoxifène, Interactions médicamenteuses)