एप्रेपिटेंट के इंटरैक्शन

• taking strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, itraconazole), except ritonavir [see Dosage and Administration (2.5) , Warnings and Precautions (5.5) , Drug Interactions (7.1) ] . (अल्प्राज़ोलम लेबल, निषेध (कॉन्ट्राइंडिकेशन))

…(Childs-Pugh categories B and C), since alfuzosin blood levels are increased in these patients [see Use in Specific Populations (8.7) and Clinical Pharmacology (12.3) ]. with potent CYP3A4 inhibitors such as ketoconazole, itraconazole, and ritonavir, since alfuzosin blood levels are increased [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . in… (अल्फुज़ोसिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

…bradycardia [see Warnings and Precautions ( 5.3 )] • Severe hepatic impairment [see Use in Specific Populations ( 8.6 )] • Pacemaker dependence (heart rate maintained exclusively by the pacemaker) [see Drug Interactions ( 7.3 )] • Concomitant use of strong cytochrome P450 3A4 (CYP3A4) inhibitors [see Drug Interactions ( 7.1 )] Acute decompensated heart failure ( 4 ) (आइवाब्राडिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Strong CYP3A4 Inducers: Do not administer strong CYP3A4 inducers with CAMPTOSAR. (इरिनोटेकन लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (उपाडासिटिनिब लेबल, दवाओं के इंटरैक्शन)

UBRELVY is contraindicated: With concomitant use of strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 )] In patients with a history of serious hypersensitivity to ubrogepant or any component of UBRELVY. (उब्रोजेपेंट लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• CYP3A Inhibitors: Avoid co-administration with strong CYP3A inhibitors. (एकालाब्रुटिनिब लेबल, दवाओं के इंटरैक्शन)

VYTORIN is contraindicated in the following conditions: Concomitant use of strong CYP3A4 inhibitors (select azole anti-fungals, macrolide antibiotics, anti-viral medications, and nefazodone) [see Drug Interactions (7.1) ] . (एज़ेटिमाइब और सिमवास्टेटिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• when coadministered with drugs that are strong inducers of CYP3A due to the potential for loss of therapeutic effect and development of resistance. (एटाज़ानाविर लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use. (एपिक्साबैन लेबल, दवाओं के इंटरैक्शन)

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 ) (एप्रेमिलास्ट लेबल, चेतावनियां और सावधानियां)

…Patients Eplerenone is contraindicated in all patients with: • serum potassium > 5.5 mEq/L at initiation, • creatinine clearance ≤ 30 mL/min, or • concomitant administration of strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, and nelfinavir) [see Drug Interactions (7.1) , Clinical Pharmacology (12.3)… (एप्लेरेनोन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

CYP3A4 Inducers: Avoid concomitant strong CYP3A4 inducers during YONSA treatment. (एबिराटेरोन लेबल, दवाओं के इंटरैक्शन)

• Moderate to Strong Inhibitors of Both CYP2C19 and CYP2C9, or Strong or Moderate CYP2C19 or CYP2C9 Inducers : Avoid concomitant use. (एब्रोसिटिनिब लेबल, दवाओं के इंटरैक्शन)

CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (एरिपिप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

WARNING Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of ergotamine tartrate and caffeine tablets with potent CYP 3A4 inhibitors including protease inhibitors and macrolide antibiotics. (एर्गोटामिन और कैफीन लेबल, बॉक्स्ड चेतावनी)

Avoid co-administering erlotinib with strong CYP3A4 inhibitors (e.g., boceprevir, clarithromycin, conivaptan, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telithromycin, voriconazole, grapefruit or grapefruit juice) or a combined CYP3A4 and CYP1A2 inhibitor (e.g., ciprofloxacin). (एर्लोटिनिब लेबल, दवाओं के इंटरैक्शन)

Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (एलेक्साकैफ्टर, टेज़ाकैफ्टर और आइवाकैफ्टर लेबल, चेतावनियां और सावधानियां)

• Recent use (i.e., within at least 72 hours) of the following potent CYP3A4 inhibitors: ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, or nelfinavir [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ]. (एलेट्रिप्टान लेबल, निषेध (कॉन्ट्राइंडिकेशन))

CYP3A4 Inducers : Avoid coadministration of VIJOICE with a strong CYP3A4 inducer. (एल्पेलिसिब लेबल, दवाओं के इंटरैक्शन)

Concomitant use of almotriptan tablets and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment [see Clinical Pharmacology ( 12.3 )] . (एल्मोट्रिप्टान लेबल, दवाओं के इंटरैक्शन)

Strongly induce CYP3A, which may lead to lower exposure of one or more components and loss of efficacy of GENVOYA and possible resistance. (एल्विटेग्राविर, कोबिसिस्टैट, एमट्रिसिटाबिन और टेनोफोविर लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Do not use avanafil in patients taking strong CYP3A4 inhibitors [see Warnings and Precautions ( 5.2 ) and Dosage and Administration ( 2.3 )]. (एवानाफिल लेबल, दवाओं के इंटरैक्शन)

Consequently, estazolam should be avoided in patients receiving ketoconazole and itraconazole, which are very potent inhibitors of CYP3A (see CONTRAINDICATIONS ). (एस्टाज़ोलम लेबल, चेतावनियां)

Cytochrome P450 3A4 Interaction The concomitant use of Oxycodone Hydrochloride Oral Solution with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (ऑक्सीकोडोन लेबल, बॉक्स्ड चेतावनी)

Cytochrome P450 3A4 Interaction The concomitant use of oxycodone hydrochloride tablets with all cytochrome P450 3A4 inhibitors may result in an increase in oxycodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (ऑक्सीकोडोन और पैरासिटामोल लेबल, बॉक्स्ड चेतावनी)

If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (ओलिसेरिडिन लेबल, दवाओं के इंटरैक्शन)

Therefore, administration of potent enzyme inducers of CYP3A4 with ketoconazole tablets is not recommended. (कीटोकोनाज़ोल लेबल, दवाओं के इंटरैक्शन)

Avoid taking a strong CYP3A4 inhibitor (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole) while taking COMETRIQ or reduce the dosage of COMETRIQ if concomitant use with strong CYP3A4 inhibitors cannot be avoided [see Dosage and Administration ( 2.2 ), Clinical Pharmacology… (कैबोज़ैंटिनिब लेबल, दवाओं के इंटरैक्शन)

Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (कैरिप्राज़िन लेबल, दवाओं के इंटरैक्शन)

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. (कोडीन लेबल, बॉक्स्ड चेतावनी)

Patients with renal or hepatic impairment should not be given colchicine capsules with drugs that inhibit both P-glycoprotein and CYP3A4 inhibitors [see Drug Interactions (7) ] . (कोल्चिसिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Concomitant use of Strong CYP3A4 Inducers is not recommended. (क्लोज़ापिन लेबल, दवाओं के इंटरैक्शन)

John's wort, a CYP3A4 inducer, in combination with zolpidem may decrease blood levels of zolpidem and is not recommended. (ज़ोल्पिडेम लेबल, दवाओं के इंटरैक्शन)

• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (टिकाग्रेलोर लेबल, दवाओं के इंटरैक्शन)

Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (टैमोक्सीफेन लेबल, दवाओं के इंटरैक्शन)

• Should not be used in combination with strong inhibitors of CYP3A4. (टैम्सुलोसिन लेबल, चेतावनियां और सावधानियां)

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 ) (टैसिमेल्टियॉन लेबल, दवाओं के इंटरैक्शन)

Drugs known to prolong the QT interval and strong CYP3A4 inhibitors should be avoided [see Warnings and Precautions (5.1) ] . (टोरेमिफेन लेबल, बॉक्स्ड चेतावनी)

…dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS [see Warnings and Precautions (5.2) ] Unable to sense or respond to thirst Hypovolemic hyponatremia Taking strong CYP3A inhibitors [see Warnings and Precautions (5.5) ] Anuria Hypersensitivity (e.g., anaphylactic shock, rash generalized) to tolvaptan or any components of the product [see Adverse… (टोल्वैप्टन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (ट्रामाडोल लेबल, बॉक्स्ड चेतावनी)

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. (ट्रामाडोल और पैरासिटामोल लेबल, बॉक्स्ड चेतावनी)

Strong CYP 3A Inhibitors Triazolam is contraindicated in patients receiving strong inhibitors of CYP 3A such as ketoconazole, itraconazole, nefazodone, ritonavir, indinavir, nelfinavir, saquinavir, and lopinavir [see Contraindications (4) , Drug Interactions (7.1) ] . (ट्रायज़ोलम लेबल, चेतावनियां और सावधानियां)

• Strong CYP3A Inhibitors and Inducers: Avoid coadministration with strong CYP3A inhibitors and inducers. (ट्रेटिनोइन लेबल, दवाओं के इंटरैक्शन)

The use of RALDESY Should be avoided in patients with known QT prolongation or in combination with other drugs that are inhibitors of CYP3A4 (e.g., itraconazole, clarithromycin, voriconazole), or known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic… (ट्रैज़ोडोन लेबल, चेतावनियां और सावधानियां)

CYP3A inhibitors: Avoid concomitant strong CYP3A inhibitors ( 7.1 ) (ट्रैबेक्टेडिन लेबल, दवाओं के इंटरैक्शन)

WARNING: PERIPHERAL ISCHEMIA FOLLOWING COADMINISTRATION WITH POTENT CYP3A4 INHIBITORS Serious and/or life-threatening peripheral ischemia has been associated with the coadministration of dihydroergotamine with potent CYP3A4 inhibitors including protease inhibitors and macrolide antibiotics. (डाइहाइड्रोएर्गोटामिन लेबल, बॉक्स्ड चेतावनी)

Co-administration of PREZCOBIX or PREZCOBIX PED with CYP3A inducers may lead to lower exposures of darunavir and cobicistat and potential loss of efficacy of darunavir and possible resistance. (डारुनाविर और कोबिसिस्टैट लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Avoid concomitant use of strong CYP3A4 inhibitors. (डासाटिनिब लेबल, दवाओं के इंटरैक्शन)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (डेक्सट्रोमेथॉर्फन और क्विनिडिन लेबल, चेतावनियां और सावधानियां)

• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (डेक्सामेथासोन लेबल, दवाओं के इंटरैक्शन)

Avoid use of moderate or strong CYP3A4 inducers with EMFLAZA, as they may reduce efficacy ( 7.1 ) (डेफ्लाज़ाकॉर्ट लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A4 inhibitors: Avoid concomitant use. (डैरिडोरेक्सेंट लेबल, दवाओं के इंटरैक्शन)

• Avoid concomitant use of doxorubicin hydrochloride with inhibitors and inducers of CYP3A4, CYP2D6, and/or P-gp ( 7.1 ) (डॉक्सोरूबिसिन लेबल, दवाओं के इंटरैक्शन)

PIFELTRO is contraindicated when co-administered with drugs that are strong cytochrome P450 (CYP)3A enzyme inducers as significant decreases in doravirine plasma concentrations may occur, which may decrease the effectiveness of PIFELTRO [see Warnings and Precautions (5.2) , Drug Interactions (7.1) , and Clinical Pharmacology (12.3) ] . (डोराविरिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Concomitant use of Docetaxel Injection and drugs that inhibit CYP3A4 may increase exposure to docetaxel and should be avoided. (डोसेटैक्सेल लेबल, दवाओं के इंटरैक्शन)

Drug-Drug Interactions Strong Inhibitors of Cytochrome P450 (CYP) 3A4 Tamsulosin-containing products, including JALYN, should not be coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole) as this can significantly increase tamsulosin exposure [see Drug Interactions (7.1) , Clinical Pharmacology (12.3) ]. (ड्यूटास्टेराइड और टैम्सुलोसिन लेबल, चेतावनियां और सावधानियां)

• CYP3A inducers: Avoid concomitant use. (ड्रोनेडेरोन लेबल, दवाओं के इंटरैक्शन)

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 ) ] . (थायोटेपा लेबल, दवाओं के इंटरैक्शन)

Patients concomitantly using strong CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole) because these medications can significantly increase exposure to naloxegol which may precipitate opioid withdrawal symptoms such as hyperhidrosis, chills, diarrhea, abdominal pain, anxiety, irritability, and yawning [see Drug Interactions (7.1) and Clinical Pharmacology… (नालोक्सेगोल लेबल, निषेध (कॉन्ट्राइंडिकेशन))

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. (नाल्डेमेडिन लेबल, दवाओं के इंटरैक्शन)

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 ). (निफेडिपिन लेबल, दवाओं के इंटरैक्शन)

Therefore, the concomitant administration of NYMALIZE and strong CYP3A4 inhibitors should generally be avoided [ see Warnings and Precautions (5.3) ]. (निमोडिपिन लेबल, दवाओं के इंटरैक्शन)

…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. (निर्माट्रेल्विर और रिटोनाविर लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Avoid use of concomitant drugs known to prolong the QT interval and strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 , 7.2 )] . (निलोटिनिब लेबल, बॉक्स्ड चेतावनी)

CYP3A4 inhibitors and inducers : SULAR is substrate of CYP3A4 and coadministration of SULAR with any known inducer or inhibitor of CYP3A4 should be avoided in general. (निसोल्डिपिन लेबल, दवाओं के इंटरैक्शन)

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 ) (नॉरएथिस्टेरोन और एथिनिल एस्ट्राडियोल लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A4 Inhibitors : Avoid coadministration of VOTRIENT with strong CYP3A4 inhibitors. (पाज़ोपैनिब लेबल, दवाओं के इंटरैक्शन)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (पाल्बोसिक्लिब लेबल, दवाओं के इंटरैक्शन)

Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (पिमावैनसेरिन लेबल, दवाओं के इंटरैक्शन)

Hypersensitivity reactions including anaphylaxis have been reported [see Warnings and Precautions (5.2) , Adverse Reactions (6.2) ] . taking pimozide. (एप्रेपिटेंट लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Cytochrome P450 3A4 Interaction The concomitant use of DEMEROL Injection with all cytochrome P450 3A4 inhibitors may result in an increase in meperidine plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (पेथिडीन लेबल, बॉक्स्ड चेतावनी)

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. (पैरासिटामोल और कोडीन लेबल, बॉक्स्ड चेतावनी)

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. (पैलिपेरिडोन लेबल, दवाओं के इंटरैक्शन)

• 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 )] . (प्राज़िक्वांटेल लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 (CYP2D6) inhibitor and a 3A4 inhibitor (CYP3A4). (प्रोपाफेनोन लेबल, चेतावनियां और सावधानियां)

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. (प्रोमेथाज़िन और कोडीन लेबल, बॉक्स्ड चेतावनी)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (फेंटानिल लेबल, बॉक्स्ड चेतावनी)

CYP3A4 Inhibitors Doses of Toviaz greater than 4 mg are not recommended in adult patients taking strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, and clarithromycin [see Dosage and Administration (2.5) ]. (फेसोटेरोडिन लेबल, दवाओं के इंटरैक्शन)

Inhibition of CYP3A4 by aprepitant, the active moiety, could result in elevated plasma concentrations of this drug, which is a CYP3A4 substrate, potentially causing serious or life-threatening reactions, such as QT prolongation, a known adverse reaction of pimozide [see Warnings and Precautions ( 5.1 )] . (फोसाप्रेपिटेंट लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Contraindicated with Strong or Moderate CYP3A4 Inhibitors The concomitant use of ADDYI and moderate or strong CYP3A4 inhibitors increases flibanserin concentrations, which can cause severe hypotension and syncope [see Warnings and Precautions (5.2) ] . (फ्लिबैनसेरिन लेबल, बॉक्स्ड चेतावनी)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (फ्लुटिकासोन लेबल, दवाओं के इंटरैक्शन)

Avoid strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): May increase risk of systemic corticosteroid and cardiovascular effects. (फ्लुटिकासोन और सैल्मेटेरोल लेबल, दवाओं के इंटरैक्शन)

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. (बिक्टेग्राविर, एमट्रिसिटाबिन और टेनोफोविर एलाफेनामाइड लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Strong CYP3A4 Inducers: Avoid concomitant use. (बोर्टेज़ोमिब लेबल, दवाओं के इंटरैक्शन)

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (बोसुटिनिब लेबल, दवाओं के इंटरैक्शन)

Co-administration of such combinations of a CYP2C9 inhibitor plus a strong or moderate CYP3A inhibitor with TRACLEER is not recommended. (बोसेंटन लेबल, दवाओं के इंटरैक्शन)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (ब्यूटाल्बिटल, एस्पिरिन, कैफीन और कोडीन लेबल, बॉक्स्ड चेतावनी)

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. (ब्यूटाल्बिटल, पैरासिटामोल, कैफीन और कोडीन लेबल, बॉक्स्ड चेतावनी)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (ब्यूप्रेनॉर्फिन लेबल, दवाओं के इंटरैक्शन)

Concomitant use of strong CYP3A4 inhibitors (e.g., azole antimycotics, HIV protease inhibitors) with CYCLOSET should be avoided. (ब्रोमोक्रिप्टिन लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A Inhibitors and Inducers: Avoid concomitant use. (मिटापिवैट लेबल, दवाओं के इंटरैक्शन)

Although there have been no reports of such interactions with methylergonovine alone, strong and moderate CYP 3A4 inhibitors should not be co-administered with methylergonovine. (मिथाइलएर्गोमेट्रिन लेबल, दवाओं के इंटरैक्शन)

CYP3A inducers: Do not use mifepristone with CYP3A inducers ( 7.3 ). (मिफेप्रिस्टोन लेबल, दवाओं के इंटरैक्शन)

Similarly, discontinuation of concomitant CYP3A4, CYP2B6, CYP2C19, or CYP2C9 inducers in METHADOSE-treated patients may increase methadone plasma concentrations resulting in fatal respiratory depression. (मेथाडोन लेबल, चेतावनियां और सावधानियां)

SELZENTRY is contraindicated in patients with severe renal impairment or ESRD (creatinine clearance [CrCl] less than 30 mL per minute) who are concomitantly taking potent CYP3A inhibitors or inducers [see Warnings and Precautions ( 5.3 )]. (मैराविरोक लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (मैसिटेंटन लेबल, दवाओं के इंटरैक्शन)

Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3) ] . (यूलिप्रिस्टल लेबल, चेतावनियां और सावधानियां)

• Certain CYP3A inducers: Coadministration with strong inducers of CYP3A is not recommended. (रिटलेसिटिनिब लेबल, दवाओं के इंटरैक्शन)

• Strong CYP3A4 Inhibitors: Avoid concomitant administration. (रिमेजेपेंट लेबल, दवाओं के इंटरैक्शन)

Use with P-gp and Strong CYP3A Inhibitors or Inducers Avoid concomitant use of XARELTO with known combined P-gp and strong CYP3A inhibitors [see Drug Interactions (7.2) ] . (रिवारोक्साबैन लेबल, चेतावनियां और सावधानियां)

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) (रैनोलाज़िन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (रोफ्लुमिलास्ट लेबल, चेतावनियां और सावधानियां)

• Avoid use with rifampin and strong CYP3A4 inducers ( 7.3 ). (रोमिडेप्सिन लेबल, दवाओं के इंटरैक्शन)

Intervention: Avoid the use of VARUBI in patients who require chronic administration of strong CYP3A4 inducers. (रोलापिटेंट लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (लुमाटेपेरोन लेबल, दवाओं के इंटरैक्शन)

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) ] . (लेनाकैपाविर लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Strong or moderate CYP3A inhibitors: Avoid concomitant use. (लेम्बोरेक्सेंट लेबल, दवाओं के इंटरैक्शन)

Avoid strong CYP3A4 inhibitors. (लैपाटिनिब लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A4 Inhibitors: Avoid coadministration of strong CYP3A4 inhibitors with VITRAKVI. (लैरोट्रेक्टिनिब लेबल, दवाओं के इंटरैक्शन)

Concomitant administration of JUXTAPID with moderate or strong CYP3A4 inhibitors, as this can increase JUXTAPID exposure [see Warnings and Precautions (5.6) , Drug Interactions (7.1) , and Clinical Pharmacology (12.3) ]. (लोमिटापाइड लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Strong CYP3A Inhibitors : Avoid concomitant use; reduce LORBRENA dose if concomitant use cannot be avoided. (लोरलाटिनिब लेबल, दवाओं के इंटरैक्शन)

Concomitant administration with strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, posaconazole, voriconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, nefazodone and cobicistat-containing products) (see WARNINGS , Myopathy/Rhabdomyolysis ). (लोवास्टेटिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole, mibefradil, etc.) [see Drug Interactions ( 7.1 )]. (ल्यूरासिडोन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (वाल्बेनाज़िन लेबल, दवाओं के इंटरैक्शन)

Therefore, the concomitant use of strong CYP3A inhibitors with vincristine sulfate should be avoided. (विन्क्रिस्टिन लेबल, दवाओं के इंटरैक्शन)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (वेपडेजेस्ट्रेंट लेबल, चेतावनियां और सावधानियां)

ZOCOR is contraindicated in the following conditions: Concomitant use of strong CYP3A4 inhibitors (select azole anti-fungals, macrolide antibiotics, anti-viral medications, and nefazodone) [see Drug Interactions (7.1) ] . (सिमवास्टेटिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

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) ]. (सिरोलिमस लेबल, चेतावनियां और सावधानियां)

Severe renal impairment (CCr < 30 mL/min) Severe hepatic impairment (Child-Pugh score ≥ 10) Concomitant administration with strong Cytochrome P450 3A4 (CYP3A4) inhibitors (e.g., ketoconazole, clarithromycin, itraconazole, ritonavir) [see DRUG INTERACTIONS (7.1) ] Patients with a history of hypersensitivity to silodosin or any of the ingredients in silodosin capsules… (सिलोडोसिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

Concomitant use of JOURNAVX with strong CYP3A inhibitors is contraindicated [see Warnings and Precautions (5.1) , Drug Interactions (7.1) ] . (सुज़ेट्रिजिन लेबल, निषेध (कॉन्ट्राइंडिकेशन))

• Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (सैल्मेटेरोल लेबल, दवाओं के इंटरैक्शन)

• Strong CYP3A Inducers: Avoid strong CYP3A4 inducers. (सोराफेनिब लेबल, दवाओं के इंटरैक्शन)

The dosage of Solifenacin succinate tablets greater than 5 mg once daily is not recommended when concomitantly used with strong CYP3A4 inhibitors [see Dosage and Administration ( 2.4 )] . (सोलिफेनासिन लेबल, दवाओं के इंटरैक्शन)

Cytochrome P450 3A4 Interaction The concomitant use of HYSINGLA ER with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (हाइड्रोकोडोन लेबल, बॉक्स्ड चेतावनी)

Cytochrome P450 3A4 Interaction The concomitant use of Hydrocodone Bitartrate and Ibuprofen Tablets with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which may cause potentially fatal respiratory depression. (हाइड्रोकोडोन और आइबुप्रोफेन लेबल, बॉक्स्ड चेतावनी)

Cytochrome P450 3A4 Interaction The concomitant use of Hydrocodone Polistirex and Chlorpheniramine Polistirex with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. (हाइड्रोकोडोन और क्लोरफेनिरामिन लेबल, बॉक्स्ड चेतावनी)

Cytochrome P450 3A4 Interaction The concomitant use of hydrocodone bitartrate and acetaminophen tablets with all Cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. (हाइड्रोकोडोन और पैरासिटामोल लेबल, बॉक्स्ड चेतावनी)

Cytochrome P450 3A4 Interaction The concomitant use of hydrocodone bitartrate and homatropine methylbromide with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. (हाइड्रोकोडोन और होमाट्रोपिन लेबल, बॉक्स्ड चेतावनी)

Intervention Vinblastine, vincristine, or ifosfamide or other chemotherapeutic agents Monitor for chemotherapeutic-related adverse reactions. (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Concomitant Use with CYP3A Inducers Use of KALYDECO with strong CYP3A inducers, such as rifampin, substantially decreases the exposure of ivacaftor, which may reduce the therapeutic effectiveness of KALYDECO. (आइवाकैफ्टर लेबल, चेतावनियां और सावधानियां)

Examples Moderate inhibitor : diltiazem Strong inhibitors : ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir Strong CYP3A4 Inducers Clinical Impact Substantially decreased exposure of aprepitant in patients chronically taking a strong CYP3A4 inducer may decrease the efficacy of CINVANTI [see Clinical Pharmacology (12.3)… (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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. (इमिप्रामिन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inducers may decrease Gleevec C max and area under curve (AUC). (इमैटिनिब लेबल, दवाओं के इंटरैक्शन)

The dose of FANAPT should be reduced in patients co-administered a strong CYP2D6 or CYP3A4 inhibitor. (इलोपेरिडोन लेबल, दवाओं के इंटरैक्शन)

CYP3A4/5 Inhibitors Co-administration of ketoconazole, a strong inhibitor of CYP3A4/5, increased the plasma exposure of axitinib in healthy volunteers. (एक्सिटिनिब लेबल, दवाओं के इंटरैक्शन)

Strong CYP 3A4 inducers: Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure. (एक्सेमेस्टेन लेबल, दवाओं के इंटरैक्शन)

Use of Cytochrome P450 3A4 Inhibitors Ritonavir and other strong cytochrome P450 3A4 (CYP3A4) inhibitors can significantly increase plasma fluticasone propionate exposure, resulting in significantly reduced serum cortisol concentrations [see Drug Interactions ( 7.2 ) and Clinical Pharmacology ( 12.3 )] . (एज़ेलास्टिन और फ्लुटिकासोन लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

LIPITOR plasma levels can be significantly increased with concomitant administration of inhibitors of CYP3A4 and transporters. (एटोरवास्टेटिन लेबल, दवाओं के इंटरैक्शन)

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. (एट्राविरिन लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Drugs Inducing or Inhibiting CYP3A Enzymes Rilpivirine is primarily metabolized by cytochrome P450 (CYP) 3A, and drugs that induce or inhibit CYP3A may thus affect the clearance of RPV [see Contraindications (4) , Warnings and Precautions (5.7) , and Clinical Pharmacology (12.3) ] . (एमट्रिसिटाबिन, रिल्पिविरिन और टेनोफोविर लेबल, दवाओं के इंटरैक्शन)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (एम्लोडिपिन लेबल, दवाओं के इंटरैक्शन)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (एम्लोडिपिन और एटोरवास्टेटिन लेबल, दवाओं के इंटरैक्शन)

• Increased exposure of amlodipine when coadministered with CYP3A inhibitors Olmesartan medoxomil ( 7.2 ): • Nonsteroidal anti-inflammatory drugs (NSAIDS) may lead to increased risk of renal impairment and loss of antihypertensive effect. (एम्लोडिपिन और ओल्मेसार्टन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 Inhibitors : Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (एम्लोडिपिन और बेनाज़ेप्रिल लेबल, दवाओं के इंटरैक्शन)

Amlodipine Impact of Other Drugs on Amlodipine CYP3A Inhibitors Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (एम्लोडिपिन और वाल्सार्टन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inhibitors: Use with caution in combination due to increased exposure of alosetron. (एलोसेट्रॉन लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A inducer and P-gp inducer : Increase the dosage as recommended. (एवरोलिमस लेबल, दवाओं के इंटरैक्शन)

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) ]. (एसोमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

The dose of LUNESTA should be reduced in patients who are administered potent inhibitors of CYP3A4, such as ketoconazole, while taking LUNESTA. (एस्ज़ोपिक्लोन लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Co-administration with strong cytochrome P450 (CYP) 3A4 inhibitors (e.g., ketoconazole) increases the systemic exposure of oxybutynin. (ऑक्सीब्यूटिनिन लेबल, दवाओं के इंटरैक्शन)

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. (ओन्डैनसेट्रॉन लेबल, दवाओं के इंटरैक्शन)

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 )] . (ओमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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 )] . (ओमेप्राज़ोल और सोडियम बाइकार्बोनेट लेबल, दवाओं के इंटरैक्शन)

Concomitant administration of CYP3A4 inhibitors may inhibit the metabolism of, and increase the mometasone furoate plasma concentration and potentially increase the risk for adverse reactions. (ओलोपाटाडीन और मोमेटासोन लेबल, दवाओं के इंटरैक्शन)

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (ओल्मेसार्टन, एम्लोडिपिन और हाइड्रोक्लोरोथायज़ाइड लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

It may be necessary to reduce the EQUETRO dose if used concomitantly with inhibitors of CYP3A4 and/or epoxide hydrolase. (कार्बामाज़ेपिन लेबल, दवाओं के इंटरैक्शन)

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. (कैनाग्लिफ्लोज़िन लेबल, दवाओं के इंटरैक्शन)

• Strong inducer of CYP3A4 or CYP2C19: Consider dose increase of EPIDIOLEX. (कैनाबिडियोल (प्रिस्क्रिप्शन दवा) लेबल, दवाओं के इंटरैक्शन)

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. (कैस्पोफंगिन लेबल, दवाओं के इंटरैक्शन)

Inhibitors of CYP3A4 and CYP3A5 Inhibitors of CYP3A4 and/or CYP3A5 may increase plasma concentrations of clindamycin [ see Clinical Pharmacology (12.3) ]. (क्लिंडामाइसिन लेबल, दवाओं के इंटरैक्शन)

Examples Moderate inhibitor : diltiazem Strong inhibitors : ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir Strong CYP3A4 Inducers Clinical Impact Substantially decreased exposure of aprepitant in patients chronically taking a strong CYP3A4 inducer may decrease the efficacy of CINVANTI [see Clinical Pharmacology (12.3)… (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

…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. (क्लोमिप्रामिन लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Although a causal relationship between a specific drug and the arrhythmia was not established in this case, erythromycin is a CYP3A4 inhibitor and has been shown to increase quinine plasma levels when used concomitantly. (क्विनीन लेबल, चेतावनियां और सावधानियां)

• Concomitant use of strong CYP3A4 inhibitors: Reduce quetiapine dose to one‑sixth when coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) ( 2.5 , 7.1 , 12.3 ) (क्वेटियापिन लेबल, दवाओं के इंटरैक्शन)

…Interactions: Effect of other Drugs on INTUNIV Concomitant Drug Name or Drug Class Clinical Rationale and Magnitude of Drug Interaction Clinical Recommendation Strong and moderate CYP3A4 inhibitors, e.g., ketoconazole, fluconazole Guanfacine is primarily metabolized by CYP3A4 and its plasma concentrations can be significantly affected resulting in an increase… (ग्वानफेसिन लेबल, दवाओं के इंटरैक्शन)

As zafirlukast is known to be an inhibitor of CYP3A4 in vitro , it is reasonable to employ appropriate clinical monitoring when these drugs are coadministered with zafirlukast. (ज़ाफिरलुकास्ट लेबल, सावधानियां)

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. (ज़िप्रासिडोन लेबल, दवाओं के इंटरैक्शन)

• CYP3A4 Inducer: Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer. (जेफिटिनिब लेबल, दवाओं के इंटरैक्शन)

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%. (ज़ेलेप्लॉन लेबल, दवाओं के इंटरैक्शन)

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 )] . (ज़ोनिसामाइड लेबल, दवाओं के इंटरैक्शन)

Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (टर्बिनाफिन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (टिनिडाज़ोल लेबल, दवाओं के इंटरैक्शन)

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 ). (टियागाबिन लेबल, चेतावनियां)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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. (टेम्सिरोलिमस लेबल, चेतावनियां और सावधानियां)

CYP3A4 Inhibitors Co-administration of a 180 mg daily dose of diltiazem with 5 mg amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. (टेल्मिसार्टन और एम्लोडिपिन लेबल, दवाओं के इंटरैक्शन)

The risk for nephrotoxicity may increase when ASTAGRAF XL is concomitantly administered with CYP3A inhibitors (by increasing tacrolimus whole blood concentrations) or drugs associated with nephrotoxicity (e.g., aminoglycosides, ganciclovir, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors). (टैक्रोलिमस लेबल, चेतावनियां और सावधानियां)

…Physicians should be aware that CIALIS for once daily use provides continuous plasma tadalafil levels and should consider this when evaluating the potential for interactions with medications (e.g., nitrates, alpha-blockers, anti-hypertensives and potent inhibitors of CYP3A4) and with substantial consumption of alcohol [see Drug Interactions ( 7.1 , 7.2 , 7.3 )] . (टैडालाफिल लेबल, चेतावनियां और सावधानियां)

Concomitant use of CYP2C9 inducers (e.g., rifampin) increase torsemide clearance and decrease plasma torsemide concentrations. (टॉरसेमाइड लेबल, दवाओं के इंटरैक्शन)

Table 7: Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention Dosage modification of XELJANZ/XELJANZ XR is recommended [see Dosage and Administration (2) , Clinical Pharmacology, Figure 3 (12.3) ] Moderate… (टोफासिटिनिब लेबल, दवाओं के इंटरैक्शन)

Drug Interactions CYP3A4 Inhibitors Ketoconazole, an inhibitor of the drug metabolizing enzyme CYP3A4, significantly increased plasma concentrations of tolterodine when coadministered to subjects who were poor metabolizers (see CLINICAL PHARMACOLOGY, Variability in Metabolism and Drug-Drug Interactions ). (टोल्टेरोडिन लेबल, दवाओं के इंटरैक्शन)

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

Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (ट्रेप्रोस्टिनिल लेबल, चेतावनियां और सावधानियां)

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. (डाइक्लोफेनाक लेबल, दवाओं के इंटरैक्शन)

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. (डाइक्लोफेनाक और मिसोप्रोस्टोल लेबल, दवाओं के इंटरैक्शन)

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. (डाइवैल्प्रोएक्स (वैल्प्रोएट) लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Initiation of medications that inhibit or induce CYP3A may increase or decrease concentrations of PREZISTA/ritonavir, respectively. (डारुनाविर लेबल, चेतावनियां और सावधानियां)

Use of CINVANTI with strong or moderate CYP3A4 inhibitors (e.g., ketoconazole, diltiazem) may increase plasma concentrations of aprepitant and result in an increased risk of adverse reactions related to CINVANTI. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

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) ] . (डेक्सलैंसोप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

Closely monitor patients for signs of reduced effectiveness when deferasirox is administered with drugs metabolized by CYP3A4 (e.g., alfentanil, aprepitant, budesonide, buspirone, conivaptan, cyclosporine, darifenacin, darunavir, dasatinib, dihydroergotamine, dronedarone, eletriptan, eplerenone, ergotamine, everolimus, felodipine, fentanyl, hormonal contraceptive… (डेफेरासिरोक्स लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

CYP3A4 Inhibitors The systemic exposure of darifenacin from darifenacin extended-release tablets is increased in the presence of CYP3A4 inhibitors. (डैरिफेनासिन लेबल, दवाओं के इंटरैक्शन)

Examples Glutethimide and phenobarbital Intervention If a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of doxercalciferol may be necessary. (डॉक्सरकैल्सिफेरॉल लेबल, दवाओं के इंटरैक्शन)

Strong cytochrome P450 (CYP) 3A inhibitors may increase exposure to doxazosin and increased risk of hypotension. (डॉक्साज़ोसिन लेबल, दवाओं के इंटरैक्शन)

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… (डोफेटिलाइड लेबल, दवाओं के इंटरैक्शन)

Inhibitors and Inducers of CYP2C9 and CYP3A4 : May alter dronabinol systemic exposure; monitor for dronabinol-related adverse reactions or loss of efficacy. (ड्रोनाबिनोल लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

DRUG INTERACTIONS Hepatic microsomal enzyme inducing agents, such as carbamazepine, were found to significantly increase the clearance of thiothixene. (थायोथिक्सीन लेबल, दवाओं के इंटरैक्शन)

Coadministration of P-gp and CYP3A4 inhibitors may increase nintedanib exposure. (निंटेडानिब लेबल, दवाओं के इंटरैक्शन)

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) ]. (नेप्रोक्सेन और एसोमेप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

Examples Moderate inhibitor : diltiazem Strong inhibitors : ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir Strong CYP3A4 Inducers Clinical Impact Substantially decreased exposure of aprepitant in patients chronically taking a strong CYP3A4 inducer may decrease the efficacy of CINVANTI [see Clinical Pharmacology (12.3)… (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Strong CYP3A4 Inducers: Decreased exposure of WAKIX; consider dosage adjustment of WAKIX ( 2.6 , 7.1 ) (पिटोलिसेंट लेबल, दवाओं के इंटरैक्शन)

Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. (पेरैम्पेनल लेबल, दवाओं के इंटरैक्शन)

Exposure of Paricalcitol Injection will increase upon coadministration with strong CYP3A inhibitors [see Clinical Pharmacology (12.3) ] . (पैरिकैल्सिटोल लेबल, दवाओं के इंटरैक्शन)

Published clinical reports indicate primaquine may inhibit CYP3A4 enzyme activity and thus may lead to increased exposure of oral CYP3A4 substrate drugs when co-administered with Primaquine phosphate Tablets. (प्राइमाक्वीन लेबल, दवाओं के इंटरैक्शन)

CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (प्रेडनिसोन लेबल, दवाओं के इंटरैक्शन)

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. (प्रेडनिसोलोन लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Phenobarbital Clinical Impact: Chronic administration of phenobarbital, a known enzyme inducer, may be associated with a decrease in the plasma half-life of fenoprofen. (फेनोप्रोफेन लेबल, दवाओं के इंटरैक्शन)

Coadministration of CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine) with felodipine may lead to several-fold increases in the plasma levels of felodipine, either due to an increase in bioavailability or due to a decrease in metabolism. (फेलोडिपिन लेबल, दवाओं के इंटरैक्शन)

Initiation of medications that inhibit or induce CYP3A may increase or decrease concentrations of fosamprenavir calcium/ritonavir, respectively. (फोसएम्प्रेनाविर लेबल, चेतावनियां और सावधानियां)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (फ्लुवोक्सामिन लेबल, चेतावनियां और सावधानियां)

Limited data in patients receiving known enzyme inducers ( phenytoin, phenobarbital, carbamazepine ) indicate only a 30% increase in the rate of flecainide elimination. (फ्लेकेनाइड लेबल, दवाओं के इंटरैक्शन)

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. (बस्पिरोन लेबल, दवाओं के इंटरैक्शन)

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

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (बुडेसोनाइड और फॉर्मोटेरोल लेबल, चेतावनियां और सावधानियां)

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 )]. (बेक्साग्लिफ्लोज़िन लेबल, दवाओं के इंटरैक्शन)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (ब्यूप्रेनॉर्फिन और नालोक्सोन लेबल, दवाओं के इंटरैक्शन)

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. (ब्रेक्सपिप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Methylprednisolone Clinical Impact Increased methylprednisolone exposure [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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) ] . (मिर्टाज़ापिन लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Ketoconazole (Potent Inhibitor of CYP3A4) Coadministration of a single 500 mg oral dose of mefloquine with 400 mg of ketoconazole once daily for 10 days in 8 healthy volunteers resulted in an increase in the mean C max and AUC of mefloquine by 64% and 79%, respectively, and an increase in the mean elimination half-life of mefloquine from 322 hours to 448 hours. (मेफ्लोक्वीन लेबल, दवाओं के इंटरैक्शन)

Inducers of CYP3A4 (e.g., phenytoin, carbamazepine, dexamethasone, rifampin, and phenobarbital) could increase the rate of elimination of donepezil. (मेमेंटिन और डोनेपेज़िल लेबल, दवाओं के इंटरैक्शन)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (मोमेटासोन लेबल, चेतावनियां और सावधानियां)

Drug Interactions with Strong Cytochrome P450 3A4 Inhibitors Caution should be exercised when considering the coadministration of Umeclidinium and Vilanterol ELLIPTA with ketoconazole and other known strong cytochrome P450 3A4 (CYP3A4) inhibitors (including, but not limited to, ritonavir, clarithromycin, conivaptan, indinavir, itraconazole, lopinavir, nefazodone,… (यूमेक्लिडिनियम और विलैंटेरोल लेबल, चेतावनियां और सावधानियां)

Strong CYP3A4 Inhibitors: Reduce, interrupt, or discontinue JAKAFI/JAKAFI XR doses as recommended except in patients with acute or chronic graft-versus-host-disease. (रक्सोलिटिनिब लेबल, दवाओं के इंटरैक्शन)

Examples Moderate inhibitor : diltiazem Strong inhibitors : ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir Strong CYP3A4 Inducers Clinical Impact Substantially decreased exposure of aprepitant in patients chronically taking a strong CYP3A4 inducer may decrease the efficacy of CINVANTI [see Clinical Pharmacology (12.3)… (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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. (रिफाब्यूटिन लेबल, दवाओं के इंटरैक्शन)

Use of CINVANTI with strong CYP3A4 inducers (e.g., rifampin) may result in a reduction in aprepitant plasma concentrations and decreased efficacy of CINVANTI. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Coadministration of EDURANT or EDURANT PED and drugs that induce CYP3A may result in decreased plasma concentrations of rilpivirine and loss of virologic response and possible resistance to rilpivirine or to the class of NNRTIs. (रिल्पिविरिन लेबल, दवाओं के इंटरैक्शन)

Carbamazepine and other enzyme inducers decrease plasma concentrations of risperidone. (रिस्पेरिडोन लेबल, दवाओं के इंटरैक्शन)

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). (रुफिनामाइड लेबल, दवाओं के इंटरैक्शन)

CYP2C8 and CYP3A4 Inhibitors Intervention: Repaglinide tablets dose reductions and increased frequency of glucose monitoring may be required when co‑administered. (रेपाग्लिनाइड लेबल, दवाओं के इंटरैक्शन)

Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (रैमेल्टियॉन लेबल, दवाओं के इंटरैक्शन)

Coadministration of a selective and potent inhibitor of CYP3A4, ketoconazole (100 mg bid for 2 days with ropivacaine infusion administered 1 hour after ketoconazole) caused a 15% reduction in in vivo plasma clearance of ropivacaine. (रोपिवाकेन लेबल, दवाओं के इंटरैक्शन)

Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (लिनाग्लिप्टिन लेबल, दवाओं के इंटरैक्शन)

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. (लिनाग्लिप्टिन और मेटफॉर्मिन लेबल, दवाओं के इंटरैक्शन)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Hormonal Contraceptives : Efficacy of contraceptives may be reduced during and for 28 days following administration of aprepitant. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (लेवोमिल्नासिप्रान लेबल, दवाओं के इंटरैक्शन)

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) ] . (लैंसोप्राज़ोल लेबल, दवाओं के इंटरैक्शन)

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. (लैकोसामाइड लेबल, दवाओं के इंटरैक्शन)

Examples Moderate inhibitor : diltiazem Strong inhibitors : ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir Strong CYP3A4 Inducers Clinical Impact Substantially decreased exposure of aprepitant in patients chronically taking a strong CYP3A4 inducer may decrease the efficacy of CINVANTI [see Clinical Pharmacology (12.3)… (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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. (लोपेरामाइड लेबल, दवाओं के इंटरैक्शन)

Benzodiazepines Clinical Impact Increased exposure to midazolam or other benzodiazepines metabolized via CYP3A4 (alprazolam, triazolam) may increase the risk of adverse reactions [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

Warfarin (a CYP2C9 substrate) : Risk of decreased INR of prothrombin time; monitor INR in 2–week period, particularly at 7 to 10 days, following initiation of CINVANTI. (एप्रेपिटेंट लेबल, चेतावनियां और सावधानियां)

Potential for Drug Interactions with Strong or Moderate CYP3A4 Inhibitors Concomitant administration with strong CYP3A4 inhibitors (such as ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (such as erythromycin) increases plasma concentrations of vardenafil. (वार्डेनाफिल लेबल, चेतावनियां और सावधानियां)

Inhibitors of CYP3A4: May cause earlier onset and/or increased severity of adverse reactions ( 7.1 ) (विनोरेल्बिन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 Inhibitors: The VIIBRYD dose should not exceed 20 mg once daily when co-administered with strong CYP3A4 inhibitors ( 2.4 , 7 ). (विलाज़ोडोन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 Substrates Clinical Impact Viloxazine is a weak inhibitor of CYP3A4 which increases the exposure of CYP3A4 substrates when coadministered [see Clinical Pharmacology (12.3) ]. (विलोक्साज़िन लेबल, दवाओं के इंटरैक्शन)

Concomitant use of CYP3A4 inhibitors and venlafaxine may increase levels of venlafaxine and ODV. (वेनलाफैक्सिन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inducers decrease verapamil levels ( 7.1 ) (वेरापामिल लेबल, दवाओं के इंटरैक्शन)

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. (वैल्प्रोइक एसिड लेबल, दवाओं के इंटरैक्शन)

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

Co-administration with a strong CYP3A4 inhibitor may increase serum levels of cinacalcet. (सिनाकैल्सेट लेबल, दवाओं के इंटरैक्शन)

Inhibitors of CYP3A4 or CYP2C19 Inhibitors of CYP3A4 Coadministration of strong (e.g., ketoconazole) and moderate (e.g., erythromycin, diltiazem and grapefruit juice) CYP3A4 inhibitors can increase exposure to cilostazol. (सिलोस्टाज़ोल लेबल, दवाओं के इंटरैक्शन)

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure. (सिल्डेनाफिल लेबल, दवाओं के इंटरैक्शन)

Monitor QT interval more frequently when SUTENT is concomitantly administered with strong CYP3A4 inhibitors or drugs known to prolong QT interval. (सुनिटिनिब लेबल, चेतावनियां और सावधानियां)

The recommended dose of BELSOMRA is 5 mg in subjects receiving moderate CYP3A inhibitors (e.g., amprenavir, aprepitant, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, imatinib, verapamil). (सुवोरेक्सेंट लेबल, दवाओं के इंटरैक्शन)

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. (सेलेकॉक्सिब लेबल, दवाओं के इंटरैक्शन)

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (सेलेजिलिन लेबल, दवाओं के इंटरैक्शन)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (सैक्साग्लिप्टिन लेबल, दवाओं के इंटरैक्शन)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (सैक्साग्लिप्टिन और मेटफॉर्मिन लेबल, दवाओं के इंटरैक्शन)

Concomitant administration of inhibitors of CYP3A4 may lead to increases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions associated with the use of excessive doses. (हाइड्रोकॉर्टिसोन लेबल, दवाओं के इंटरैक्शन)

The effect of CYP3A4 inhibition and of decreased CYP2D6 enzyme may be additive. (हेलोपेरिडोल लेबल, दवाओं के इंटरैक्शन)

TAF is a weak inhibitor of CYP3A in vitro . (एमट्रिसिटाबिन और टेनोफोविर लेबल, दवाओं के इंटरैक्शन)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (एरिबुलिन लेबल, दवाओं के इंटरैक्शन)

Drugs Metabolized by CYP3A — In vitro studies utilizing human liver microsomes suggest that olanzapine has little potential to inhibit CYP3A. (ओलैंज़ापिन और फ्लुओक्सेटिन लेबल, दवाओं के इंटरैक्शन)

Examples ondansetron, granisetron, dolasetron 7.2 Effect of Other Drugs on the Pharmacokinetics of Aprepitant Aprepitant is a CYP3A4 substrate [see Clinical Pharmacology (12.3) ] . (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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. (ग्लिसरॉल फिनाइलब्यूटिरेट लेबल, दवाओं के इंटरैक्शन)

However, no formal drug-drug interaction studies between zileuton and CYP3A4 inhibitors, such as ketaconazole, have been conducted. (ज़ाइल्यूटॉन लेबल, दवाओं के इंटरैक्शन)

Drug Interactions If phenytoin or other hepatic enzyme inducers are taken concurrently with Norpace or Norpace CR, lower plasma levels of disopyramide may occur. (डाइसोपाइरामाइड लेबल, दवाओं के इंटरैक्शन)

The effect of potent CYP3A4 inhibitors on dutasteride has not been studied. (ड्यूटास्टेराइड लेबल, दवाओं के इंटरैक्शन)

Effects of Noxafil and Noxafil PowderMix on Other Drugs Posaconazole is a strong CYP3A4 inhibitor. (पोसाकोनाज़ोल लेबल, दवाओं के इंटरैक्शन)

Examples rifampin, carbamazepine, phenytoin (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

An in vitro study using human liver microsomes suggests that famciclovir is not an inhibitor of CYP3A4 enzymes. (फैमसिक्लोविर लेबल, दवाओं के इंटरैक्शन)

Additionally, in vitro studies have shown ketoconazole, a potent inhibitor of CYP3A4 activity, to be at least 100 times more potent than fluoxetine or norfluoxetine as an inhibitor of the metabolism of several substrates for this enzyme, including astemizole, cisapride, and midazolam. (फ्लुओक्सेटिन लेबल, दवाओं के इंटरैक्शन)

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. (मेक्सिलेटिन लेबल, दवाओं के इंटरैक्शन)

CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (रिफैक्सिमिन लेबल, दवाओं के इंटरैक्शन)

Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (रियोसिगुआट लेबल, दवाओं के इंटरैक्शन)

Etoposide, vinorelbine, paclitaxel, and docetaxel No dosage adjustment needed. (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

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). (एसेनापिन लेबल, दवाओं के इंटरैक्शन)

Inhibitors of Cytochrome P450 3A4 In controlled clinical studies co-administration of desloratadine with ketoconazole, erythromycin, or azithromycin resulted in increased plasma concentrations of desloratadine and 3 hydroxydesloratadine, but there were no clinically relevant changes in the safety profile of desloratadine. [See Clinical Pharmacology (12.3) .]… (डेसलोराटाडीन लेबल, दवाओं के इंटरैक्शन)

Etoposide, vinorelbine, paclitaxel, and docetaxel No dosage adjustment needed. (एप्रेपिटेंट लेबल, दवाओं के इंटरैक्शन)

CYP2C19 and CYP3A4 Inducer Co-administration of Micafungin in Sodium Chloride Injection with rifampin and ritonavir did not alter the pharmacokinetics of micafungin. (माइकाफंगिन लेबल, दवाओं के इंटरैक्शन)

…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) ]. (मोंटेलुकास्ट लेबल, दवाओं के इंटरैक्शन)

Other HIV Protease Inhibitors (CYP3A4 Inhibition) In Vivo Studies Showed No Significant Effects of Indinavir on Voriconazole Exposure In Vitro Studies Demonstrated Potential for Inhibition of Voriconazole Metabolism (Increased Plasma Exposure) No dosage adjustment in the voriconazole dosage needed for concomitant administration with indinavir. (वोरिकोनाज़ोल लेबल, दवाओं के इंटरैक्शन)