Interaksi Efavirenz

CYP3A4 Inducers: Avoid concomitant strong CYP3A4 inducers during YONSA treatment. (label Abirateron, Interaksi obat)

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs alone or in combination with other antiretrovirals [See Warnings and Precautions (5. (label Adefovir, Peringatan kotak hitam)

• CYP3A Inhibitors: Avoid co-administration with strong CYP3A inhibitors. (label Akalabrutinib, Interaksi obat)

Moderate CYP3A4/5 inducers (e.g., bosentan, efavirenz, etravirine, modafinil, and nafcillin) may also reduce the plasma exposure of axitinib and should be avoided if possible. (label Aksitinib, Interaksi obat)

…(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… (label Alfuzosin, Kontraindikasi)

Concomitant use of almotriptan tablets and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment [see Clinical Pharmacology ( 12.3 )] . (label Almotriptan, Interaksi obat)

CYP3A4 Inducers : Avoid coadministration of VIJOICE with a strong CYP3A4 inducer. (label Alpelisib, Interaksi obat)

• 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) ] . (label Alprazolam, Kontraindikasi)

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

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 ) (label Apremilast, Peringatan dan perhatian)

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

CYP3A4 Inducers : Avoid concomitant use for greater than 14 days ( 7.1 ) (label Aripiprazol, Interaksi obat)

Treatment-experienced patients: Coadministration of efavirenz and atazanavir is not recommended. (label Efavirenz, Interaksi obat)

Do not use avanafil in patients taking strong CYP3A4 inhibitors [see Warnings and Precautions ( 5.2 ) and Dosage and Administration ( 2.3 )]. (label Avanafil, Interaksi obat)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

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

Strong CYP3A4 Inducers: Avoid concomitant use. (label Bortezomib, Interaksi obat)

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

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (label Bosutinib, Interaksi obat)

Concomitant use of strong CYP3A4 inhibitors (e.g., azole antimycotics, HIV protease inhibitors) with CYCLOSET should be avoided. (label Bromokriptin, Interaksi obat)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (label Buprenorfin, Interaksi obat)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (label Butalbital, aspirin, kafein, dan kodein, Peringatan kotak hitam)

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. (label Butalbital, parasetamol, kafein, dan kodein, Peringatan kotak hitam)

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

Strong CYP3A4 inhibitors: Avoid concomitant use. (label Daridoreksant, Interaksi obat)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

Avoid concomitant use of strong CYP3A4 inhibitors. (label Dasatinib, Interaksi obat)

Avoid use of moderate or strong CYP3A4 inducers with EMFLAZA, as they may reduce efficacy ( 7.1 ) (label Deflazakort, Interaksi obat)

• Avoid concomitant use of strong CYP3A4 inhibitors or inducers. (label Deksametason, Interaksi obat)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (label Dekstrometorfan dan kuinidin, Peringatan dan perhatian)

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. (label Dihidroergotamin, Peringatan kotak hitam)

• Avoid concomitant use of doxorubicin hydrochloride with inhibitors and inducers of CYP3A4, CYP2D6, and/or P-gp ( 7.1 ) (label Doksorubisin, Interaksi obat)

HIV Antiviral Agents efavirenz etravirine nevirapine ↓ doravirine Use with efavirenz, etravirine, or nevirapine is not recommended. (label Doravirin, Interaksi obat)

Concomitant use of Docetaxel Injection and drugs that inhibit CYP3A4 may increase exposure to docetaxel and should be avoided. (label Dosetaksel, Interaksi obat)

• CYP3A inducers: Avoid concomitant use. (label Dronedaron, Interaksi obat)

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) ]. (label Dutasterid dan tamsulosin, Peringatan dan perhatian)

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

Lactic Acidosis and Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs and other antiretrovirals. (label Efavirenz, lamivudin, dan tenofovir, Peringatan dan perhatian)

Therefore, concomitant use with strong CYP3A inducers is not recommended [see Drug Interactions (7.1) and Clinical Pharmacology (12.3) ] . (label Eleksakaftor, tezakaftor, dan ivakaftor, Peringatan dan perhatian)

• 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) ]. (label Eletriptan, Kontraindikasi)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

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

Therapy with BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also receiving highly active antiretroviral therapy (HAART) [see Warnings and Precautions (5.2) ] . (label Entekavir, Peringatan kotak hitam)

…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)… (label Eplerenon, Kontraindikasi)

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. (label Ergotamin dan kafein, Peringatan kotak hitam)

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). (label Erlotinib, Interaksi obat)

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

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) ] . (label Ezetimib dan simvastatin, Kontraindikasi)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (label Fentanil, Peringatan kotak hitam)

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) ]. (label Fesoterodin, Interaksi obat)

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) ] . (label Flibanserin, Peringatan kotak hitam)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (label Flutikason, Interaksi obat)

Avoid strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): May increase risk of systemic corticosteroid and cardiovascular effects. (label Flutikason dan salmeterol, Interaksi obat)

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

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

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

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. (label Hidrokodon, Peringatan kotak hitam)

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. (label Hidrokodon dan homatropin, Peringatan kotak hitam)

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. (label Hidrokodon dan ibuprofen, Peringatan kotak hitam)

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. (label Hidrokodon dan klorfeniramin, Peringatan kotak hitam)

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. (label Hidrokodon dan parasetamol, Peringatan kotak hitam)

Increased Toxicity with Concomitant Use of Antiretroviral Drugs Pancreatitis Pancreatitis (including fatal cases) have occurred in patients with HIV infection during therapy with hydroxyurea and didanosine, with or without stavudine. (label Hidroksiurea, Interaksi obat)

• Strong CYP3A4 Inducers: Do not administer strong CYP3A4 inducers with CAMPTOSAR. (label Irinotekan, Interaksi obat)

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

…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 ) (label Ivabradin, Kontraindikasi)

Coadministration with other antiretroviral medications for PrEP is not recommended. (label Kabotegravir, Interaksi obat)

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… (label Kabozantinib, Interaksi obat)

Intervention: Concomitant use of VRAYLAR with a CYP3A4 inducer is not recommended [see Dosage and Administration ( 2.1 , 2.6 ) ] . (label Kariprazin, Interaksi obat)

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

Antiviral and antiretroviral drugs: Avoid concomitant use. (label Kladribin, Interaksi obat)

CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole. (label Klopidogrel, Peringatan dan perhatian)

• Concomitant use of Strong CYP3A4 Inducers is not recommended. (label Klozapin, Interaksi obat)

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. (label Kodein, Peringatan kotak hitam)

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) ] . (label Kolkisin, Kontraindikasi)

Avoid strong CYP3A4 inhibitors. (label Lapatinib, Interaksi obat)

Strong CYP3A4 Inhibitors: Avoid coadministration of strong CYP3A4 inhibitors with VITRAKVI. (label Larotrektinib, Interaksi obat)

Velpatasvir/ Sofosbuvir ↓ velpatasvir Coadministration of efavirenz and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (label Efavirenz, Interaksi obat)

Strong or moderate CYP3A inhibitors: Avoid concomitant use. (label Lemboreksant, Interaksi obat)

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

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) ]. (label Lomitapid, Kontraindikasi)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

• Strong CYP3A Inhibitors : Avoid concomitant use; reduce LORBRENA dose if concomitant use cannot be avoided. (label Lorlatinib, Interaksi obat)

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 ). (label Lovastatin, Kontraindikasi)

CYP3A4 inducers: Avoid concomitant use with CAPLYTA. (label Lumateperon, Interaksi obat)

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole, mibefradil, etc.) [see Drug Interactions ( 7.1 )]. (label Lurasidon, Kontraindikasi)

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 )]. (label Maravirok, Kontraindikasi)

Strong CYP3A4 inducers (rifampin) reduce exposure to macitentan: avoid co-administration with OPSUMIT ( 7.1 , 12.3 ). (label Masitentan, Interaksi obat)

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. (label Metilergometrin, Interaksi obat)

CYP3A inducers: Do not use mifepristone with CYP3A inducers ( 7.3 ). (label Mifepriston, Interaksi obat)

Strong CYP3A Inhibitors and Inducers: Avoid concomitant use. (label Mitapivat, Interaksi obat)

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. (label Naldemedin, Interaksi obat)

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… (label Naloksegol, Kontraindikasi)

CYP2B6 Inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) may reduce efficacy by reducing bupropion exposure, avoid concomitant use. (label Naltrekson dan bupropion, Interaksi obat)

Co-administration of nevirapine and efavirenz is not recommended as this combination has been associated with an increase in adverse reactions and no improvement in efficacy. (label Nevirapin, Peringatan dan perhatian)

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 ). (label Nifedipin, Interaksi obat)

Avoid use of concomitant drugs known to prolong the QT interval and strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 , 7.2 )] . (label Nilotinib, Peringatan kotak hitam)

Therefore, the concomitant administration of NYMALIZE and strong CYP3A4 inhibitors should generally be avoided [ see Warnings and Precautions (5.3) ]. (label Nimodipin, Interaksi obat)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

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. (label Nisoldipin, Interaksi obat)

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 ) (label Noretisteron dan etinilestradiol, Interaksi obat)

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. (label Oksikodon, Peringatan kotak hitam)

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. (label Oksikodon dan parasetamol, Peringatan kotak hitam)

If a CYP3A4 inducer is discontinued, consider OLINVYK dosage reduction and monitor for signs of respiratory depression. (label Oliseridin, Interaksi obat)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (label Palbosiklib, Interaksi obat)

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. (label Paliperidon, Interaksi obat)

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. (label Parasetamol dan kodein, Peringatan kotak hitam)

Strong CYP3A4 Inhibitors : Avoid coadministration of VOTRIENT with strong CYP3A4 inhibitors. (label Pazopanib, Interaksi obat)

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. (label Petidin, Peringatan kotak hitam)

Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID. (label Pimavanserin, Interaksi obat)

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

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

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. (label Prometazin dan kodein, Peringatan kotak hitam)

• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 (CYP2D6) inhibitor and a 3A4 inhibitor (CYP3A4). (label Propafenon, Peringatan dan perhatian)

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) (label Ranolazin, Kontraindikasi)

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

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

• Strong CYP3A4 Inhibitors: Avoid concomitant administration. (label Rimegepant, Interaksi obat)

• Certain CYP3A inducers: Coadministration with strong inducers of CYP3A is not recommended. (label Ritlesitinib, Interaksi obat)

Protease inhibitor: Lopinavir/ritonavir ↓ lopinavir * Lopinavir/ritonavir once daily dosing is not recommended when coadministered with efavirenz. (label Efavirenz, Interaksi obat)

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

• Drug Interactions: Use with strong cytochrome P450 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin) is not recommended. (label Roflumilast, Peringatan dan perhatian)

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

• Avoid use with rifampin and strong CYP3A4 inducers ( 7.3 ). (label Romidepsin, Interaksi obat)

• Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (label Salmeterol, Interaksi obat)

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… (label Silodosin, Kontraindikasi)

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) ] . (label Simvastatin, Kontraindikasi)

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) ]. (label Sirolimus, Peringatan dan perhatian)

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

Velpatasvir/ Sofosbuvir ↓ velpatasvir Coadministration of efavirenz and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir. (label Efavirenz, Interaksi obat)

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 )] . (label Solifenasin, Interaksi obat)

• Strong CYP3A Inducers: Avoid strong CYP3A4 inducers. (label Sorafenib, Interaksi obat)

St. John's wort dapat menurunkan kadar beberapa obat HIV dalam darah hingga cukup untuk menyebabkan kegagalan pengobatan. (NCCIH, St. John's Wort)

Concomitant use of JOURNAVX with strong CYP3A inhibitors is contraindicated [see Warnings and Precautions (5.1) , Drug Interactions (7.1) ] . (label Suzetrigin, Kontraindikasi)

Inducers of CYP3A4 Strong CYP3A4 inducers should not be used with tamoxifen. (label Tamoksifen, Interaksi obat)

• Should not be used in combination with strong inhibitors of CYP3A4. (label Tamsulosin, Peringatan dan perhatian)

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 ) (label Tasimelteon, Interaksi obat)

Not recommended with ATRIPLA, which contains efavirenz, emtricitabine, and tenofovir disoproxil fumarate, unless needed for dose adjustment when coadministered with rifampin. (label Efavirenz, Peringatan dan perhatian)

• Avoid use with strong CYP3A inhibitors or CYP3A inducers. (label Tikagrelor, Interaksi obat)

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 ) ] . (label Tiotepa, Interaksi obat)

…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… (label Tolvaptan, Kontraindikasi)

Drugs known to prolong the QT interval and strong CYP3A4 inhibitors should be avoided [see Warnings and Precautions (5.1) ] . (label Toremifen, Peringatan kotak hitam)

CYP3A inhibitors: Avoid concomitant strong CYP3A inhibitors ( 7.1 ) (label Trabektedin, Interaksi obat)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (label Tramadol, Peringatan kotak hitam)

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. (label Tramadol dan parasetamol, Peringatan kotak hitam)

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… (label Trazodon, Peringatan dan perhatian)

• Strong CYP3A Inhibitors and Inducers: Avoid coadministration with strong CYP3A inhibitors and inducers. (label Tretinoin, Interaksi obat)

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) ] . (label Triazolam, Peringatan dan perhatian)

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. (label Ubrogepant, Kontraindikasi)

Ella should not be administered with CYP3A4 inducers [see Drug interactions (7.1) and Clinical Pharmacology (12.3) ] . (label Ulipristal, Peringatan dan perhatian)

Strong CYP3A4 Inducers : Coadministration of RINVOQ/RINVOQ LQ with strong CYP3A4 inducers is not recommended. (label Upadasitinib, Interaksi obat)

Use of strong CYP3A4 inducers with INGREZZA or INGREZZA SPRINKLE Concomitant use is not recommended. (label Valbenazin, Interaksi obat)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (label Vepdegestrant, Peringatan dan perhatian)

Therefore, the concomitant use of strong CYP3A inhibitors with vincristine sulfate should be avoided. (label Vinkristin, Interaksi obat)

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

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

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including zidovudine and other antiretrovirals. (label Zidovudin, Peringatan kotak hitam)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Patients receiving efavirenz should be alerted to the potential for additive central nervous system effects when efavirenz is used concomitantly with alcohol or psychoactive drugs. (label Efavirenz, Peringatan dan perhatian)

CYP3A4 inhibitors: Use with caution in combination due to increased exposure of alosetron. (label Alosetron, Interaksi obat)

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

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

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

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

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

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

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (label Efavirenz, Interaksi obat)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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 )]. (label Beksagliflozin, Interaksi obat)

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

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. (label Brekspiprazol, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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… (label Budesonid, Peringatan dan perhatian)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (label Budesonid dan formoterol, Peringatan dan perhatian)

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

Bupropion dose should not exceed the maximum recommended dose. (label Efavirenz, Interaksi obat)

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. (label Buspiron, Interaksi obat)

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

CYP3A4 Inhibitors The systemic exposure of darifenacin from darifenacin extended-release tablets is increased in the presence of CYP3A4 inhibitors. (label Darifenasin, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with dexlansoprazole may reduce antiviral effect and promote the development of drug resistance . (label Dekslansoprazol, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (label Desogestrel dan etinilestradiol, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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. (label Diklofenak, Interaksi obat)

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. (label Diklofenak dan misoprostol, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Strong cytochrome P450 (CYP) 3A inhibitors may increase exposure to doxazosin and increased risk of hypotension. (label Doksazosin, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Examples Glutethimide and phenobarbital Intervention If a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of doxercalciferol may be necessary. (label Dokserkalsiferol, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

Monitor for increased dronabinol-related adverse reactions when dronabinol oral solution is co-administered with inhibitors of CYP2C9 (e.g., amiodarone, fluconazole) and inhibitors of CYP3A4 enzymes (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, erythromycin, grapefruit juice). (label Dronabinol, Interaksi obat)

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

Consider monitoring serum potassium concentration in high-risk patients who take a strong CYP3A4 inhibitor long-term and concomitantly. (label Drospirenon dan etinilestradiol, Peringatan dan perhatian)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Strong CYP 3A4 inducers: Concomitant use of strong CYP 3A4 inducers decreases exemestane exposure. (label Eksemestan, Interaksi obat)

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

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

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Inhibitors of CYP3A4 such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may increase plasma concentrations of estrogens and may result in side effects. (label Estradiol, Interaksi obat)

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

Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism and decrease or increase the estrogen plasma concentration. (label Estradiol dan noretisteron, Interaksi obat)

Concomitant administration of itraconazole, a strong CYP3A4 inhibitor, with DUAVEE, resulted in increases in bazedoxifene exposure (40%) and, to a lesser extent, conjugated estrogens exposure (9% for baseline-adjusted total estrone, 5% for total equilin), compared to DUAVEE alone [see Pharmacokinetics (12.3) ] . (label Estrogen terkonjugasi dan bazedoksifen, Interaksi obat)

The dose of LUNESTA should be reduced in patients who are administered potent inhibitors of CYP3A4, such as ketoconazole, while taking LUNESTA. (label Eszopiklon, Peringatan dan perhatian)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Decreased exposure of etonogestrel may be expected. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Concomitant use of Etravirine with efavirenz or nevirapine may cause a significant decrease in the plasma concentrations of etravirine and loss of therapeutic effect of Etravirine. (label Etravirin, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Phenobarbital Clinical Impact: Chronic administration of phenobarbital, a known enzyme inducer, may be associated with a decrease in the plasma half-life of fenoprofen. (label Fenoprofen, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

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

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

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

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

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (label Efavirenz, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

• CYP3A4 Inducer: Increase IRESSA to 500 mg daily in patients receiving a strong CYP3A4 inducer. (label Gefitinib, Interaksi obat)

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

…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… (label Guanfasin, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

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. (label Hidrokortison, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

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

• CYP3A4 Inducers: Monitor for increased toxicity when used in combination with CYP3A4 inducers. (label Ifosfamid, Interaksi obat)

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

CYP3A4 inducers may decrease Gleevec C max and area under curve (AUC). (label Imatinib, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

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. (label Ivakaftor, Peringatan dan perhatian)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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. (label Kanagliflozin, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Co-administration of CYP2C19 inhibitors, such as omeprazole or fluvoxamine, with carisoprodol could result in increased exposure of carisoprodol and decreased exposure of meprobamate. (label Karisoprodol, Interaksi obat)

Amiodarone Amiodarone and its metabolite desethyl amiodarone, inhibitors of CYP2C9, and P- glycoprotein increased concentrations of the S(-)-enantiomer of carvedilol by at least 2 fold [see Clinical Pharmacology (12.5) ]. (label Karvedilol, Interaksi obat)

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

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Inhibitors of CYP3A4 and CYP3A5 Inhibitors of CYP3A4 and/or CYP3A5 may increase plasma concentrations of clindamycin [ see Clinical Pharmacology (12.3) ]. (label Klindamisin, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

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

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

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

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

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Enzyme inducers (e.g., CYP3A4) : May decrease the effectiveness of TYBLUME or increase breakthrough bleeding. (label Levonorgestrel dan etinilestradiol, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Strong P-glycoprotein/CYP3A4 inducer: The efficacy of TRADJENTA may be reduced when administered in combination (e.g., with rifampin). (label Linagliptin, Interaksi obat)

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. (label Linagliptin dan metformin, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Thus concomitant usage of CYP2C9 inhibitors (such as amiodarone, fluconazole, and sulphaphenazole) may lead to abnormally high plasma levels of meloxicam due to reduced metabolic clearance [ see Use in Specific Populations ( 8.8 ); and Clinical Pharmacology ( 12.3 , 12.5 ) ]. (label Meloksikam, Interaksi obat)

Inducers of CYP3A4 (e.g., phenytoin, carbamazepine, dexamethasone, rifampin, and phenobarbital) could increase the rate of elimination of donepezil. (label Memantin dan donepezil, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Cytochrome P450-3A4 Inhibitors: May result in prolonged sedation due to decreased plasma clearance of midazolam. (label Midazolam, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (label Mometason, Peringatan dan perhatian)

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

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

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (label Naproksen dan esomeprazol, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

…salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g., methandrostenolone), guanethidine, gymnema sylvestre, glucomannan, thioctic acid, and inhibitors of CYP2C9 (e.g., amiodarone, fluconazole, voriconazole, sulfinpyrazone) or in patients known to be poor metabolizers of CYP2C9 substrates, alcohol. (label Nateglinid, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Coadministration of P-gp and CYP3A4 inhibitors may increase nintedanib exposure. (label Nintedanib, Interaksi obat)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (label Norelgestromin dan etinilestradiol, Interaksi obat)

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

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (label Norgestimat dan etinilestradiol, Interaksi obat)

Concomitant administration of CYP3A4 inhibitors such as itraconazole, fluconazole, grapefruit juice or ketoconazole may increase plasma hormone concentrations. (label Norgestrel dan etinilestradiol, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Co-administration with strong cytochrome P450 (CYP) 3A4 inhibitors (e.g., ketoconazole) increases the systemic exposure of oxybutynin. (label Oksibutinin, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] . (label Omeprazol dan natrium bikarbonat, Interaksi obat)

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

Drug Interactions and Decreased Vitamin Absorption ORLISTAT may interact with concomitant drugs including cyclosporine, levothyroxine, warfarin, amiodarone, antiepileptic drugs, and antiretroviral drugs [see Drug Interactions (7) ]. (label Orlistat, Peringatan dan perhatian)

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

Exposure of Paricalcitol Injection will increase upon coadministration with strong CYP3A inhibitors [see Clinical Pharmacology (12.3) ] . (label Parikalsitol, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (label Efavirenz, Interaksi obat)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (label Efavirenz, Interaksi obat)

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. (label Prednisolon, Interaksi obat)

CYP 3A4 inducers and inhibitors: May, respectively, increase or decrease clearance of corticosteroids, necessitating dose adjustment. (label Prednison, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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. (label Propranolol, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

Rifampin (strong CYP enzyme inducer): Decreases exposure to and effects of ramelteon. (label Ramelteon, Interaksi obat)

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

CYP2C8 and CYP3A4 Inhibitors Intervention: Repaglinide tablets dose reductions and increased frequency of glucose monitoring may be required when co‑administered. (label Repaglinid, Interaksi obat)

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

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. (label Rilpivirin, Interaksi obat)

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

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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. (label Ropivakain, Interaksi obat)

HMG-CoA reductase inhibitors: Atorvastatin PravastatinSimvastatin ↓ atorvastatin * ↓ pravastatin * ↓ simvastatin * Plasma concentrations of atorvastatin, pravastatin and simvastatin decreased. (label Efavirenz, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Strong CYP3A4 Inhibitors: Reduce, interrupt, or discontinue JAKAFI/JAKAFI XR doses as recommended except in patients with acute or chronic graft-versus-host-disease. (label Ruksolitinib, Interaksi obat)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (label Saksagliptin, Interaksi obat)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (label Saksagliptin dan metformin, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Drugs that induce CYP3A4 (e.g., phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin) should be used with caution. (label Selegilin, Interaksi obat)

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. (label Selekoksib, Interaksi obat)

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Increases in sertraline dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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. (label Siklesonid, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure. (label Sildenafil, Interaksi obat)

Strong and moderate CYP3A4 and CYP2C19 inhibitors: Increase exposure to cilostazol. (label Silostazol, Interaksi obat)

Co-administration with a strong CYP3A4 inhibitor may increase serum levels of cinacalcet. (label Sinakalset, Interaksi obat)

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

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered. (label Efavirenz, Peringatan dan perhatian)

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

Monitor QT interval more frequently when SUTENT is concomitantly administered with strong CYP3A4 inhibitors or drugs known to prolong QT interval. (label Sunitinib, Peringatan dan perhatian)

Strong CYP3A inducers: Efficacy may be reduced ( 7.2 ). (label Suvoreksant, Interaksi obat)

…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 )] . (label Tadalafil, Peringatan dan perhatian)

Antimalarials: Artemether/lumefantrine Atovaquone/ proguanil ↓ artemether * ↓ dihydroartemisinin * ↓ lumefantrine * ↓ atovaquone ↓ proguanil Consider alternatives to artemether/ lumefantrine because of the risk of QT interval prolongation. (label Efavirenz, Interaksi obat)

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

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

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

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

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. (label Temsirolimus, Peringatan dan perhatian)

Terbinafine clearance is increased 100% by rifampin, a CYP450 enzyme inducer, and decreased 33% by cimetidine, a CYP450 enzyme inhibitor. (label Terbinafin, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

CYP3A4 inducers/inhibitors: Monitor for decreased tinidazole effect or increased adverse reactions ( 7.2 ) (label Tinidazol, Interaksi obat)

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

DRUG INTERACTIONS Hepatic microsomal enzyme inducing agents, such as carbamazepine, were found to significantly increase the clearance of thiothixene. (label Tiotiksen, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

CYP2C9: Concomitant use with CYP2C9 inhibitors can decrease torsemide clearance. (label Torasemid, Interaksi obat)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. (label Treprostinil, Peringatan dan perhatian)

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. (label Triamsinolon, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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,… (label Umeklidinium dan vilanterol, Peringatan dan perhatian)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (label Efavirenz, Interaksi obat)

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

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

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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) ]. (label Viloksazin, Interaksi obat)

Inhibitors of CYP3A4: May cause earlier onset and/or increased severity of adverse reactions ( 7.1 ) (label Vinorelbin, Interaksi obat)

Antidepressant: Bupropion Sertraline ↓ bupropion * ↓ sertraline * Increases in bupropion dosage should be guided by clinical response. (label Efavirenz, Interaksi obat)

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

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%. (label Zaleplon, Interaksi obat)

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

Patients who are receiving concomitant anticonvulsant medications primarily metabolized by the liver, such as phenytoin and phenobarbital, may require periodic monitoring of plasma levels [see Drug Interactions ( 7.1 ) ] . (label Efavirenz, Peringatan dan perhatian)

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

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

The effect of potent CYP3A4 inhibitors on dutasteride has not been studied. (label Dutasterid, Interaksi obat)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (label Eribulin, Interaksi obat)

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

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

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

An in vitro study using human liver microsomes suggests that famciclovir is not an inhibitor of CYP3A4 enzymes. (label Famsiklovir, Interaksi obat)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

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

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. (label Gliserol fenilbutirat, Interaksi obat)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash. (label Efavirenz, Peringatan dan perhatian)

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

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

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

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

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

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. (label Meksiletin, Interaksi obat)

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

CYP3A4 Substrates An in vitro study has suggested that rifaximin induces CYP3A4 [see Clinical Pharmacology ( 12.3 )] . (label Rifaksimin, Interaksi obat)

Strong CYP3A inducers: Strong inducers of CYP3A (for example, rifampin, phenytoin, carbamazepine, phenobarbital or St. (label Riosiguat, Interaksi obat)

However, no formal drug-drug interaction studies between zileuton and CYP3A4 inhibitors, such as ketaconazole, have been conducted. (label Zileuton, Interaksi obat)

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

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

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

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

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

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

Effect of Other Drugs on Micafungin in Sodium Chloride Injection CYP3A4, CYP2C9 and CYP2C19 Inhibitors Co-administration of Micafungin in Sodium Chloride Injection with cyclosporine, itraconazole, voriconazole and fluconazole did not alter the pharmacokinetics of micafungin. (label Mikafungin, Interaksi obat)

…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) ]. (label Montelukast, Interaksi obat)

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

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