Interaksi Nafsilin

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

• CYP3A Inducers: Avoid co-administration with strong CYP3A inducers. (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)

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

AMOXIL is contraindicated in patients who have experienced a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to AMOXIL or to other β-lactam antibacterial drugs (e.g., penicillins and cephalosporins). (label Amoksisilin, Kontraindikasi)

History of a serious hypersensitivity reaction (e.g., anaphylaxis or Stevens-Johnson syndrome) to AUGMENTIN or to other beta‑lactams (e.g., penicillins or cephalosporins). (label Amoksisilin dan klavulanat, Kontraindikasi)

CONTRAINDICATIONS The use of Ampicillin is contraindicated in individuals with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to ampicillin or to other beta-lactam antibacterial drugs. (label Ampisilin, Kontraindikasi)

CONTRAINDICATIONS The use of UNASYN is contraindicated in individuals with a history of serious hypersensitivity reactions (e.g., anaphylaxis or Stevens-Johnson syndrome) to ampicillin, sulbactam or to other beta-lactam antibacterial drugs (e.g., penicillins and cephalosporins). (label Ampisilin dan sulbaktam, Kontraindikasi)

• Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use. (label Apiksaban, 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)

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

• when coadministered with drugs that are strong inducers of CYP3A due to the potential for loss of therapeutic effect and development of resistance. (label Atazanavir, Kontraindikasi)

Concomitant administration of BIXLENVO is contraindicated with: dofetilide due to the potential for increased dofetilide plasma concentrations and associated serious and/or life-threatening events. strong CYP3A inducers due to decreased plasma concentrations of BIC and LEN, which may result in the loss of therapeutic effect and development of resistance to BIXLENVO. (label Biktegravir, emtrisitabin, dan tenofovir alafenamid, Kontraindikasi)

Drug Interactions Tetracycline, a bacteriostatic antibiotic, may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (label Nafsilin, Interaksi obat)

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

• Strong CYP3A Inducers: Avoid concomitant use with BOSULIF. (label Bosutinib, 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)

Moderate or Strong CYP3A4 inducers: Avoid concomitant use. (label Daridoreksant, Interaksi obat)

Co-administration of PREZCOBIX or PREZCOBIX PED with CYP3A inducers may lead to lower exposures of darunavir and cobicistat and potential loss of efficacy of darunavir and possible resistance. (label Darunavir dan kobisistat, Kontraindikasi)

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

Since bacteriostatic drugs may interfere with the bactericidal action of penicillins, it is advisable to avoid giving tetracycline-class drugs in conjunction with penicillin. (label Demeklosiklin, Interaksi obat)

Avoid co-administration of tetracyclines with penicillin. (label Doksisiklin, Interaksi obat)

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

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

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

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)

Strongly induce CYP3A, which may lead to lower exposure of one or more components and loss of efficacy of GENVOYA and possible resistance. (label Elvitegravir, kobisistat, emtrisitabin, dan tenofovir, Kontraindikasi)

INVANZ is contraindicated in patients with known hypersensitivity to any component of this product or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to beta-lactams. (label Ertapenem, Kontraindikasi)

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

Preventing or Managing DI The concomitant use of ADDYI with CYP3A4 inducers is not recommended. (label Flibanserin, Interaksi obat)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (label Hidrokodon, Peringatan kotak hitam)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (label Hidrokodon dan homatropin, Peringatan kotak hitam)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (label Hidrokodon dan ibuprofen, Peringatan kotak hitam)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. (label Hidrokodon dan klorfeniramin, Peringatan kotak hitam)

In addition, discontinuation of a concomitantly used Cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentrations. (label Hidrokodon dan parasetamol, Peringatan kotak hitam)

Hypersensitivity Reactions: Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving therapy with beta-lactams. (label Imipenem dan silastatin, Peringatan dan perhatian)

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

Avoid concomitant use of CYP3A4 inducers when using Corlanor. (label Ivabradin, Interaksi obat)

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

Therefore, administration of potent enzyme inducers of CYP3A4 with ketoconazole tablets is not recommended. (label Ketokonazol, Interaksi obat)

• 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)

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

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

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

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

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

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

Strong CYP3A4 inducers (e.g., rifampin, avasimibe, St. (label Lurasidon, Kontraindikasi)

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

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

Penicillin Because bacteriostatic drugs may interfere with the bactericidal action of penicillin, avoid giving EMROSI in conjunction with penicillin. (label Minosiklin, 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)

Strong CYP3A4 inducers (e.g., rifampin) : Decreased concentrations of naloxegol; concomitant use is not recommended. (label Naloksegol, Interaksi obat)

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)

Strong CYP3A Inducers: Avoid concomitant use with CAVHANZA. (label Nilotinib, Interaksi obat)

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

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)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in oxycodone plasma concentration. (label Oksikodon, Peringatan kotak hitam)

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

VOTRIENT is not recommended if chronic use of strong CYP3A4 inducers cannot be avoided. (label Pazopanib, Interaksi obat)

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in meperidine plasma concentration. (label Petidin, Peringatan kotak hitam)

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

• Patients taking strong Cytochrome P450 3A enzyme (CYP3A) inducers, such as rifampin, [see Warnings and Precautions ( 5.6 ) and Drug Interactions ( 7.1 , 7.2 )] . (label Prazikuantel, Kontraindikasi)

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)

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)

• Strong and Moderate CYP3A Inducers: Avoid concomitant administration. (label Rimegepant, Interaksi obat)

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

Avoid concomitant use of XARELTO with drugs that are known combined P-gp and strong CYP3A inducers [see Drug Interactions (7.3) ] . (label Rivaroksaban, Peringatan dan perhatian)

• 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)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

WARNINGS Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibacterial drugs. (label Nafsilin, Peringatan)

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)

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

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

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)

Drug Interactions Tetracycline, a bacteriostatic antibiotic, may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (label Nafsilin, Interaksi obat)

• 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)

Avoid concomitant use of SAMSCA with strong CYP3A inducers. (label Tolvaptan, Interaksi obat)

Coadministration with a strong CYP3A4 inducer may result in a relevant decrease in FARESTON exposure and should be avoided. (label Toremifen, Interaksi obat)

CYP3A inducers: Avoid concomitant strong CYP3A inducers ( 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)

Avoid concomitant use with strong CYP3A inducers if possible. (label Tretinoin, Interaksi obat)

Strong CYP3A4 Inducers: Should be avoided as concomitant use will result in reduction of ubrogepant exposure. (label Ubrogepant, Interaksi obat)

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)

Strong CYP3A Inducers : Avoid concomitant use with strong CYP3A inducers. (label Vepdegestrant, Interaksi obat)

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

• Use with CYP3A Inducers: Increase the risk of reduced efficacy of alprazolam. (label Alprazolam, Interaksi obat)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (label Amlodipin, Interaksi obat)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (label Amlodipin dan atorvastatin, Interaksi obat)

Blood pressure should be monitored when amlodipine is coadministered with CYP3A4 inducers (e.g. rifampicin, St. (label Amlodipin dan benazepril, Interaksi obat)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (label Amlodipin dan olmesartan, Interaksi obat)

Blood pressure should be closely monitored when amlodipine is coadministered with CYP3A inducers (e.g. rifampicin, St. (label Amlodipin dan valsartan, Interaksi obat)

Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (label Asam valproat, Interaksi obat)

Use caution when CAYSTON is administered to patients with a known allergic reaction to beta-lactams. (label Aztreonam, Peringatan dan perhatian)

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)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Benazepril dan hidroklorotiazid, Peringatan)

Other drugs may compete with penicillin G for renal tubular secretion and thus prolong the serum half-life of penicillin. (label Benzilpenisilin (penisilin G), Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Bisoprolol dan hidroklorotiazid, Peringatan)

Strong CYP3A4 inducers Double the recommended dosage and further adjust based on clinical response. (label Brekspiprazol, Interaksi obat)

Therefore, potent inhibitors or inducers of CYP3A4 may increase or reduce the circulating levels of CYCLOSET, respectively. (label Bromokriptin, Interaksi obat)

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

Initiation of medications that inhibit or induce CYP3A may increase or decrease concentrations of PREZISTA/ritonavir, respectively. (label Darunavir, Peringatan dan perhatian)

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

Drugs that Cause Hypokalemia The risk of hypokalemia is greater with coadministration of KEVEYIS and other drugs that can cause hypokalemia (e.g., loop diuretics, thiazide diuretics, laxatives, antifungals, penicillins, and theophylline) [see Warnings and Precautions (5.3) ] . (label Diklorfenamid, Interaksi obat)

Hepatic enzyme-inducing drugs (e.g., phenytoin, carbamazepine, phenobarbital, primidone, rifampin) can increase valproate clearance, while enzyme inhibitors (e.g., felbamate) can decrease valproate clearance. (label Divalproeks (valproat), Interaksi obat)

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

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

Coadministration of RPV and drugs that induce CYP3A may result in decreased plasma concentrations of RPV and loss of virologic response and possible resistance to RPV or to the class of NNRTIs. (label Emtrisitabin, rilpivirin, dan tenofovir, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Enalapril dan hidroklorotiazid, Peringatan)

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

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

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

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)

Drugs that Induce CYP3A4 (Rifampicin) Racemic zopiclone exposure was decreased 80% by concomitant use of rifampicin, a potent inducer of CYP3A4. (label Eszopiklon, Interaksi obat)

Strong CYP3A inducer and P-gp inducer : Increase the dosage as recommended. (label Everolimus, Interaksi obat)

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)

CYP3A4 Inducers No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. (label Fesoterodin, Interaksi obat)

Limited data in patients receiving known enzyme inducers ( phenytoin, phenobarbital, carbamazepine ) indicate only a 30% increase in the rate of flecainide elimination. (label Flekainid, Interaksi obat)

Initiation of medications that inhibit or induce CYP3A may increase or decrease concentrations of fosamprenavir calcium/ritonavir, respectively. (label Fosamprenavir, Peringatan dan perhatian)

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)

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

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

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

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Hidroklorotiazid, Peringatan dan perhatian)

Concomitant administration of inducers of CYP3A4 may lead to decreases in serum concentrations of ALKINDI SPRINKLE and increase the risk of adverse reactions, including adrenal crisis. (label Hidrokortison, Interaksi obat)

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

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

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

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Irbesartan dan hidroklorotiazid, Peringatan dan perhatian)

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)

• Strong inducer of CYP3A4 or CYP2C19: Consider dose increase of EPIDIOLEX. (label Kanabidiol (obat resep), Interaksi obat)

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)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Kandesartan dan hidroklorotiazid, Peringatan)

Inducers of Hepatic CYP Enzymes Rifampin : Rifampin is a potent CYP3A4 inducer and concomitant administration with caspofungin acetate for injection is expected to reduce the plasma concentrations of caspofungin acetate for injection. (label Kaspofungin, Interaksi obat)

Miscellaneous Cytochrome P450 Inducers: Efavirenz Nevirapine Rifampicin Rifabutin Rifapentine Use With Caution Inducers of CYP3A enzymes, such as efavirenz, nevirapine, rifampicin, rifabutin, and rifapentine will increase the metabolism of clarithromycin, thus decreasing plasma concentrations of clarithromycin, while increasing those of 14-OH-clarithromycin. (label Klaritromisin, Interaksi obat)

Inducers of CYP3A4 and CYP3A5 Inducers of CYP3A4 and/or CYP3A5 may reduce plasma concentrations of clindamycin. (label Klindamisin, Interaksi obat)

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

The absorption of tetracycline, furosemide, penicillin G, hydrochlorothiazide, and gemfibrozil was significantly decreased when given simultaneously with colestipol hydrochloride; these drugs were not tested to determine the effect of administration one hour before colestipol hydrochloride. (label Kolestipol, Interaksi obat)

Drug Interactions Cholestyramine for Oral Suspension USP may delay or reduce the absorption of concomitant oral medication such as phenylbutazone, warfarin, thiazide diuretics (acidic), or propranolol (basic), as well as tetracycline, penicillin G, phenobarbital, thyroid and thyroxine preparations, estrogens and progestins, and digitalis. (label Kolestiramin, Interaksi obat)

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

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Kuinapril dan hidroklorotiazid, Peringatan)

Antiepileptics (AEDs) (Carbamazepine, Phenobarbital, and Phenytoin) Carbamazepine, phenobarbital, and phenytoin are CYP3A4 inducers and may decrease quinine plasma concentrations if used concurrently with quinine sulfate. (label Kuinin, Interaksi obat)

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

In patients taking ARAVA, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (label Leflunomid, Interaksi obat)

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

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)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Lisinopril dan hidroklorotiazid, Peringatan)

…Nasal/Ophthalmic Corticosteroids: e.g., betamethasone budesonide ciclesonide dexamethasone fluticasone methylprednisolone mometasone prednisone triamcinolone ↓ lopinavir ↑ glucocorticoids Coadministration with oral dexamethasone or other systemic corticosteroids that induce CYP3A may result in loss of therapeutic effect and development of resistance to lopinavir. (label Lopinavir dan ritonavir, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Losartan dan hidroklorotiazid, Peringatan dan perhatian)

• If patients with severe renal impairment or ESRD receiving SELZENTRY (without concomitant CYP3A inducers or inhibitors) experience postural hypotension, the dose of SELZENTRY should be reduced from 300 mg twice daily to 150 mg twice daily. (label Maravirok, Peringatan dan perhatian)

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

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

CYP3A4 inducers Drugs (e.g. nevirapine, rifampin) that are strong inducers of CYP3A4 are likely to decrease the pharmacological action of methylergonovine maleate. (label Metilergometrin, 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)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Metoprolol dan hidroklorotiazid, Peringatan dan perhatian)

Effect of Other Drugs on XATMEP Oral Antibiotics Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. (label Metotreksat, Interaksi obat)

Examples Cyclosporine A, trimethoprim/sulfamethoxazole, bile acid sequestrants (cholestyramine), rifampin as well as aminoglycoside, cephalosporin, fluoroquinolone and penicillin classes of antimicrobials Drugs Modulating Glucuronidation Clinical Impact Concomitant use with drugs inducing glucuronidation decreases MPA systemic exposure, potentially reducing mycophenolate… (label Mikofenolat, Interaksi obat)

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

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (label Naproksen dan esomeprazol, Interaksi obat)

Possible Reduced Efficacy with Strong CYP3A4 Inducers Concomitant use of strong CYP3A4 inducers (e.g., carbamazepine, phenobarbital, phenytoin, rifampin, St. (label Nimodipin, Peringatan dan perhatian)

Coadministration with oral doses of a P-gp and CYP3A4 inducer, rifampicin, decreased exposure to nintedanib by 50%. (label Nintedanib, Interaksi obat)

…immunodeficiency virus (HIV)/Hepatitis C virus (HCV) protease inhibitors, non-nucleoside reverse transcriptase inhibitors , and HIV/AIDS medications containing strong inhibitors or inducers of CYP3A Significant changes (increase or decrease) in the plasma concentrations of estrogen and/or progestin have been noted in some cases of co-administration with HIV protease… (label Norgestimat dan etinilestradiol, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Olmesartan dan hidroklorotiazid, Peringatan dan perhatian)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Olmesartan, amlodipin, dan hidroklorotiazid, Peringatan dan perhatian)

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

Table 6: Clinically Relevant Interactions Affecting Omeprazole when Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of omeprazole when used concomitantly with strong inducers [see Clinical Pharmacology ( 12.3 )] . (label Omeprazol dan natrium bikarbonat, Interaksi obat)

Phenytoin, Carbamazepine, and Rifampin In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. (label Ondansetron, Interaksi obat)

Moderate and Strong CYP3A4 Inducers (including carbamazepine, oxcarbazepine, and phenytoin): increase clearance of perampanel and decrease perampanel plasma concentrations. (label Perampanel, Interaksi obat)

Nephrotoxicity in critically ill patients has been observed; the use of piperacillin and tazobactam was found to be an independent risk factor for renal failure and was associated with delayed recovery of renal function as compared to other beta-lactam antibacterial drugs in a randomized, multicenter, controlled trial in critically ill patients. (label Piperasilin dan tazobaktam, Peringatan dan perhatian)

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

Drug Interactions When probenecid is used to elevate plasma concentrations of penicillin or other beta-lactams, or when such drugs are given to patients taking probenecid therapeutically, high plasma concentrations of the other drug may increase the incidence of adverse reactions associated with that drug. (label Probenesid, Interaksi obat)

DRUG INTERACTIONS When probenecid is used to elevate plasma concentrations of penicillin, or other beta-lactams, or when such drugs are given to patients taking probenecid therapeutically, high plasma concentrations of the other drug may increase the incidence of adverse reactions associated with that drug. (label Probenesid dan kolkisin, Interaksi obat)

Drug Interactions Protamine sulfate has been shown to be incompatible with certain antibiotics, including several of the cephalosporins and penicillins (see DOSAGE AND ADMINISTRATION ). (label Protamin, Perhatian)

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

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

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

Carbamazepine and other enzyme inducers decrease plasma concentrations of risperidone. (label Risperidon, Interaksi obat)

Effects of Other AEDs on BANZEL Potent cytochrome P450 enzyme inducers, such as carbamazepine, phenytoin, primidone, and phenobarbital, appear to increase the clearance of BANZEL (see Table 6). (label Rufinamid, Interaksi obat)

Strong CYP3A4 Inducers Concomitant use of JAKAFI/JAKAFI XR with strong CYP3A4 inducers may decrease ruxolitinib exposure [ see Clinical Pharmacology ( 12.3 )] , which may reduce efficacy of JAKAFI/JAKAFI XR. (label Ruksolitinib, Interaksi obat)

Salicylate competes with a number of drugs for protein binding sites, notably penicillin, thiopental, thyroxine, triiodothyronine, phenytoin, sulfinpyrazone, naproxen, warfarin, methotrexate, and possibly corticosteroids. [When Salsalate tablets, USP are administered with aspirin, its protein binding is reduced, although the clearance of free Salsalate tablets,… (label Salsalat, Interaksi obat)

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

The nafcillin-cyclosporine interaction was documented in a patient during two separate courses of therapy. (label Nafsilin, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Spironolakton dan hidroklorotiazid, Peringatan)

Drugs that May Enhance the Neuromuscular Blocking Action of Succinylcholine : promazine, oxytocin, aprotinin, certain non-penicillin antibiotics, quinidine, β-adrenergic blockers, procainamide, lidocaine, trimethaphan, lithium carbonate, magnesium salts, quinine, chloroquine, isoflurane, desflurane, metoclopramide, terbutaline, and drugs that reduce plasma cholinesterase… (label Suksinilkolin, Interaksi obat)

• CYP3A4 Inducers : Consider dose increase of SUTENT when administered with strong CYP3A4 inducers. (label Sunitinib, Interaksi obat)

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

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

Risk of Rejection with Strong CYP3A Inducers and Risk of Serious Adverse Reactions with Strong CYP3A Inhibitors The concomitant use of strong CYP3A inducers may increase the metabolism of tacrolimus, leading to lower whole blood trough concentrations and greater risk of rejection. (label Takrolimus, Peringatan dan perhatian)

Patients should be monitored for adequate clinical effect when amlodipine is co-administered with CYP3A4 inducers. (label Telmisartan dan amlodipin, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Telmisartan dan hidroklorotiazid, Peringatan dan perhatian)

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)

In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (label Teriflunomid, Interaksi obat)

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

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

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

CYP3A4 Inducers: Increase in RALDESY dosage may be necessary ( 2.5 , 7 ). (label Trazodon, Interaksi obat)

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

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

…from blood bank (may contain up to 30 mEq of potassium per liter of plasma or up to 65 mEq per liter of whole blood when stored for more than 10 days); low-salt milk (may contain up to 60 mEq of potassium per liter); potassium-containing medications (such as parenteral penicillin G potassium); salt substitutes (most contain substantial amounts of potassium). (label Triamteren, Interaksi obat)

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Triamteren dan hidroklorotiazid, Peringatan)

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

Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (label Valsartan dan hidroklorotiazid, Peringatan dan perhatian)

CYP3A4 inducers decrease verapamil levels ( 7.1 ) (label Verapamil, Interaksi obat)

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

Nafcillin in high dosage regimens, i.e., 2 grams every 4 hours, has been reported to decrease the effects of warfarin. (label Nafsilin, Interaksi obat)

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)

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

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

Counsel women to use an alternative method of contraception or a back-up method when enzyme inducers are used with CHCs, and to continue back-up contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability. (label Desogestrel dan etinilestradiol, Interaksi obat)

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

• Cytochrome P450 3A4 inducers, inhibitors, or substrates: May alter docetaxel metabolism. (label Dosetaksel, Interaksi obat)

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with COCs. (label Drospirenon dan etinilestradiol, Interaksi obat)

TAF is not an inhibitor or inducer of CYP3A in vivo . (label Emtrisitabin dan tenofovir, 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)

Infants born to women treated during pregnancy with oral erythromycin for early syphilis should be treated with an appropriate penicillin regimen. (label Eritromisin, Peringatan)

Inducers of CYP3A4 such as St. (label Estradiol, Interaksi obat)

Inducers of CYP3A4 such as St. (label Estradiol dan noretisteron, Interaksi obat)

Inducers of CYP3A4, such as St. (label Estrogen terkonjugasi dan bazedoksifen, Interaksi obat)

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with CHCs. (label Etonogestrel dan etinilestradiol, Interaksi obat)

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

The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (label Klonazepam, Interaksi obat)

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

There have been reports of individuals with a history of penicillin hypersensitivity who have experienced severe hypersensitivity reactions when treated with another β-lactam. (label Meropenem, Peringatan dan perhatian)

Some antibiotics such as penicillin may compete with phenylacetylglutamine and hippurate for active secretion by renal tubules, which may affect the overall disposition of the infused drug. (label Natrium fenilasetat dan natrium benzoat, Interaksi obat)

Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. (label Neomisin, Interaksi obat)

Counsel patients to use a back-up or alternative method of contraception when enzyme inducers are used with CHCs. (label Norelgestromin dan etinilestradiol, Interaksi obat)

Counsel women to use an alternative non-hormonal method of contraception or a back-up method when enzyme inducers are used with HCs, and to continue back-up non-hormonal contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability. (label Noretisteron, Interaksi obat)

Counsel women to use an alternative method of contraception or a back-up method when enzyme inducers are used with COCs, and to continue back-up contraception for 28 days after discontinuing the enzyme inducer to ensure contraceptive reliability. (label Norgestrel dan etinilestradiol, Interaksi obat)

Patients who are allergic to penicillin may theoretically have cross-sensitivity to penicillamine. (label Penisilamin, Perhatian)

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)

Drug Interactions Tetracycline, a bacteriostatic antibiotic, may antagonize the bactericidal effect of penicillin, and concurrent use of these drugs should be avoided. (label Nafsilin, Interaksi obat)

Concurrent use of strong CYP3A inducers (e.g., St. (label Vinkristin, Interaksi obat)

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

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