Interaksi Grapefruit

Grapefruit or grapefruit juice may also increase axitinib plasma concentrations and should be avoided. (label Aksitinib, Interaksi obat)

Concomitant intake of large quantities, more than 1.2 liters daily, of grapefruit juice is not recommended in patients taking amlodipine and atorvastatin tablets [see Drug Interactions (7.3) ]. (label Amlodipin dan atorvastatin, Peringatan dan perhatian)

Concomitant intake of large quantities, more than 1.2 liters daily, of grapefruit juice is not recommended in patients taking LIPITOR [see Drug Interactions (7.1) ] . (label Atorvastatin, Peringatan dan perhatian)

Patients receiving buspirone should be advised to avoid drinking such large amounts of grapefruit juice. (label Buspiron, Interaksi obat)

• Grapefruit juice: Avoid concomitant use. (label Dronedaron, Interaksi obat)

Avoid food or drink containing grapefruit. (label Eleksakaftor, tezakaftor, dan ivakaftor, Interaksi obat)

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)

Intervention: Avoid grapefruit juice when taking VYTORIN. (label Ezetimib dan simvastatin, Interaksi obat)

Grapefruit juice may also increase plasma concentrations of imatinib; avoid grapefruit juice [see Clinical Pharmacology (12.3)] . (label Imatinib, Interaksi obat)

Avoid food or drink containing grapefruit. (label Ivakaftor, Interaksi obat)

Avoid ingestion of foods (e.g., grapefruit, grapefruit juice) or nutritional supplements that are known to inhibit cytochrome P450 while taking COMETRIQ. (label Kabozantinib, Interaksi obat)

CYP3A4 The concomitant use of colchicine capsules and CYP3A4 inhibitors (e.g., clarithromycin, ketoconazole, grapefruit juice, erythromycin, verapamil, etc.) should be avoided due to the potential for serious and life-threatening toxicity [see Warnings and Precautions (5.3) and Clinical Pharmacology (12) ] . (label Kolkisin, Interaksi obat)

Although the clinical significance of this interaction is unknown, grapefruit juice should be avoided. (label Kuinidin, Interaksi obat)

Avoid coadministration of VITRAKVI with strong CYP3A4 inhibitors, including grapefruit or grapefruit juice. (label Larotrektinib, Interaksi obat)

Patients must avoid grapefruit juice ( 4 , 5.6 , 7.1 ). (label Lomitapid, Interaksi obat)

…products Gemfibrozil Avoid with lovastatin Cyclosporine Danazol Do not exceed 20 mg lovastatin daily Diltiazem Dronedarone Verapamil Amiodarone Do not exceed 40 mg lovastatin daily Grapefruit juice Avoid grapefruit juice Immune-Mediated Necrotizing Myopathy There have been rare reports of immune-mediated necrotizing myopathy (IMNM), an autoimmune myopathy, associated… (label Lovastatin, Peringatan)

•Avoid consumption of grapefruit or grapefruit juice during treatment with MOVANTIK [see Dosage and Administration (2.1) ] . (label Naloksegol, Interaksi obat)

Grapefruit juice should be avoided by patients on nifedipine. (label Nifedipin, Perhatian)

Avoid grapefruit juice. (label Nimodipin, Interaksi obat)

Avoid grapefruit or grapefruit juice during IBRANCE treatment. (label Palbosiklib, Interaksi obat)

Interaction with Food Patients should avoid grapefruit juice because it may inhibit the metabolism of pimozide by CYP 3A4. (label Pimozid, Interaksi obat)

Grapefruit Juice Grapefruit and grapefruit juice affect metabolism, increasing blood concentrations of cyclosporine, thus should be avoided. (label Siklosporin, Interaksi obat)

Intervention: Avoid grapefruit juice when taking ZOCOR. (label Simvastatin, Interaksi obat)

Grapefruit Juice Because grapefruit juice inhibits the CYP3A4-mediated metabolism of sirolimus, it must not be taken with sirolimus [ see Clinical Pharmacology (12.3) ]. (label Sirolimus, Interaksi obat)

Avoid food or drink containing grapefruit. (label Suzetrigin, Interaksi obat)

Avoid grapefruit or grapefruit juice. (label Takrolimus, Interaksi obat)

Patients should avoid grapefruit juice beverages while taking SAMSCA [see Clinical Pharmacology (12.3) ] . (label Tolvaptan, Interaksi obat)

Grapefruit juice may also increase plasma concentrations of toremifene and should be avoided. (label Toremifen, Interaksi obat)

Food or drink containing grapefruit should be avoided during treatment with RINVOQ/RINVOQ LQ. (label Upadasitinib, Interaksi obat)

CYP450 Inhibitors Grapefruit juice, certain fluoroquinolone and macrolide antibiotics, azole antifungals, cimetidine Increased exposure of amiodarone. (label Amiodaron, Interaksi obat)

Jus grapefruit dapat menaikkan kadar dalam darah beberapa penghambat kanal kalsium yang digunakan untuk tekanan darah, yang mungkin menyebabkan penurunan tekanan darah yang berlebihan. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Although specific interactions have not been studied, other CYP3A4 inhibitors, including grapefruit juice are likely to increase avanafil exposure. (label Avanafil, Interaksi obat)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir), grapefruit juice CYP3A4 Inducers Clinical Impact: The concomitant use of Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate Capsules and CYP3A4 inducers can result in lower codeine levels, greater norcodeine levels,… (label Butalbital, parasetamol, kafein, dan kodein, Interaksi obat)

Therefore, give one third the recommended dosage of EMFLAZA when moderate or strong CYP3A4 inhibitors (e.g., clarithromycin, fluconazole, diltiazem, verapamil, grapefruit juice) are used concomitantly with EMFLAZA [see Dosage and Administration ( 2.5 ) and Clinical Pharmacology ( 12.3 )] . (label Deflazakort, Interaksi obat)

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

Inhibitors of this isoenzyme (e.g., macrolide antibiotics, azole antifungal agents, protease inhibitors, serotonin reuptake inhibitors, amiodarone, cannabinoids, diltiazem, grapefruit juice, nefazadone, norfloxacin, quinine, zafirlukast) should be cautiously co-administered with dofetilide as they can potentially increase dofetilide levels. (label Dofetilid, 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)

Concomitant administration of moderate or strong CYP3A4 inhibitors such as azole antifungals (e.g., ketoconazole, itraconazole, voriconazole, fluconazole), verapamil, macrolides (e.g., clarithromycin, erythromycin), diltiazem, and grapefruit juice can increase the plasma concentrations of the estrogen or the progestin or both. (label Drospirenon dan etinilestradiol, 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)

…Systemic Exposure of COCs (enzyme inhibitors): Concomitant administration of moderate or strong CYP3A4 inhibitors like azole antifungals (for example, ketoconazole, itraconazole, voriconazole, fluconazole), verapamil, macrolides (for example, clarithromycin, erythromycin), diltiazem, and grapefruit increase the serum concentrations of both estradiol and dienogest. (label Estradiol dan dienogest, Interaksi obat)

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

Concomitant administration of strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma estrogen and/or progestin concentrations. (label Etonogestrel dan etinilestradiol, Interaksi obat)

Jus grapefruit menaikkan kadar obat antipenolakan transplantasi dalam darah. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Jus grapefruit mengubah jumlah obat-obat ini yang mencapai aliran darah (menaikkan sebagian besar, tetapi menurunkan feksofenadin). (FDA, Grapefruit Juice and Some Drugs Don't Mix)

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

No dosing adjustments are recommended in the presence of moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole, diltiazem, verapamil and grapefruit juice). (label Fesoterodin, Interaksi obat)

…telaprevir, telithromycin and conivaptan Examples of moderate CYP3A4 inhibitors Amprenavir, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, verapamil, and grapefruit juice Clinical Implications The concomitant use of ADDYI with moderate or strong CYP3A4 inhibitors increases flibanserin exposure compared to the use of ADDYI alone. (label Flibanserin, Interaksi obat)

Jus grapefruit dapat menaikkan kadar dalam darah beberapa penghambat kanal kalsium yang digunakan untuk tekanan darah, yang mungkin menyebabkan penurunan tekanan darah yang berlebihan. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Examples of moderate CYP3A4 inhibitors include diltiazem, verapamil, and grapefruit juice [ s ee Warnings and Precautions ( 5.3 ) and Clinical Pharmacology ( 12.3 )] . (label Ivabradin, Interaksi obat)

CYP3A inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice The effect of grapefruit juice on CYP3A4 enzymes (e.g., strong vs. moderate inhibition) depends on its brand, concentration, and preparation. , or ketoconazole may increase systemic exposure of the estrogen and/or progestin component of CHCs. (label Levonorgestrel dan etinilestradiol, Interaksi obat)

Jus grapefruit dapat menaikkan kadar dalam darah beberapa penghambat kanal kalsium yang digunakan untuk tekanan darah, yang mungkin menyebabkan penurunan tekanan darah yang berlebihan. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

Jus grapefruit dapat menaikkan kadar dalam darah beberapa penghambat kanal kalsium yang digunakan untuk tekanan darah, yang mungkin menyebabkan penurunan tekanan darah yang berlebihan. (FDA, Grapefruit Juice and Some Drugs Don't Mix)

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

Substances increasing the systemic concentrations of HCs: Co-administration of certain HCs and strong or moderate CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase the systemic concentrations of progestins, including norethindrone. (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)

Examples Clarithromycin, conivaptan, grapefruit juice, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, mibefradil, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, and voriconazole Intervention If a patient initiates or discontinues therapy with a strong CYP3A4 inhibitor, dose adjustment of Paricalcitol Injection may be necessary. (label Parikalsitol, Interaksi obat)

In addition, grapefruit juice was also reported to produce a 1.6-fold increase in the C max and a 1.9-fold increase in the AUC of praziquantel. (label Prazikuantel, Interaksi obat)

Drugs that inhibit these CYP pathways (such as desipramine, paroxetine, ritonavir, sertraline for CYP2D6; ketoconazole, erythromycin, saquinavir, and grapefruit juice for CYP3A4; and amiodarone and tobacco smoke for CYP1A2) can be expected to cause increased plasma levels of propafenone. (label Propafenon, Peringatan dan perhatian)

Moderate CYP3A Inhibitors Limit the dose of ASPRUZYO Sprinkle to 500 mg twice daily in patients on moderate CYP3A inhibitors, including diltiazem, verapamil, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products [see Dosage and Administration (2.2), Clinical Pharmacology (12.3)]. (label Ranolazin, Interaksi obat)

Inhibitors of CYP3A4 or CYP2C19 Inhibitors of CYP3A4 Coadministration of strong (e.g., ketoconazole) and moderate (e.g., erythromycin, diltiazem and grapefruit juice) CYP3A4 inhibitors can increase exposure to cilostazol. (label Silostazol, Interaksi obat)

The recommended dose of BELSOMRA is 5 mg in subjects receiving moderate CYP3A inhibitors (e.g., amprenavir, aprepitant, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, imatinib, verapamil). (label Suvoreksant, Interaksi obat)

Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure. (label Tadalafil, Interaksi obat)

Dose adjustment is recommended with concomitant use of UBRELVY and moderate CYP3A4 inhibitors (e.g., cyclosporine, ciprofloxacin, fluconazole, fluvoxamine, grapefruit juice) [see Dosage and Administration ( 2.2 )] . (label Ubrogepant, Interaksi obat)

…recommended not to exceed a single 5 mg dose of vardenafil hydrochloride tablets in a 24-hour period when used in combination with erythromycin. [See Dosage and Administration (2.4) and Warnings and Precautions (5) .] Although specific interactions have not been studied, other CYP3A4 inhibitors, including grapefruit juice would likely increase vardenafil exposure. (label Vardenafil, Interaksi obat)

Grapefruit juice may significantly increase verapamil levels ( 7.3 ) (label Verapamil, Interaksi obat)

Strong and moderate CYP3A inhibitors include, but are not limited to, atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil. (label Dekstrometorfan dan kuinidin, Peringatan dan perhatian)

Less potent inhibitors include saquinavir, nefazodone, fluconazole, grapefruit juice, fluoxetine, fluvoxamine, zileuton, and clotrimazole. (label Dihidroergotamin, Peringatan)

Examples of less potent CYP 3A4 inhibitors include: saquinavir, nefazodone, fluconazole, fluoxetine, grapefruit juice, fluvoxamine, zileuton, metronidazole, and clotrimazole. (label Ergotamin dan kafein, Peringatan)

Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir), grapefruit juice. (label Fentanil, Interaksi obat)

Examples: Anti-fungals: itraconazole, posaconazole, voriconazole Antibiotics: erythromycin and clarithromycin Antiretrovirals: ritonavir Grapefruit juice CYP3A4 Inducers Clinical Impact: Hydrocortisone is metabolized by cytochrome P450 3A4 (CYP3A4). (label Hidrokortison, Interaksi obat)

…itraconazole, fluconazole, voriconazole ) , cimetidine, ciprofloxacin, clarithromycin, dalfopristin, danazol, dantrolene, delavirdine, diltiazem, erythromycin, fluoxetine, fluvoxamine, grapefruit juice, ibuprofen, isoniazid, loratadine, nefazodone, niacinamide, nicotinamide, olanzapine, omeprazole, oxybutynin, quinine, quinupristin, ticlopidine, troleandomycin, valproate,… (label Karbamazepin, Interaksi obat)

Quinine sulfate may be taken with grapefruit juice. (label Kuinin, Interaksi obat)

Examples of some of the strong CYP 3A4 inhibitors include saquinavir, grapefruit juice, nefazodone, macrolide antibiotics (e.g., troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole). (label Metilergometrin, Interaksi obat)

Some botanicals and foods can interact with warfarin sodium through CYP450 interactions (e.g., echinacea, grapefruit juice, ginkgo, goldenseal, St. (label Warfarin, Interaksi obat)

The following have no clinically relevant effects on the pharmacokinetics of amlodipine: cimetidine, grapefruit juice, magnesium and aluminum hydroxide antacid, sildenafil. (label Telmisartan dan amlodipin, Interaksi obat)