Palbocyklib: interakcje

• CYP3A Inhibitors: Avoid co-administration with strong CYP3A inhibitors. (etykieta leku Akalabrutynib, Interakcje z innymi lekami)

…(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… (etykieta leku Alfuzosyna, Przeciwwskazania)

Concomitant use of almotriptan tablets and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment [see Clinical Pharmacology ( 12.3 )] . (etykieta leku Almotryptan, Interakcje z innymi lekami)

• 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) ] . (etykieta leku Alprazolam, Przeciwwskazania)

For patients receiving ELIQUIS at a dose of 2.5 mg twice daily, avoid coadministration with combined P-gp and strong CYP3A4 inhibitors [see Dosage and Administration (2.6) and Clinical Pharmacology (12.3) ] . (etykieta leku Apiksaban, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Do not use avanafil in patients taking strong CYP3A4 inhibitors [see Warnings and Precautions ( 5.2 ) and Dosage and Administration ( 2.3 )]. (etykieta leku Awanafil, Interakcje z innymi lekami)

Concomitant administration of BIXLENVO with combined P-gp, UGT1A1, and strong CYP3A inhibitors is not recommended. (etykieta leku Biktegrawir + emtrycytabina + alafenamid tenofowiru, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• Strong and Moderate CYP3A Inhibitors: Avoid concomitant use with BOSULIF. (etykieta leku Bosutynib, Interakcje z innymi lekami)

Concomitant use of strong CYP3A4 inhibitors (e.g., azole antimycotics, HIV protease inhibitors) with CYCLOSET should be avoided. (etykieta leku Bromokryptyna, Interakcje z innymi lekami)

Evaluate patients starting CYP3A4 inhibitors or stopping CYP3A4 inducers at frequent intervals for respiratory depression. (etykieta leku Buprenorfina, Interakcje z innymi lekami)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (etykieta leku Butalbital + kwas acetylosalicylowy + kofeina + kodeina, Ostrzeżenie w ramce)

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. (etykieta leku Butalbital + paracetamol + kofeina + kodeina, Ostrzeżenie w ramce)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Strong CYP3A4 inhibitors: Avoid concomitant use. (etykieta leku Daridoreksant, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A4 inhibitors. (etykieta leku Dazatynib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (etykieta leku Dekstrometorfan + chinidyna, Ostrzeżenia i środki ostrożności)

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. (etykieta leku Dihydroergotamina, Ostrzeżenie w ramce)

Concomitant use of Docetaxel Injection and drugs that inhibit CYP3A4 may increase exposure to docetaxel and should be avoided. (etykieta leku Docetaksel, Interakcje z innymi lekami)

Avoid concomitant use of Doxorubicin Hydrochloride Injection with inhibitors of CYP3A4, CYP2D6, or P-gp. (etykieta leku Doksorubicyna, Interakcje z innymi lekami)

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) ]. (etykieta leku Dutasteryd + tamsulosyna, Ostrzeżenia i środki ostrożności)

Avoid concomitant use of strong CYP3A inducers (e.g., phenytoin, rifampin, carbamazepine, enzalutamide, and St John's Wort) [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• 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) ]. (etykieta leku Eletryptan, Przeciwwskazania)

…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)… (etykieta leku Eplerenon, Przeciwwskazania)

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. (etykieta leku Ergotamina + kofeina, Ostrzeżenie w ramce)

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). (etykieta leku Erlotynib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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) ] . (etykieta leku Ezetymib + symwastatyna, Przeciwwskazania)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of fentanyl. (etykieta leku Fentanyl, Ostrzeżenie w ramce)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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) ]. (etykieta leku Fezoterodyna, Interakcje z innymi lekami)

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) ] . (etykieta leku Flibanseryna, Ostrzeżenie w ramce)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (etykieta leku Flutykazon, Interakcje z innymi lekami)

Avoid strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): May increase risk of systemic corticosteroid and cardiovascular effects. (etykieta leku Flutykazon + salmeterol, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Avoid grapefruit or grapefruit juice during IBRANCE treatment. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Hydrokodon, Ostrzeżenie w ramce)

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. (etykieta leku Hydrokodon + chlorfenamina, Ostrzeżenie w ramce)

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. (etykieta leku Hydrokodon + homatropina, Ostrzeżenie w ramce)

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. (etykieta leku Hydrokodon + ibuprofen, Ostrzeżenie w ramce)

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. (etykieta leku Hydrokodon + paracetamol, Ostrzeżenie w ramce)

• Strong CYP3A4 Inhibitors: Do not administer strong CYP3A4 inhibitors with CAMPTOSAR. (etykieta leku Irynotekan, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

…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 ) (etykieta leku Iwabradyna, Przeciwwskazania)

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… (etykieta leku Kabozantynib, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inducers (e.g., phenytoin, rifampin, carbamazepine, enzalutamide, and St John's Wort) [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Kodeina, Ostrzeżenie w ramce)

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) ] . (etykieta leku Kolchicyna, Przeciwwskazania)

Avoid strong CYP3A4 inhibitors. (etykieta leku Lapatynib, Interakcje z innymi lekami)

Strong CYP3A4 Inhibitors: Avoid coadministration of strong CYP3A4 inhibitors with VITRAKVI. (etykieta leku Larotrektynib, Interakcje z innymi lekami)

Strong or moderate CYP3A inhibitors: Avoid concomitant use. (etykieta leku Lemboreksant, Interakcje z innymi lekami)

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) ]. (etykieta leku Lomitapid, Przeciwwskazania)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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 ). (etykieta leku Lowastatyna, Przeciwwskazania)

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, voriconazole, mibefradil, etc.) [see Drug Interactions ( 7.1 )]. (etykieta leku Lurazydon, Przeciwwskazania)

Strong CYP3A4 inhibitors (ketoconazole, ritonavir) increase exposure to macitentan: avoid co-administration with OPSUMIT ( 7.2 , 12.3 ) . (etykieta leku Macytentan, Interakcje z innymi lekami)

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 )]. (etykieta leku Marawirok, Przeciwwskazania)

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. (etykieta leku Metyloergometryna, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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… (etykieta leku Naloksegol, Przeciwwskazania)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Avoid use of concomitant drugs known to prolong the QT interval and strong CYP3A4 inhibitors [see Drug Interactions ( 7.1 , 7.2 )] . (etykieta leku Nilotynib, Ostrzeżenie w ramce)

Therefore, the concomitant administration of NYMALIZE and strong CYP3A4 inhibitors should generally be avoided [ see Warnings and Precautions (5.3) ]. (etykieta leku Nimodypina, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Nizoldypina, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Oksykodon, Ostrzeżenie w ramce)

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. (etykieta leku Oksykodon + paracetamol, Ostrzeżenie w ramce)

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. (etykieta leku Paracetamol + kodeina, Ostrzeżenie w ramce)

Strong CYP3A4 Inhibitors : Avoid coadministration of VOTRIENT with strong CYP3A4 inhibitors. (etykieta leku Pazopanib, Interakcje z innymi lekami)

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. (etykieta leku Petydyna, Ostrzeżenie w ramce)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Prometazyna + kodeina, Ostrzeżenie w ramce)

• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 (CYP2D6) inhibitor and a 3A4 inhibitor (CYP3A4). (etykieta leku Propafenon, Ostrzeżenia i środki ostrożności)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

• Strong CYP3A4 Inhibitors: Avoid concomitant administration. (etykieta leku Rymegepant, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Use with P-gp and Strong CYP3A Inhibitors or Inducers Avoid concomitant use of XARELTO with known combined P-gp and strong CYP3A inhibitors [see Drug Interactions (7.2) ] . (etykieta leku Rywaroksaban, Ostrzeżenia i środki ostrożności)

• Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir, ketoconazole): Use not recommended. (etykieta leku Salmeterol, Interakcje z innymi lekami)

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 )] . (etykieta leku Solifenacyna, Interakcje z innymi lekami)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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… (etykieta leku Sylodosyna, Przeciwwskazania)

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) ] . (etykieta leku Symwastatyna, Przeciwwskazania)

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) ]. (etykieta leku Syrolimus, Ostrzeżenia i środki ostrożności)

• Should not be used in combination with strong inhibitors of CYP3A4. (etykieta leku Tamsulosyna, Ostrzeżenia i środki ostrożności)

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 ) ] . (etykieta leku Tiotepa, Interakcje z innymi lekami)

…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… (etykieta leku Tolwaptan, Przeciwwskazania)

• CYP3A Inducers: Avoid concurrent use of IBRANCE with strong CYP3A inducers. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Drugs known to prolong the QT interval and strong CYP3A4 inhibitors should be avoided [see Warnings and Precautions (5.1) ] . (etykieta leku Toremifen, Ostrzeżenie w ramce)

CYP3A inhibitors: Avoid concomitant strong CYP3A inhibitors ( 7.1 ) (etykieta leku Trabektedyna, Interakcje z innymi lekami)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (etykieta leku Tramadol, Ostrzeżenie w ramce)

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. (etykieta leku Tramadol + paracetamol, Ostrzeżenie w ramce)

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… (etykieta leku Trazodon, Ostrzeżenia i środki ostrożności)

• Strong CYP3A Inhibitors and Inducers: Avoid coadministration with strong CYP3A inhibitors and inducers. (etykieta leku Tretynoina, Interakcje z innymi lekami)

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) ] . (etykieta leku Triazolam, Ostrzeżenia i środki ostrożności)

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. (etykieta leku Ubrogepant, Przeciwwskazania)

For patients with atopic dermatitis, coadministration of RINVOQ 30 mg once daily with strong CYP3A4 inhibitors is not recommended. (etykieta leku Upadacytynib, Interakcje z innymi lekami)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (etykieta leku Vepdegestrant, Ostrzeżenia i środki ostrożności)

Therefore, the concomitant use of strong CYP3A inhibitors with vincristine sulfate should be avoided. (etykieta leku Winkrystyna, Interakcje z innymi lekami)

Avoid concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole). (etykieta leku Palbocyklib, Interakcje z innymi lekami)

CYP3A4/5 Inhibitors Co-administration of ketoconazole, a strong inhibitor of CYP3A4/5, increased the plasma exposure of axitinib in healthy volunteers. (etykieta leku Aksytynib, Interakcje z innymi lekami)

CYP3A4 inhibitors: Use with caution in combination due to increased exposure of alosetron. (etykieta leku Alosetron, Interakcje z innymi lekami)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (etykieta leku Amlodypina, Interakcje z innymi lekami)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (etykieta leku Amlodypina + atorwastatyna, Interakcje z innymi lekami)

CYP3A4 Inhibitors : Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (etykieta leku Amlodypina + benazepryl, Interakcje z innymi lekami)

• Increased exposure of amlodipine when coadministered with CYP3A inhibitors Olmesartan medoxomil ( 7.2 ): • Nonsteroidal anti-inflammatory drugs (NSAIDS) may lead to increased risk of renal impairment and loss of antihypertensive effect. (etykieta leku Amlodypina + olmesartan, Interakcje z innymi lekami)

Amlodipine Impact of Other Drugs on Amlodipine CYP3A Inhibitors Coadministration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (etykieta leku Amlodypina + walsartan, Interakcje z innymi lekami)

CYP2D6 inhibitors and CYP3A4 Inhibitors : See full prescribing information for ABILIFY MAINTENA dosage modifications when used concomitantly with CYP2D6 inhibitors and/or CYP3A4 inhibitors for greater than 14 days ( 7.1 ) (etykieta leku Arypiprazol, Interakcje z innymi lekami)

LIPITOR plasma levels can be significantly increased with concomitant administration of inhibitors of CYP3A4 and transporters. (etykieta leku Atorwastatyna, Interakcje z innymi lekami)

Use of Cytochrome P450 3A4 Inhibitors Ritonavir and other strong cytochrome P450 3A4 (CYP3A4) inhibitors can significantly increase plasma fluticasone propionate exposure, resulting in significantly reduced serum cortisol concentrations [see Drug Interactions ( 7.2 ) and Clinical Pharmacology ( 12.3 )] . (etykieta leku Azelastyna + flutykazon, Ostrzeżenia i środki ostrożności)

Strong CYP3A4 Inhibitors: Closely monitor patients with concomitant use. (etykieta leku Bortezomib, Interakcje z innymi lekami)

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. (etykieta leku Brekspiprazol, Interakcje z innymi lekami)

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… (etykieta leku Budezonid, Ostrzeżenia i środki ostrożności)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (etykieta leku Budezonid + formoterol, Ostrzeżenia i środki ostrożności)

Inhibitors of CYP3A4 Clinical Impact: The concomitant use of buprenorphine and CYP3A4 inhibitors can increase the plasma concentration of buprenorphine, resulting in increased or prolonged opioid effects, particularly when an inhibitor is added after a stable dose of buprenorphine and naloxone sublingual tablet is achieved. (etykieta leku Buprenorfina + nalokson, Interakcje z innymi lekami)

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. (etykieta leku Buspiron, Interakcje z innymi lekami)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Although a causal relationship between a specific drug and the arrhythmia was not established in this case, erythromycin is a CYP3A4 inhibitor and has been shown to increase quinine plasma levels when used concomitantly. (etykieta leku Chinina, Ostrzeżenia i środki ostrożności)

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. (etykieta leku Cyklezonid, Interakcje z innymi lekami)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Cylostazol, Interakcje z innymi lekami)

Co-administration with a strong CYP3A4 inhibitor may increase serum levels of cinacalcet. (etykieta leku Cynakalcet, Interakcje z innymi lekami)

Co-administration of darunavir and ritonavir and other drugs that inhibit CYP3A, or P-gp may decrease the clearance of darunavir and ritonavir and may result in increased plasma concentrations of darunavir and ritonavir (see Table 10 ). (etykieta leku Darunawir, Interakcje z innymi lekami)

Co-administration of PREZCOBIX or PREZCOBIX PED and other drugs that inhibit CYP3A may result in increased plasma concentrations of darunavir and cobicistat (see Table 2 ). (etykieta leku Darunawir + kobicystat, Interakcje z innymi lekami)

CYP3A4 Inhibitors The systemic exposure of darifenacin from darifenacin extended-release tablets is increased in the presence of CYP3A4 inhibitors. (etykieta leku Daryfenacyna, Interakcje z innymi lekami)

Moderate or strong CYP3A4 inhibitors: Give one third of the recommended dosage of EMFLAZA ( 7.1 ) (etykieta leku Deflazakort, Interakcje z innymi lekami)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of dexlansoprazole is expected when used concomitantly with strong inhibitors [see Clinical Pharmacology (12.3) ] . (etykieta leku Dekslanzoprazol, Interakcje z innymi lekami)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etykieta leku Dezogestrel + etynyloestradiol, Interakcje z innymi lekami)

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… (etykieta leku Dofetylid, Interakcje z innymi lekami)

Strong cytochrome P450 (CYP) 3A inhibitors may increase exposure to doxazosin and increased risk of hypotension. (etykieta leku Doksazosyna, Interakcje z innymi lekami)

Co-administration of PIFELTRO and drugs that are inhibitors of CYP3A may result in increased plasma concentrations of doravirine. (etykieta leku Dorawiryna, Interakcje z innymi lekami)

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). (etykieta leku Dronabinol, Interakcje z innymi lekami)

Effects of Other Drugs on Dronedarone Ketoconazole and Other Potent CYP3A Inhibitors Concomitant use of ketoconazole as well as other potent CYP3A inhibitors such as itraconazole, voriconazole, ritonavir, clarithromycin, and nefazodone is contraindicated because exposure to dronedarone is significantly increased [see Contraindications (4) , Clinical Pharmacology… (etykieta leku Dronedaron, Interakcje z innymi lekami)

Consider monitoring serum potassium concentration in high-risk patients who take a strong CYP3A4 inhibitor long-term and concomitantly. (etykieta leku Drospirenon + etynyloestradiol, Ostrzeżenia i środki ostrożności)

Concomitant Use with CYP3A Inhibitors Exposure to elexacaftor, tezacaftor and ivacaftor are increased when used concomitantly with strong or moderate CYP3A inhibitors. (etykieta leku Eleksakaftor + tezakaftor + iwakaftor, Ostrzeżenia i środki ostrożności)

Coadministration of GENVOYA with other drugs that inhibit CYP3A may decrease the clearance and increase the plasma concentration of cobicistat. (etykieta leku Elwitegrawir + kobicystat + emtrycytabina + tenofowir, Interakcje z innymi lekami)

Drugs Inducing or Inhibiting CYP3A Enzymes Rilpivirine is primarily metabolized by cytochrome P450 (CYP) 3A, and drugs that induce or inhibit CYP3A may thus affect the clearance of RPV [see Contraindications (4) , Warnings and Precautions (5.7) , and Clinical Pharmacology (12.3) ] . (etykieta leku Emtrycytabina + rylpiwiryna + tenofowir, Interakcje z innymi lekami)

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. (etykieta leku Estradiol, Interakcje z innymi lekami)

…exposure at steady state. [See Clinical Pharmacology (12.3).] Substances Increasing the 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,… (etykieta leku Estradiol + dienogest, Interakcje z innymi lekami)

Inducers and/or inhibitors of CYP3A4 may affect estrogen drug metabolism and decrease or increase the estrogen plasma concentration. (etykieta leku Estradiol + noretysteron, Interakcje z innymi lekami)

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) ] . (etykieta leku Estrogeny skoniugowane + bazedoksyfen, Interakcje z innymi lekami)

The dose of LUNESTA should be reduced in patients who are administered potent inhibitors of CYP3A4, such as ketoconazole, while taking LUNESTA. (etykieta leku Eszopiklon, Ostrzeżenia i środki ostrożności)

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. (etykieta leku Etonogestrel + etynyloestradiol, Interakcje z innymi lekami)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

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. (etykieta leku Felodypina, Interakcje z innymi lekami)

Potential Pimozide Interaction Pimozide is metabolized by the cytochrome P4503A4 isoenzyme, and it has been demonstrated that ketoconazole, a potent inhibitor of CYP3A4, blocks the metabolism of this drug, resulting in increased plasma concentrations of parent drug. (etykieta leku Fluwoksamina, Ostrzeżenia i środki ostrożności)

A Grade ≥3 decrease in neutrophil counts was reported in 66% of patients receiving IBRANCE plus letrozole in PALOMA-2 and 66% of patients receiving IBRANCE plus fulvestrant in PALOMA-3. (etykieta leku Palbocyklib, Ostrzeżenia i środki ostrożności)

• CYP3A4 Inhibitor: Monitor adverse reactions if concomitant use with IRESSA. (etykieta leku Gefitynib, Interakcje z innymi lekami)

…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… (etykieta leku Guanfacyna, Interakcje z innymi lekami)

The effect of CYP3A4 inhibition and of decreased CYP2D6 enzyme may be additive. (etykieta leku Haloperydol, Interakcje z innymi lekami)

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. (etykieta leku Hydrokortyzon, Interakcje z innymi lekami)

• CYP3A4 Inhibitors: Use in combination with CYP3A4 inhibitors could decrease the effectiveness of ifosfamide. (etykieta leku Ifosfamid, Interakcje z innymi lekami)

The dose of FANAPT should be reduced in patients co-administered a strong CYP2D6 or CYP3A4 inhibitor. (etykieta leku Iloperydon, Interakcje z innymi lekami)

Potential for other drugs to affect ivacaftor CYP3A inhibitors: Reduce KALYDECO dosage in patients aged 6 months and older when co-administered with strong CYP3A inhibitors (e.g., ketoconazole) or moderate CYP3A inhibitors (e.g., fluconazole). (etykieta leku Iwakaftor, Interakcje z innymi lekami)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

Clinically Significant Drug Interactions with VRAYLAR Strong or Moderate CYP3A4 Inhibitors Clinical Impact: Concomitant use of VRAYLAR with a strong or moderate CYP3A4 inhibitor increases the exposures of cariprazine and its major active metabolite, didesmethylcariprazine (DDCAR), compared to use of VRAYLAR alone [see Clinical Pharmacology ( 12.3 ) ]. (etykieta leku Kariprazyna, Interakcje z innymi lekami)

Inhibitors of CYP3A4 and CYP3A5 Inhibitors of CYP3A4 and/or CYP3A5 may increase plasma concentrations of clindamycin [ see Clinical Pharmacology (12.3) ]. (etykieta leku Klindamycyna, Interakcje z innymi lekami)

CYP2D6 and CYP3A4 Inhibitors Concomitant treatment with CLOZARIL and CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline) can increase clozapine levels and lead to adverse reactions [see Clinical Pharmacology ( 12.3 )] . (etykieta leku Klozapina, Interakcje z innymi lekami)

• Concomitant use of strong CYP3A4 inhibitors: Reduce quetiapine dose to one‑sixth when coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) ( 2.5 , 7.1 , 12.3 ) (etykieta leku Kwetiapina, Interakcje z innymi lekami)

Strong CYP3A4 or CYP2C9 Inhibitors Patients with renal or hepatic impairment who are taking strong inhibitors of CYP3A4 and CYP2C9 may have a significant increase in exposure to VIMPAT. (etykieta leku Lakozamid, Interakcje z innymi lekami)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of lansoprazole is expected when used concomitantly with strong inhibitors [see Clinical Pharmacology (12.3) ] . (etykieta leku Lanzoprazol, Interakcje z innymi lekami)

A Grade ≥3 decrease in neutrophil counts was reported in 66% of patients receiving IBRANCE plus letrozole in PALOMA-2 and 66% of patients receiving IBRANCE plus fulvestrant in PALOMA-3. (etykieta leku Palbocyklib, Ostrzeżenia i środki ostrożności)

Strong CYP3A4 inhibitors : Maximum recommended dosage is 80 mg once daily ( 7 ). (etykieta leku Lewomilnacypran, Interakcje z innymi lekami)

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. (etykieta leku Lewonorgestrel + etynyloestradiol, Interakcje z innymi lekami)

Drug Interactions Effects of Other Drugs on Loperamide Concomitant use of loperamide hydrochloride capsules with inhibitors of CYP3A4 (e.g., itraconazole) or CYP2C8 (e.g., gemfibrozil) or inhibitors of P-glycoprotein (e.g., quinidine, ritonavir) can increase exposure to loperamide. (etykieta leku Loperamid, Interakcje z innymi lekami)

Strong CYP3A4 inhibitors: Recommended dosage is 10.5 mg once daily. (etykieta leku Lumateperon, Interakcje z innymi lekami)

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

Drugs That May Have Their Plasma Concentrations Altered by Palbociclib Coadministration of midazolam with multiple doses of IBRANCE increased the midazolam plasma exposure by 61%, in healthy subjects, compared to administration of midazolam alone. (etykieta leku Palbocyklib, Interakcje z innymi lekami)

…mifepristone is contraindicated. [See Contraindications (4.3)] 5.6 Use of Strong CYP3A Inhibitors Mifepristone should be used with caution in patients taking ketoconazole and other strong inhibitors of CYP3A, such as itraconazole, nefazodone, ritonavir, nelfinavir, indinavir, atazanavir, amprenavir, fosamprenavir, clarithromycin, conivaptan, lopinavir/ritonavir, posaconazole,… (etykieta leku Mifepryston, Ostrzeżenia i środki ostrożności)

Examples phenytoin, carbamazepine, rifampin Strong CYP3A Inhibitors Clinical Impact The concomitant use of strong CYP3A inhibitors with REMERON/REMERONSolTab may increase the plasma concentration of mirtazapine [see Clinical Pharmacology (12.3) ] . (etykieta leku Mirtazapina, Interakcje z innymi lekami)

Strong cytochrome P450 3A4 inhibitors (e.g., ritonavir): Risk of increased systemic corticosteroid effects. (etykieta leku Mometazon, Ostrzeżenia i środki ostrożności)

Moderate (e.g., fluconazole, atazanavir, aprepitant, diltiazem, erythromycin) and Strong (e.g., itraconazole, ketoconazole, clarithromycin, ritonavir, saquinavir) CYP3A Inhibitors Clinical Impact Increase in plasma naldemedine concentrations [see Clinical Pharmacology (12.3) ] Intervention Monitor for potential naldemedine-related adverse reactions [see Adverse… (etykieta leku Naldemedyna, Interakcje z innymi lekami)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (etykieta leku Naproksen + ezomeprazol, Interakcje z innymi lekami)

…as ketoconazole, fluconazole, itraconazole, clarithromycin, erythromycin (Azithromycin, although structurally related to the class of macrolide antibiotic is void of clinically relevant CYP3A4 inhibition), grapefruit, nefazodone, fluoxetine, saquinavir, indinavir, nelfinavir, and ritonavir may result in increased exposure to nifedipine when co-administered. (etykieta leku Nifedypina, Interakcje z innymi lekami)

Coadministration of P-gp and CYP3A4 inhibitors may increase nintedanib exposure. (etykieta leku Nintedanib, Interakcje z innymi lekami)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etykieta leku Norelgestromin + etynyloestradiol, Interakcje z innymi lekami)

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. (etykieta leku Noretysteron, Interakcje z innymi lekami)

CYP3A4 inhibitors such as itraconazole or ketoconazole may increase plasma hormone levels. (etykieta leku Noretysteron + etynyloestradiol, Interakcje z innymi lekami)

Concomitant administration of CYP3A4 inhibitors such as itraconazole, fluconazole, grapefruit juice or ketoconazole may increase plasma hormone concentrations. (etykieta leku Norgestrel + etynyloestradiol, Interakcje z innymi lekami)

CYP3A4 inhibitors such as itraconazole, voriconazole, fluconazole, grapefruit juice, or ketoconazole may increase plasma hormone concentrations. (etykieta leku Norgestymat + etynyloestradiol, Interakcje z innymi lekami)

Co-administration with strong cytochrome P450 (CYP) 3A4 inhibitors (e.g., ketoconazole) increases the systemic exposure of oxybutynin. (etykieta leku Oksybutynina, Interakcje z innymi lekami)

Risk of Use in Patients with Decreased Cytochrome P450 2D6 Function or Concomitant Use or Discontinuation with Cytochrome P450 3A4 Inhibitors and Inducers Risk of Increased Oliceridine Plasma Concentrations Increased plasma concentrations of oliceridine, which may result in prolonged opioid adverse reactions and exacerbated respiratory depression, may occur when… (etykieta leku Olicerydyna, Ostrzeżenia i środki ostrożności)

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (etykieta leku Olmesartan + amlodypina + hydrochlorotiazyd, Interakcje z innymi lekami)

Concomitant administration of CYP3A4 inhibitors may inhibit the metabolism of, and increase the mometasone furoate plasma concentration and potentially increase the risk for adverse reactions. (etykieta leku Olopatadyna + mometazon, Interakcje z innymi lekami)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (etykieta leku Omeprazol, Interakcje z innymi lekami)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact: Increased exposure of omeprazole [see Clinical Pharmacology ( 12.3 )] . (etykieta leku Omeprazol + wodorowęglan sodu, Interakcje z innymi lekami)

Exposure of Paricalcitol Injection will increase upon coadministration with strong CYP3A inhibitors [see Clinical Pharmacology (12.3) ] . (etykieta leku Parykalcytol, Interakcje z innymi lekami)

Strong CYP3A4 Inhibitors: Reduce NUPLAZID dose to 10 mg once daily. (etykieta leku Pimawanseryna, Interakcje z innymi lekami)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

CYP 3A4 inhibitors (e.g., ketoconazole, macrolide antibiotics): Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60% leading to an increased risk of corticosteroid side effects. (etykieta leku Prednizolon, Interakcje z innymi lekami)

CYP 3A4 Inhibitors (e.g., Ketoconazole, Macrolide Antibiotics) Ketoconazole has been reported to decrease the metabolism of certain corticosteroids by up to 60% leading to increased risk of corticosteroid side effects. (etykieta leku Prednizon, Interakcje z innymi lekami)

Published clinical reports indicate primaquine may inhibit CYP3A4 enzyme activity and thus may lead to increased exposure of oral CYP3A4 substrate drugs when co-administered with Primaquine phosphate Tablets. (etykieta leku Prymachina, Interakcje z innymi lekami)

Ketoconazole (strong CYP3A4 inhibitor): Increases AUC for ramelteon; administer with caution. (etykieta leku Ramelteon, Interakcje z innymi lekami)

CYP2C8 and CYP3A4 Inhibitors Intervention: Repaglinide tablets dose reductions and increased frequency of glucose monitoring may be required when co‑administered. (etykieta leku Repaglinid, Interakcje z innymi lekami)

Use with inhibitors of CYP3A4 or dual inhibitors of CYP3A4 and CYP1A2 (e.g., erythromycin, ketoconazole, fluvoxamine, enoxacin, cimetidine) will increase roflumilast systemic exposure and may result in increased adverse reactions. (etykieta leku Roflumilast, Interakcje z innymi lekami)

• Monitor for toxicities related to increased romidepsin exposure when co-administering romidepsin with strong CYP3A4 inhibitors ( 7.2 ). (etykieta leku Romidepsyna, Interakcje z innymi lekami)

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. (etykieta leku Ropiwakaina, Interakcje z innymi lekami)

Strong CYP3A4 Inhibitors: Reduce, interrupt, or discontinue JAKAFI/JAKAFI XR doses as recommended except in patients with acute or chronic graft-versus-host-disease. (etykieta leku Ruksolitynib, Interakcje z innymi lekami)

Coadministration of EDURANT or EDURANT PED and drugs that inhibit CYP3A may result in increased plasma concentrations of rilpivirine. (etykieta leku Rylpiwiryna, Interakcje z innymi lekami)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (etykieta leku Saksagliptyna, Interakcje z innymi lekami)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (etykieta leku Saksagliptyna + metformina, Interakcje z innymi lekami)

Monitor QT interval more frequently when SUTENT is concomitantly administered with strong CYP3A4 inhibitors or drugs known to prolong QT interval. (etykieta leku Sunitynib, Ostrzeżenia i środki ostrożności)

CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, erythromycin) increase SILDENAFIL ORAL FILM exposure. (etykieta leku Syldenafil, Interakcje z innymi lekami)

…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 )] . (etykieta leku Tadalafil, Ostrzeżenia i środki ostrożności)

The dose of the sensitive CYP3A substrate with a narrow therapeutic index (e.g., alfentanil, cyclosporine, dihydroergotamine, ergotamine, everolimus, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus) may need to be reduced, as IBRANCE may increase its exposure [see Clinical Pharmacology (12.3) ] . (etykieta leku Palbocyklib, Interakcje z innymi lekami)

CYP3A4 Inhibitors Co-administration of a 180 mg daily dose of diltiazem with 5 mg amlodipine in elderly hypertensive patients resulted in a 60% increase in amlodipine systemic exposure. (etykieta leku Telmisartan + amlodypina, Interakcje z innymi lekami)

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. (etykieta leku Temsyrolimus, Ostrzeżenia i środki ostrożności)

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

Drug Interactions CYP3A4 Inhibitors Ketoconazole, an inhibitor of the drug metabolizing enzyme CYP3A4, significantly increased plasma concentrations of tolterodine when coadministered to subjects who were poor metabolizers (see CLINICAL PHARMACOLOGY, Variability in Metabolism and Drug-Drug Interactions ). (etykieta leku Tolterodyna, Interakcje z innymi lekami)

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. (etykieta leku Triamcynolon, Interakcje z innymi lekami)

Simultaneous administration of drugs that inhibit the activity of liver microsomal enzymes, i.e., CYP3A4 inhibitors such as cimetidine and ketoconazole, may prolong the half-life and decrease the plasma clearance of tinidazole, increasing the plasma concentrations of tinidazole. (etykieta leku Tynidazol, Interakcje z innymi lekami)

Increase in Plasma Concentrations of ella Associated with Co-Administered Drugs CYP3A4 inhibitors such as itraconazole or ketoconazole increase plasma concentrations of ella [see Pharmacokinetics (12.3) ] . (etykieta leku Uliprystal, Interakcje z innymi lekami)

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,… (etykieta leku Umeklidynium + wilanterol, Ostrzeżenia i środki ostrożności)

In patients taking a strong CYP2D6 or CYP3A4 inhibitor, or who are CYP2D6 poor metabolizers, INGREZZA and INGREZZA SPRINKLE concentrations may be higher and QT prolongation clinically significant [see Clinical Pharmacology ( 12.2 )] . (etykieta leku Walbenazyna, Ostrzeżenia i środki ostrożności)

Potential for Drug Interactions with Strong or Moderate CYP3A4 Inhibitors Concomitant administration with strong CYP3A4 inhibitors (such as ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (such as erythromycin) increases plasma concentrations of vardenafil. (etykieta leku Wardenafil, Ostrzeżenia i środki ostrożności)

Closely monitor INR if a concomitant drug is a CYP2C9, 1A2, and/or 3A4 inhibitor or inducer. (etykieta leku Warfaryna, Interakcje z innymi lekami)

Concomitant use of CYP3A4 inhibitors and venlafaxine may increase levels of venlafaxine and ODV. (etykieta leku Wenlafaksyna, Interakcje z innymi lekami)

CYP3A4 Inhibitors: The VIIBRYD dose should not exceed 20 mg once daily when co-administered with strong CYP3A4 inhibitors ( 2.4 , 7 ). (etykieta leku Wilazodon, Interakcje z innymi lekami)

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) ]. (etykieta leku Wiloksazyna, Interakcje z innymi lekami)

Inhibitors of CYP3A4: May cause earlier onset and/or increased severity of adverse reactions ( 7.1 ) (etykieta leku Winorelbina, Interakcje z innymi lekami)

As zafirlukast is known to be an inhibitor of CYP3A4 in vitro , it is reasonable to employ appropriate clinical monitoring when these drugs are coadministered with zafirlukast. (etykieta leku Zafirlukast, Środki ostrożności)

Drugs That Inhibit CYP3A4 CYP3A4 is a minor metabolic pathway for the elimination of zaleplon because the sum of desethylzaleplon (formed via CYP3A4 in vitro) and its metabolites, 5-oxo-desethylzaleplon and 5-oxo-desethylzaleplon glucuronide, account for only 9% of the urinary recovery of a zaleplon dose. (etykieta leku Zaleplon, Interakcje z innymi lekami)

CYP3A4 Inhibitors Ketoconazole Ketoconazole, a potent CYP3A4 inhibitor, increased the exposure to and pharmacodynamic effects of zolpidem. (etykieta leku Zolpidem, Interakcje z innymi lekami)

Ketoconazole Ketoconazole, a potent inhibitor of CYP3A4, at a dose of 400 mg QD for 5 days, increased the AUC and C max of ziprasidone by about 35 to 40%. (etykieta leku Zyprazydon, Interakcje z innymi lekami)

Potential for REYATAZ to Affect Other Drugs Atazanavir is an inhibitor of CYP3A and UGT1A1. (etykieta leku Atazanawir, Interakcje z innymi lekami)

The effect of potent CYP3A4 inhibitors on dutasteride has not been studied. (etykieta leku Dutasteryd, Interakcje z innymi lekami)

Although potent inhibitors of cytochrome P450 3A4 (e.g., ketoconazole) have not been studied clinically, in vitro studies have shown that erythromycin and oleandomycin inhibit the metabolism of disopyramide. (etykieta leku Dyzopiramid, Interakcje z innymi lekami)

TAF is a weak inhibitor of CYP3A in vitro . (etykieta leku Emtrycytabina + tenofowir, Interakcje z innymi lekami)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (etykieta leku Erybulina, Interakcje z innymi lekami)

An in vitro study using human liver microsomes suggests that famciclovir is not an inhibitor of CYP3A4 enzymes. (etykieta leku Famcyklowir, Interakcje z innymi lekami)

Additionally, in vitro studies have shown ketoconazole, a potent inhibitor of CYP3A4 activity, to be at least 100 times more potent than fluoxetine or norfluoxetine as an inhibitor of the metabolism of several substrates for this enzyme, including astemizole, cisapride, and midazolam. (etykieta leku Fluoksetyna, Interakcje z innymi lekami)

Effect of SUNLENCA on Other Drugs Lenacapavir is a moderate inhibitor of CYP3A. (etykieta leku Lenakapawir, Interakcje z innymi lekami)

Effect of Other Drugs on the Metabolism of Donepezil Inhibitors of CYP3A4 (e.g., ketoconazole) and CYP2D6 (e.g., quinidine), inhibit donepezil metabolism in vitro . (etykieta leku Memantyna + donepezyl, Interakcje z innymi lekami)

Inhibitors of CYP3A4, CYP2B6, CYP2C19, CYP2C9, or CYP2D6 Clinical Impact: Methadone undergoes hepatic N-demethylation by several cytochrome P450 (CYP) isoforms, including CYP3A4, CYP2B6, CYP2C19, CYP2C9, and CYP2D6. (etykieta leku Metadon, Interakcje z innymi lekami)

Drugs Metabolized by CYP3A — In vitro studies utilizing human liver microsomes suggest that olanzapine has little potential to inhibit CYP3A. (etykieta leku Olanzapina + fluoksetyna, Interakcje z innymi lekami)

Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Concomitant use of ASPRUZYO Sprinkle with strong CYP3A inhibitors, including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir is contraindicated [see Contraindications (4), Clinical Pharmacology (12.3)]. (etykieta leku Ranolazyna, Interakcje z innymi lekami)

Clinically Significant Interactions Affecting Other Drugs CYP3A Substrates Where Small Concentration Changes May Lead to Serious Adverse Reactions Clinical Impact Ritlecitinib is a CYP3A inhibitor. (etykieta leku Rytlecytynib, Interakcje z innymi lekami)

Grade ≥3 neutropenia was reported in 61% of patients receiving IBRANCE in combination with trastuzumab, with or without pertuzumab, and endocrine therapy. (etykieta leku Palbocyklib, Ostrzeżenia i środki ostrożności)

However, no formal drug-drug interaction studies between zileuton and CYP3A4 inhibitors, such as ketaconazole, have been conducted. (etykieta leku Zileuton, Interakcje z innymi lekami)

Inhibitors of Cytochrome P450 3A4 In controlled clinical studies co-administration of desloratadine with ketoconazole, erythromycin, or azithromycin resulted in increased plasma concentrations of desloratadine and 3 hydroxydesloratadine, but there were no clinically relevant changes in the safety profile of desloratadine. [See Clinical Pharmacology (12.3) .]… (etykieta leku Desloratadyna, Interakcje z innymi lekami)