For drug interaction purposes, the inhibitors and inducers of CYP3A metabolism listed above can alter serum concentrations of drugs that are dependent upon the CYP3A subfamily of liver enzymes, including CYP3A4, for elimination or activation.

Examples of drugs that are substrates of P-gp efflux pump include: Apixaban, colchicine, cyclosporine, dabigatran, digoxin, edoxaban, rivaroxaban, and tacrolimus. The degree of effect on P-gp substrate serum concentration may be altered by dose and timing of orally administered P-gp inhibitor or inducer.

Inhibition of CYP3A4 (ie, without P-gp inhibition) may also increase apixaban and rivaroxaban effect, but to a lesser extent than dual inhibition of CYP3A4 and P-gp. Examples of CYP3A4 inhibitors that do not also inhibit P-gp include diltiazem, fluconazole, and voriconazole.

Nefazodone is a strong inhibitor of CYP3A4; it can significantly elevate levels of co-administered medications that are dependent on CYP3A4 metabolism for clearance 2 to 5 (parent) 2 to 33 (active metabolites)

Management: If use of alfentanil and strong CYP3A4 inhibitors is necessary, consider dosage reduction of alfentanil until stable drug effects are achieved. Frequently monitor patients for respiratory depression and sedation when these agents are combined.

For drug interaction purposes, the inhibitors and inducers of CYP3A metabolism listed above can alter serum concentrations of drugs that are dependent upon the CYP3A subfamily of liver enzymes, including CYP3A4, for elimination or activation.

This is a partial list of medications that may increase or decrease warfarin effect on the INR. The patient's medications should be analyzed closely for drug interactions with warfarin, especially when initiating or altering therapy.

Apr 23, 2024 · Lipid-altering agents encompass several classes of drugs that include hydroxymethylglutaryl (HMG) CoA reductase inhibitors or statins, fibric acid derivatives, bile acid sequestrants, cholesterol absorption inhibitors, and nicotinic acid.

Jun 5, 2020 · Co-administration of drugs that are inhibitors of CYP 3A and/or P-gp may INCREASE glucocorticoid exposure and toxicity ¶ Antimicrobials: Clarithromycin, telithromycin: Increased glucocorticoid effects due to decreased clearance. Methylprednisolone and dexamethasone clearance may be reduced by approximately 30 to 50%.

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