VinCRIStine (Liposomal): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of VinCRIStine (Liposomal). Etoposide Phosphate: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Etoposide Phosphate. CYP3A4 Inhibitors (Strong) may increase the serum concentration of Irinotecan Products. Olaparib: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Olaparib. Physeal dysplasia in the femur was observed in offspring of rats treated with oral doses of esomeprazole magnesium at doses equal to or greater than 138 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis).Effects on maternal bone were observed in pregnant and lactating rats in a pre- and postnatal toxicity study when esomeprazole magnesium was administered at oral doses of 14 to 280 mg/kg/day (about 3.4 to 68 times an oral human dose of 40 mg on a body surface area basis). Management: The addition of a CYP2C8 inhibitor to this drug combination may substantially increase the magnitude of increase in repaglinide exposure.Retapamulin: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Retapamulin.
Ivacaftor: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Ivacaftor. Specifically, proton pump inhibitors may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption. Management: Avoid concurrent use of axitinib with any strong CYP3A inhibitor whenever possible. More specifically, tetrahydrocannabinol and cannabidiol serum concentrations may be increased. Cariprazine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Cariprazine. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.Tell your doctor about all your current medicines. Recommended dose adjustments vary by tofacitinib formulation and therapeutic indication. Monitor patients for both reduced efficacy and increased toxicities.Suvorexant: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Suvorexant. Dasatinib: Proton Pump Inhibitors may decrease the serum concentration of Dasatinib. Some combinations are specifically contraindicated by manufacturers; others may have recommended dose adjustments. If they’re more severe or don’t go away, talk to your doctor or pharmacist.Call your doctor right away if you have serious side effects. Patients with additional risk factors for QTc prolongation may be at even higher risk.Escitalopram: Omeprazole may increase the serum concentration of Escitalopram. Also see individual agents.<1%, postmarketing, and/or case reports: Hepatotoxicity (idiosyncratic) (Chalasani 2014)• Altered cardiac conduction: Macrolides have been associated with rare QT• Anaphylactoid/hypersensitivity reactions: Serious and occasionally severe or fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy, especially with a history of beta-lactam hypersensitivity, history of sensitivity to multiple allergens, or previous IgE-mediated reactions (eg, anaphylaxis, angioedema, urticaria). Management: Consider alternative antimicrobial therapy for patients receiving a CYP3A inducer. Consider alternative methods to minimize/control acid reflux (eg, diet modification) or alternative antimicrobial therapy if use of PPIs can not be avoided.Cefpodoxime: Proton Pump Inhibitors may decrease the serum concentration of Cefpodoxime. Monitor for respiratory depression and sedation. If such concurrent use cannot be avoided, the dose of olaparib tablets should be reduced to 100 mg twice daily and the dose of olaparib capsules should be reduced to 150 mg twice daily.Oliceridine: CYP3A4 Inhibitors (Strong) may increase the serum concentration of Oliceridine. Discontinue if acute interstitial nephritis develops.• Superinfection: Prolonged use of amoxicillin or clarithromycin may result in fungal or bacterial superinfection, including • Coronary artery disease (CAD): Use clarithromycin with caution in patients with CAD; postmarketing safety trial suggests increased risk of cardiovascular mortality with short-term clarithromycin use (vs placebo) in patients with stable CAD.
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