Apremilast(continued)
▶Enzalutamidemoderately decreases the exposure to
apremilast. Avoid.rStudy
▶Mitotanemoderately decreases the exposure toapremilast.
Avoid.rStudy
▶Rifampicinmoderately decreases the exposure toapremilast.
Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
apremilast. Avoid.rTheoretical
Aprepitant
▶Aprepitantis predicted to increase the exposure toaldosterone
antagonists(eplerenone). Adjusteplerenonedose.rStudy
▶Aprepitantis predicted to increase the exposure toalpha
blockers(tamsulosin).oTheoretical
▶Aprepitantis predicted to increase the exposure toalprazolam.
rStudy
▶Aprepitantincreases the exposure toantiarrhythmics
(dronedarone).rTheoretical
▶Aprepitantis predicted to increase the exposure to
antiarrhythmics(propafenone). Monitor and adjust dose.
oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to markedly decrease the
exposure toaprepitant. Avoid.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure toaprepitant.
oStudy
▶Aprepitantis predicted to increase the exposure toantifungals,
azoles(isavuconazole).oTheoretical
▶Aprepitantis predicted to increase the exposure to
antihistamines, non-sedating(mizolastine).rTheoretical
▶Aprepitantis predicted to increase the exposure to
antihistamines, non-sedating(rupatadine). Avoid.oStudy
▶Aprepitantis predicted to increase the concentration of
antimalarials(piperaquine).rTheoretical
▶Aprepitantis predicted to increase the exposure toaxitinib.
oTheoretical
▶Aprepitantis predicted to increase the exposure to
bedaquiline. Avoid prolonged use.nTheoretical
▶Aprepitantis predicted to increase the exposure tobosutinib.
Avoid or adjust dose.rTheoretical
▶Aprepitantis predicted to increase the exposure tobuspirone.
Use with caution and adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure to
cabozantinib.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toaprepitantandaprepitantis predicted
to increase the exposure tocalcium channel blockers(diltiazem,
verapamil).oStudy
▶Aprepitantis predicted to increase the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure toceritinib.
oTheoretical
▶Aprepitantincreases the concentration ofciclosporin.r
Study
▶Cobicistatis predicted to markedly increase the exposure to
aprepitant.oStudy
▶Aprepitantis predicted to increase the exposure to
cobimetinib.rTheoretical
▶Aprepitantis predicted to increase the exposure tocolchicine.
Adjustcolchicinedose with moderate inhibitors of CYP3A4.
rStudy
▶Aprepitantis predicted to decrease the efficacy ofcombined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactionsp. 497.rStudy
▶Aprepitantmoderately increases the exposure tocorticosteroids
(dexamethasone). Monitor and adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure to
corticosteroids(methylprednisolone). Monitor and adjust dose.
oStudy
▶Aprepitantdecreases the anticoagulant effect ofcoumarins.
oStudy▶Aprepitantis predicted to slightly increase the exposure to
darifenacin.oStudy
▶Aprepitantis predicted to increase the exposure todasatinib.
rStudy
▶Aprepitantis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Aprepitantincreases the risk of QT-prolongation when given
withdomperidone. Avoid.rStudy
▶Aprepitantis predicted to increase the exposure todopamine
receptor agonists(bromocriptine).rTheoretical
▶Aprepitantis predicted to increase the concentration of
dopamine receptor agonists(cabergoline).oAnecdotal
▶Aprepitantis predicted to moderately increase the exposure to
dutasteride.nStudy
▶Aprepitantis predicted to increase the exposure toeliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶Enzalutamideis predicted to markedly decrease the exposure
toaprepitant. Avoid.oStudy
▶Aprepitantis predicted to increase the risk of ergotism when
given withergometrine.rTheoretical
▶Aprepitantis predicted to increase the risk of ergotism when
given withergotamine.rTheoretical
▶Aprepitantis predicted to increase the exposure toerlotinib.
oTheoretical
▶Aprepitantis predicted to decrease the efficacy ofetonogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Aprepitantis predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure to
fesoterodine. Adjustfesoterodinedose with moderate
inhibitors of CYP3A4 in hepatic and renal impairment.n
Study
▶Aprepitantis predicted to increase the exposure togefitinib.
oTheoretical
▶Aprepitantis predicted to increase the concentration of
guanfacine. Adjustguanfacinedose,p. 231.oTheoretical
▶HIV-protease inhibitorsare predicted to markedly increase the
exposure toaprepitant.oStudy
▶Aprepitantis predicted to decrease the effects ofhormone
replacement therapy.oAnecdotal
▶Aprepitantis predicted to increase the exposure toibrutinib.
Adjustibrutinibdose with moderate inhibitors of CYP3A4.
rStudy
▶Idelalisibis predicted to markedly increase the exposure to
aprepitant.oStudy
▶Aprepitantis predicted to increase the exposure toimatinib.
oTheoretical
▶Aprepitantis predicted to increase the exposure toivabradine.
Adjustivabradinedose.rTheoretical
▶Aprepitantis predicted to increase the exposure toivacaftor.
Adjustivacaftordose with moderate inhibitors of CYP3A4,
p. 186.rStudy
▶Aprepitantis predicted to increase the exposure tolapatinib.
oStudy
▶Aprepitantis predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, seeContraceptives,
interactionsp. 497.rTheoretical
▶Aprepitantis predicted to increase the exposure tolomitapide.
Avoid.oTheoretical
▶Aprepitantis predicted to increase the exposure tolurasidone.
oStudy
▶Macrolides(clarithromycin)are predicted to markedly increase
the exposure toaprepitant.oStudy
▶Aprepitantis predicted to increase the exposure tomidazolam.
Monitor side effects and adjust dose.rStudy
▶Aprepitantis predicted to increase the exposure to
midostaurin.oTheoretical
▶Mitotaneis predicted to markedly decrease the exposure to
aprepitant. Avoid.oStudy
▶Aprepitantis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Aprepitantis predicted to increase the exposure tonilotinib.
oTheoretical880 Apremilast—Aprepitant BNFC 2018 – 2019
Interactions|Appendix 1A1