▶Aprepitantis predicted to decrease the efficacy of
norethisterone. For FSRH guidance, seeContraceptives,
interactionsp. 497.rAnecdotal
▶Aprepitantis predicted to increase the exposure toolaparib.
Avoid moderate inhibitors of CYP3A4 or adjustolaparibdose.
oTheoretical
▶Aprepitantis predicted to increase the exposure toopioids
(alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and
adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure toopioids
(methadone, sufentanil).oTheoretical
▶Aprepitantis predicted to increase the exposure tooxybutynin.
nTheoretical
▶Aprepitantis predicted to increase the exposure topazopanib.
oTheoretical
▶Aprepitantis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(avanafil). Adjustavanafil
dose.oTheoretical
▶Aprepitantis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(sildenafil). Monitor or
adjustsildenafildose with moderate inhibitors of CYP3A4,
p. 120.oStudy
▶Aprepitantis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(tadalafil).rTheoretical
▶Aprepitantis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(vardenafil). Adjust dose.
rTheoretical
▶Aprepitantis predicted to increase the exposure topimozide.
Avoid.rTheoretical
▶Aprepitantis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Aprepitantis predicted to increase the exposure toranolazine.
rStudy
▶Aprepitantis predicted to increase the exposure toribociclib.
oStudy
▶Rifampicinis predicted to markedly decrease the exposure to
aprepitant. Avoid.oStudy
▶Aprepitantis predicted to increase the exposure toruxolitinib.
oTheoretical
▶Aprepitantis predicted to increase the exposure tosaxagliptin.
nStudy
▶Aprepitantis predicted to increase the exposure tosimeprevir.
Avoid.rStudy
▶Aprepitantincreases the concentration ofsirolimus. Monitor
and adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure toSSRIs
(dapoxetine). Adjustdapoxetinedose with moderate inhibitors
of CYP3A4.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
aprepitant. Avoid.oTheoretical
▶Aprepitantis predicted to increase the exposure tostatins
(atorvastatin). Monitor and adjust dose.rStudy
▶Aprepitantis predicted to increase the exposure tostatins
(simvastatin). Use with caution and adjustsimvastatindose,
p. 134.rStudy
▶Aprepitantis predicted to increase the exposure tosunitinib.
oTheoretical
▶Aprepitantis predicted to increase the concentration of
tacrolimus.rStudy
▶Aprepitantis predicted to increase the exposure totaxanes
(cabazitaxel).oTheoretical
▶Aprepitantis predicted to increase the concentration of
temsirolimus.oTheoretical
▶Aprepitantis predicted to increase the exposure totofacitinib.
oStudy
▶Aprepitantis predicted to increase the exposure totolterodine.
nTheoretical
▶Aprepitantis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Aprepitantis predicted to increase the exposure totrazodone.
oTheoretical
▶Aprepitantdecreases the efficacy ofulipristal. For FSRH
guidance, seeContraceptives, interactionsp. 497.r
Anecdotal
▶Aprepitantis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Aprepitantis predicted to increase the exposure tovinca
alkaloids.rTheoretical
▶Aprepitantis predicted to increase the exposure tozopiclone.
Adjust dose.oStudy
Argatroban→seeTABLE 3p. 847 (anticoagulant effects)
▶Ranibizumabis predicted to increase the risk of bleeding
events when given withargatroban.rTheoretical
Aripiprazole→seeTABLE 8p. 848 (hypotension),TABLE 11p. 849 (CNS
depressant effects)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to moderately decrease
the exposure toaripiprazole. Adjustaripiprazoledose,p. 249.
oStudy→Also seeTABLE 11p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to slightly increase the exposure toaripiprazole.
Adjustaripiprazoledose,p. 249.oStudy
▶Bupropionis predicted to moderately increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Cinacalcetis predicted to moderately increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Cobicistatis predicted to slightly increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Aripiprazoleis predicted to decrease the effects ofdopamine
receptor agonists.oTheoretical→Also seeTABLE 8p. 848
▶Enzalutamideis predicted to moderately decrease the
exposure toaripiprazole. Adjustaripiprazoledose,p. 249.
oStudy
▶HIV-protease inhibitorsare predicted to slightly increase the
exposure toaripiprazole. Adjustaripiprazoledose,p. 249.
oStudy
▶Idelalisibis predicted to slightly increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Aripiprazoleis predicted to decrease the effects oflevodopa.
rTheoretical→Also seeTABLE 8p. 848
▶Macrolides(clarithromycin)are predicted to slightly increase
the exposure toaripiprazole. Adjustaripiprazoledose,p. 249.
oStudy
▶Mitotaneis predicted to moderately decrease the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Rifampicinis predicted to moderately decrease the exposure
toaripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶SSRIs(fluoxetine, paroxetine)are predicted to moderately
increase the exposure toaripiprazole. Adjustaripiprazoledose,
p. 249.oStudy
▶Terbinafineis predicted to moderately increase the exposure
toaripiprazole. Adjustaripiprazoledose,p. 249.oStudy
Arsenic trioxide→seeTABLE 15p. 850 (myelosuppression),TABLE 9
p. 849 (QT-interval prolongation)
Artemether→see antimalarials
Artenimol→see antimalarials
Articaine→seeTABLE 11p. 849 (CNS depressant effects)
Ascorbic acid
▶Ascorbic acidis predicted to increase the risk of cardiovascular
side-effects when given withdeferiprone.rTheoretical
▶Ascorbic acidis predicted to increase the risk of cardiovascular
side-effects when given withiron chelators(desferrioxamine).
rTheoretical
Asenapine→seeTABLE 8p. 848 (hypotension),TABLE 11p. 849 (CNS
depressant effects)
▶Asenapineis predicted to decrease the effects ofdopamine
receptor agonists. Adjust dose.oTheoretical→Also see
TABLE 8p. 848
▶Asenapineis predicted to decrease the effects oflevodopa.
Adjust dose.rTheoretical→Also seeTABLE 8p. 848
▶SSRIs(fluvoxamine)increase the exposure toasenapine.
oStudy
▶SSRIs(paroxetine)moderately increase the exposure to
asenapine.oStudy
Asparaginase→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)BNFC 2018 – 2019 Aprepitant—Asparaginase 881
Interactions|Appendix 1A1