Phosphodiesterase type-5 inhibitors(continued)
▶Enzalutamideis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors(sildenafil, vardenafil).
oTheoretical
▶Etravirinemoderately decreases the exposure to
phosphodiesterase type-5 inhibitors. Adjust dose.o
Study
▶Grapefruit juiceis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors. Use with caution or avoid.
oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tophosphodiesterase type-5 inhibitors(avanafil, vardenafil).
Avoid.rStudy→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
tosildenafil. Avoid potent inhibitors of CYP3A4 or adjust
sildenafildose,p. 120.rStudy→Also seeTABLE 9p. 849
▶HIV-protease inhibitorsare predicted to increase the exposure
totadalafil. Use with caution or avoid.rStudy
▶Idelalisibis predicted to increase the exposure to
phosphodiesterase type-5 inhibitors(avanafil, vardenafil). Avoid.
rStudy
▶Idelalisibis predicted to increase the exposure tosildenafil.
Avoid potent inhibitors of CYP3A4 or adjustsildenafildose,
p. 120.rStudy
▶Idelalisibis predicted to increase the exposure totadalafil. Use
with caution or avoid.rStudy
▶Imatinibis predicted to increase the exposure toavanafil.
Adjustavanafildose.oTheoretical
▶Imatinibis predicted to increase the exposure tosildenafil.
Monitor or adjustsildenafildose with moderate inhibitors of
CYP3A4,p. 120.oStudy
▶Imatinibis predicted to increase the exposure totadalafil.
rTheoretical
▶Imatinibis predicted to increase the exposure tovardenafil.
Adjust dose.rTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure tosildenafil. Avoid potent inhibitors of CYP3A4 or
adjustsildenafildose,p. 120.rStudy→Also seeTABLE 9
p. 849
▶Macrolides(clarithromycin)are predicted to increase the
exposure totadalafil. Use with caution or avoid.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure toavanafil. Adjustavanafildose.oTheoretical
▶Macrolides(erythromycin)are predicted to increase the
exposure tosildenafil. Monitor or adjustsildenafildose with
moderate inhibitors of CYP3A4,p. 120.oStudy→Also
seeTABLE 9p. 849
▶Macrolides(erythromycin)are predicted to increase the
exposure totadalafil.rTheoretical
▶Macrolides(erythromycin)are predicted to increase the
exposure tovardenafil. Adjust dose.rTheoretical→Also
seeTABLE 9p. 849
▶Macrolides(clarithromycin)are predicted to increase the
exposure tophosphodiesterase type-5 inhibitors(avanafil,
vardenafil). Avoid.rStudy→Also seeTABLE 9p. 849
▶Mitotaneis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors(avanafil, tadalafil). Avoid.
rStudy
▶Mitotaneis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors(sildenafil, vardenafil).
oTheoretical
▶Netupitantis predicted to increase the exposure toavanafil.
Adjustavanafildose.oTheoretical
▶Netupitantis predicted to increase the exposure tosildenafil.
Monitor or adjustsildenafildose with moderate inhibitors of
CYP3A4,p. 120.oStudy
▶Netupitantis predicted to increase the exposure totadalafil.
rTheoretical
▶Netupitantis predicted to increase the exposure tovardenafil.
Adjust dose.rTheoretical
▶Nevirapineis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors.oTheoretical
▶Nicorandilis predicted to increase the risk of hypotension
when given withphosphodiesterase type-5 inhibitors. Avoid.
rTheoretical→Also seeTABLE 8p. 848▶Nilotinibis predicted to increase the exposure toavanafil.
Adjustavanafildose.oTheoretical
▶Nilotinibis predicted to increase the exposure tosildenafil.
Monitor or adjustsildenafildose with moderate inhibitors of
CYP3A4,p. 120.oStudy→Also seeTABLE 9p. 849
▶Nilotinibis predicted to increase the exposure totadalafil.
rTheoretical
▶Nilotinibis predicted to increase the exposure tovardenafil.
Adjust dose.rTheoretical→Also seeTABLE 9p. 849
▶Nitratespotentially increase the risk of hypotension when
given withphosphodiesterase type-5 inhibitors. Avoid.r
Study→Also seeTABLE 8p. 848
▶Ribociclibis predicted to increase the exposure tosildenafil.
Avoid.oTheoretical→Also seeTABLE 9p. 849
▶Rifampicinis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors(avanafil, tadalafil). Avoid.
rStudy
▶Rifampicinis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors(sildenafil, vardenafil).
oTheoretical
▶Riociguatis predicted to increase the risk of hypotension
when given withphosphodiesterase type-5 inhibitors. Avoid.
rTheoretical→Also seeTABLE 8p. 848
▶Phosphodiesterase type-5 inhibitorsare predicted to increase
the risk of hypotension when given withsapropterin.o
Theoretical→Also seeTABLE 8p. 848
▶St John’s Wortis predicted to decrease the exposure to
phosphodiesterase type-5 inhibitors.oTheoretical
Pibrentasvir
▶Antiarrhythmics(dronedarone)potentially increase the
exposure topibrentasvir.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to moderately to markedly
decrease the exposure topibrentasvir. Avoid.rStudy
▶Antiepileptics(eslicarbazepine, oxcarbazepine)potentially
decrease the exposure topibrentasvir. Avoid.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole)potentially
increase the exposure topibrentasvir.oTheoretical
▶Bosentanis predicted to decrease the exposure topibrentasvir.
Avoid.rStudy
▶Ciclosporinincreases the exposure topibrentasvir. Avoid or
monitor.rStudy
▶Crizotinibpotentially decreases the exposure topibrentasvir.
Avoid.rTheoretical
▶Pibrentasvir(with glecaprevir) increases the exposure to
dabigatran. Avoid.oStudy
▶Pibrentasvir(with glecaprevir) increases the exposure to
digoxin.oStudy
▶Efavirenzis predicted to decrease the exposure topibrentasvir.
Avoid.rStudy
▶Enzalutamideis predicted to moderately to markedly decrease
the exposure topibrentasvir. Avoid.rStudy
▶HIV-protease inhibitors(atazanavir, lopinavir)(boosted with
ritonavir) increase the exposure topibrentasvir. Avoid.r
Study
▶HIV-protease inhibitors(ritonavir)potentially increase the
exposure topibrentasvir.rTheoretical
▶Lumacaftorpotentially decreases the exposure topibrentasvir.
Avoid.rTheoretical
▶Mitotaneis predicted to moderately to markedly decrease the
exposure topibrentasvir. Avoid.rStudy
▶Nevirapineis predicted to decrease the exposure to
pibrentasvir. Avoid.rStudy
▶Rifampicinis predicted to moderately to markedly decrease
the exposure topibrentasvir. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
pibrentasvir. Avoid.rStudy
▶Pibrentasvir(with glecaprevir) increases the exposure to
statins(atorvastatin, simvastatin). Avoid.oStudy
▶Pibrentasvir(with glecaprevir) is predicted to increase the
exposure tostatins(fluvastatin).oTheoretical
▶Pibrentasvir(with glecaprevir) increases the exposure to
statins(pravastatin). Use with caution and adjustpravastatin
dose.oStudy974 Phosphodiesterase type-5 inhibitors—Pibrentasvir BNFC 2018 – 2019
Interactions|Appendix 1A1