Table 1.

Inhibitors and inducers of CYP3A4 which potentially increase or decrease naldemedine concentrations.

Strong Inhibitors of CYP3A4: Increase Naldemedine Concentration	Inducers of CYP3A4: Decrease Naldemedine Concentration
Itraconazole	Rifampine
Ketoconaxole	St. John’s wort
Clarithromycin
Grapefruit juice
Moderate Inhibitors of CYP3A4: Diltiazem Erythromycin Verapamil

Potent inhibitors of the P-glycoprotein pump, like ciclosporin, have the potential to elevate naldemedine blood levels.