Table 2.
CYP3A4 inducers and inhibitors
| Drug class | Agent | Wash-out |
|---|---|---|
| CYP3A4 inducers | ||
| Antibiotics | All rifamycin agents (e.g., rifampicin, rifabutin, rifapentine) | 14 days |
| Anticonvulsants | Phenytoin, carbamazepine, barbiturates (e.g., phenobarbital) | |
| Antiretrovirals | Efavirenz, nevirapine | |
| Glucocorticoids (oral) | Cortisone (>50 mg), hydrocortisone (>40 mg), prednisone (>10 mg), methylprednisone (>8 mg), dexamethasone (>1.5 mg) | Not Applicable |
| Others | St. John’s wort (Hypericum perforatum), modafinil | Not Applicable |
| CYP3A4 inhibitors | ||
| Antibiotics | Clarithromycin, erythromycin, troleandomycin | 7 days |
| Antifungals | Itraconazole, ketoconazole, fluconazole (>150 mg/d), voriconazole | |
| Antiretrovirals, protease inhibitors | Delavirdine, nelfinavir, amprenavir, ritonavir, indinavir, saquinavir, lopinivir | |
| Calcium channel blockers | Verapamil, diltiazem | |
| Antidepressants | Nefazodone, fluvoxamine | |
| GI agents | Cimetidine, aprepitant | |
| Others | Grapefruit, grapefruit juice | |
| Amiodarone | 6 months | |
| Miscellaneous | ||
| Antacids | Mylanta®, Maalox®, Tums®, Rennie® | 1 h before and after dosing |
| Herbal or dietary supplements | Ginkgo biloba, grape seed, valerian, ginseng, echinacea, evening primrose oil | 14 days |