Disulfiram Inhibits CYP2C9. Inhibits aldehyde dehydrogenase.
Estrogens Estrogen metabolism (CYP3A4) susceptible to induction and inhibition. Enterohepatic circulation of estrogen may be interrupted by alteration in bowel flora (eg, due to antibiotics).
Benzodiazepines: [P] Decreased metabolism of chlordiazepoxide and diazepam but not lorazepam and oxazepam. Metronidazole: [NE] Confusion and psychoses reported in patients receiving this combination; mechanisms unknown.
Phenytoin: [P] Decreased phenytoin metabolism. See also Alcohol; Anticoagulants, oral.
Ampicillin: [NP] Interruption of enterohepatic circulation of estrogen; possible reduction in oral contraceptive efficacy. Some other oral antibiotics may have a similar effect. Bexarotene: [P] Increased estrogen metabolism, possible reduction in oral contraceptive efficacy. Bosentan: [NP] Enzyme induction leading to reduced estrogen effect. Corticosteroids: [P] Decreased metabolism of corticosteroids leading to increased corticosteroid effect. Dexamethasone may increase estrogen metabolism.
Efavirenz: [P] Increased estrogen metabolism, possible reduction in oral contraceptive efficacy. Griseofulvin: [NP] Increased estrogen metabolism, possible reduction in oral contraceptive efficacy.
Nelfinavir: [P] Increased estrogen metabolism, possible reduction in oral contraceptive efficacy. Nevirapine: [NP] Increased estrogen metabolism, possible reduction in oral contraceptive efficacy.
Phenytoin: [P] Increased estrogen metabolism; possible reduction in oral contraceptive efficacy. Primidone: [P] Increased estrogen metabolism; possible reduction in oral contraceptive efficacy.
Rifabutin: [P] Increased estrogen metabolism; possible reduction in oral contraceptive efficacy. Rifampin: [P] Increased estrogen metabolism; possible reduction in oral contraceptive efficacy.
St. John’s wort: [P] Increased estrogen metabolism; possible reduction in oral contraceptive efficacy. See also Barbiturates; Carbamazepine.
Amiodarone: [NP] Decreased atorvastatin, lovastatin, and simvastatin metabolism.
Expect similar interactions with dronedarone. Antivirals: [P] Amprenavir, atazanavir, boceprevir, darunavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, simeprevir, and telaprevir inhibit the metabolism of atorvastatin, lovastatin, and simvastatin.
Bosentan: [P] Increased atorvastatin, lovastatin, and simvastatin metabolism. Carbamazepine: [P] Increased atorvastatin, lovastatin, and simvastatin metabolism. Clofibrate: [NP] Increased risk of myopathy. Cobicistat: [P] Decreased metabolism of atorvastatin, lovastatin, and simvastatin. Conivaptan: [P] Decreased metabolism of atorvastatin, lovastatin, and simvastatin. Cyclosporine: [P] Decreased atorvastatin, lovastatin, rosuvastatin, pitavastatin, and simvastatin elimination.