HomeDrug ClassesCYP3A4 Inhibitors

CYP3A4 Inhibitors

CYP3A4 inhibitors block the liver enzyme responsible for metabolizing over 50% of all drugs. When combined with CYP3A4 substrates, they can dramatically increase drug levels and cause toxicity.

61 drugs in this class6 notable interactions shown

CYP3A4 Inhibitors Drugs (61)

AmlodipineAprepitantAponvieAtazanavir And CobicistatEvotazAvacopanTavneosCenobamateXcopriCeritinibClarithromycinCobicistatTybostCrizotinibCyclosporineNeoralDarunavirDarunavir Ethanolate And CobicistatPrezcobixDarunavir, Cobicistat, Emtricitabine, And Tenofovir AlafenamideSymtuzaEfavirenzEfavirenzEfavirenz, Emtricitabine And Tenofovir Disoproxil FumarateEfavirenz, Emtricitabine And Tenofovir Disoproxil FumarateEfavirenz, Lamivudine And Tenofovir Disoproxil FumarateSymfiElbasvir And GrazoprevirZepatierElvitegravir, Cobicistat, Emtricitabine, And Tenofovir AlafenamideGenvoyaElvitegravir, Cobicistat, Emtricitabine, And Tenofovir Disoproxil FumarateStribildErdafitinibBalversaEverolimusEverolimusEverolimus TabletsEverolimusFexinidazoleFexinidazoleFluconazoleGivinostatDuvyzatGlecaprevir And PibrentasvirMavyretIdelalisibZydeligItraconazoleIvacaftorKalydecoKetoconazoleLazertinibLazcluzeLetermovirLevoketoconazoleRecorlevLonafarnibZokinvyLopinavir And RitonavirLopinavir And RitonavirLumacaftor And IvacaftorOrkambiMaribavirLivtencityMavorixaforXolremdiMirabegronMirabegronNetupitant And PalonosetronAkynzeoNicardipine HydrochlorideNicardipine HydrochlorideNirogacestatOgsiveoOsimertinibTagrissoPacritinibVonjoPalbociclibIbrancePazopanibPerampanelFycompaPirtobrutinibJaypircaRanolazineRanolazineRilzabrutinibWayrilzRitonavirRitonavir 100 MgRitonavir Film CoatedSelpercatinibRetevmoSuvorexantBelsomraTicagrelorTicagrelorTriclabendazoleEgatenTrofinetideDaybueTucatinibTukysaVoriconazoleVoxelotorOxbrytaXanomeline And Trospium ChlorideCobenfy

Notable CYP3A4 Inhibitors Interactions

Amlodipine + Ezetimibe And SimvastatinContraindicated

] Ezetimibe and Simvastatin Tablets Drug Interactions Associated With Increased Risk of Myopathy/Rhabdomyolysis ( 2.3 , 2.4 , 4 , 5.1 , 7.1 , 7.2 , 7.3 , 7.8 , 12.3 ) Interacting Agents Prescribing Recommendations Strong CYP3A4 Inhibitors, (e.g., itraconazole, ketoconazole, posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, boceprevir, telaprevir, nefazodone, cobicistat-containing products), gemfibrozil, cyclosporine, danazol Contraindicated with ezetimibe and simvastatin tablets Niacin (≥1 g/day) For Chinese patients, not recommended with ezetimibe and simvastatin tablets Verapamil, diltiazem, dronedarone Do not exceed 10 mg/10 mg ezetimibe and simvastatin tablets, daily Amiodarone, amlodipine, ranolazine Do not exceed 10 mg/20 mg ezetimibe and simvastatin tablets, daily Lomitapide For patients with HoFH, do not exceed 10 mg/20 mg ezetimibe and simvastatin tablets 1 Daptomycin Temporally suspend ezetimibe and simvastatin tablets Grapefruit juice Avoid grapefruit juice 1. 7.3 Amiodarone, Dronedarone, Ranolazine, or Calcium Channel Blockers The risk of myopathy, including rhabdomyolysis, is increased by concomitant administration of amiodarone, dronedarone, ranolazine, or calcium channel blockers such as verapamil, diltiazem or amlodipine [ see Dosage and Administration ( 2.3 ) and Warnings and Precautions ( 5.1 ) and Table 6 in Clinical Pharmacology ( 12.3 ) ].

Amlodipine + SimvastatinContraindicated

7 DRUG INTERACTIONS Drug Interactions Associated with increased Risk of Risk of Myopathy/Rhabdomyolysis ( 2.3 , 2.4 , 4 , 5.1 , 7.1 , 7.2 , 7.3 , 12.3 ) Interacting Agents Prescribing Recommendations Strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole,posaconazole, voriconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, boceprevir, telaprevir, nefazodone, cobicistat-containing products), gemfibrozil, cyclosporine, danazol Contraindicated with simvastatin Niacin (≥1 g/day) For Chinese patients, notrecommended with simvastatin Verapamil, diltiazem, dronedarone Do not exceed 10 mg simvastatin daily Amiodarone, amlodipine, ranolazine Do not exceed 20 mg simvastatin daily Lomitapide For patients with HoFH, do not exceed 20 mg simvastatin daily* Daptomycin Temporarily suspend simvastatin Grapefruit juice Avoid grapefruit juice *For patients with HoFH who have been taking 80 mg simvastatin chronically (e.g., for 12 months or more) without evidence of muscle toxicity, do not exceed 40 mg simvastatin when taking lomitapide. 7.3 Amiodarone, Dronedarone, Ranolazine, or Calcium Channel Blockers The risk of myopathy, including rhabdomyolysis, is increased by concomitant administration of amiodarone, dronedarone, ranolazine, or calcium channel blockers such as verapamil, diltiazem, or amlodipine [see Dosage and Administration (2.3) and Warnings and Precautions (5.1) , and Table 3 in Clinical Pharmacology (12.3) ].

Amlodipine + Amlodipine And Atorvastatin⚠️Major

7 DRUG INTERACTIONS Data from a drug-drug interaction study involving 10 mg of amlodipine and 80 mg of atorvastatin in healthy subjects indicate that the pharmacokinetics of amlodipine are not altered when the drugs are co-administered. The effect of amlodipine on the pharmacokinetics of atorvastatin showed no effect on the C max : 91% (90% confidence interval: 80 to 103%), but the AUC of atorvastatin increased by 18% (90% confidence interval: 109 to 127%) in the presence of amlodipine, which is not clinically meaningful. No drug interaction studies have been conducted with amlodipine besylate and atorvastatin calcium and other drugs, although studies have been conducted in the individual amlodipine and atorvastatin components, as described below: Amlodipine Increased Risk of Myopathy and Rhabdomyolysis ( 2 , 5.1 , 7.3 , 12.3 ) Cyclosporine, tipranavir plus ritonavir, glecaprevir plus pibrentasvir Avoid atorvastatin Clarithromycin, itraconazole, saquinavir plus ritonavir, darunavir plus ritonavir, fosamprenavir, fosamprenavir plus ritonavir, elbasvir plus grazoprevir,letermovir Do not exceed 20 mg atorvastatin daily Nelfinavir Do not exceed 40 mg atorvastatin daily Lopinavir plus ritonavir, simeprevir, fibric acid derivatives, erythromycin, azole antifungals, lipid-modifying doses of niacin, colchicine Consider the risk/benefit of concomitant use with atorvastatin Other Lipid-Lowering Medications: Increased risk of myopathy (7) .

Aprepitant + PimozideContraindicated

Increased pimozide exposure. CINVANTI is contraindicated.

Aprepitant + Alprazolam⚠️Major

Increased alprazolam exposure may increase risk of adverse reactions with 3-day aprepitant regimen; monitor for benzodiazepine-related adverse reactions.

Aprepitant + Carbamazepine⚠️Major

Strong CYP3A4 inducer substantially decreases aprepitant exposure, which may decrease efficacy. Avoid concomitant use.

Check Your CYP3A4 Inhibitors Interactions

Enter your specific medications to see all interactions — including combinations with CYP3A4 Inhibitors drugs.

Check Interactions →

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.