elagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations.
Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. enzalutamideenzalutamide will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels enzalutamide will decrease the level or effect sildenafil oral jelly 100 mg of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
dronedaronedronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dronedarone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. duvelisibduvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.
duvelisib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. efavirenzefavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels efavirenz will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels elagolixelagolix decreases levels of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels epoprostenolepoprostenol increases effects of sildenafil by additive vasodilation.
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epoprostenol increases effects of sildenafil by additive vasodilation. erythromycin baseerythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider a starting dose of 25 mg in patients treated with erythromycin. erythromycin base will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
amifostineamifostine increases effects of sildenafil by additive vasodilation. amifostine increases effects of sildenafil by additive vasodilation. aprepitantaprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. aprepitant will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. armodafinilarmodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
armodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. artemether/lumefantrineartemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. artemether/lumefantrine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. atenololatenolol increases effects of sildenafil by additive vasodilation. atenolol increases effects of sildenafil by additive vasodilation. erythromycin ethylsuccinate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Drug Class | Interaction Effect | Clinical Significance |
|---|---|---|
| Nitrates | Potentiates hypotension | Absolute contraindication |
| Alpha-blockers | Increased hypotensive effect | Use with caution |
| CYP3A4 inhibitors | Increased sildenafil levels | Dose adjustment needed |
| Protease inhibitors | Elevates sildenafil exposure | Increased side effects |
erythromycin lactobionateerythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
| Use | Evidence Level | Description | Caution |
|---|---|---|---|
| Altitude Sickness | Experimental | Vasodilation might improve oxygenation | Not FDA approved, consult specialist |
| Premature Ejaculation | Anecdotal evidence | Local vasodilation effects may extend ejaculatory latency | Limited data |
| Cold-induced Vasospasm | Off-label | May alleviate symptoms of vasospasm | Requires medical supervision |
erythromycin lactobionate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
erythromycin stearateerythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels carvedilolcarvedilol increases effects of sildenafil by additive vasodilation. carvedilol increases effects of sildenafil by additive vasodilation. cenobamatecenobamate will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. cenobamate will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
cimetidinecimetidine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cimetidine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclosporinecyclosporine will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclosporine will increase the sildenafil citrate tablets 150 mg level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazoldanazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin stearate will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. esmololesmolol increases effects of sildenafil by additive vasodilation. esmolol increases effects of sildenafil by additive vasodilation.
If unavoidable, monitor patients for loss of efficacy unless otherwise recommended in the CYP3A4 substrate prescribing information. tovorafenib will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tucatinibtucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
tucatinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acebutololacebutolol increases effects of sildenafil by additive vasodilation. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy. acebutolol increases effects of sildenafil by additive vasodilation. etravirineetravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels etravirine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels fedratinibfedratinib will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
danazol will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. darunavirdarunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with PDE-5 inhibitors may result in an increase in PDE-5 inhibitor-associated adverse reactions (eg, hypotension, syncope, visual disturbances and priapism). darunavir will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. deferasiroxdeferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
deferasirox will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasonedexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. dexamethasone will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazemdiltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. diltiazem will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary.
betaxololbetaxolol increases effects of sildenafil by additive vasodilation. betaxolol increases effects of sildenafil by additive vasodilation. bisoprololbisoprolol increases effects of sildenafil by additive vasodilation. bisoprolol increases effects of sildenafil by additive vasodilation. bosentanbosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.
Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels bosentan will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels butalbitalbutalbital will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. butalbital will decrease the sildenafil 100mg lowest price level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. carbamazepinecarbamazepine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potent CYP3A4 inducers are expected to cause substantial decreases in sildenafil plasma levels carbamazepine will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.