OBJECT DRUGS

• Almotriptan (Axert)
• Eletriptan (Relpax)

PRECIPITANT DRUGS

Enzyme Inhibitors:

• Amiodarone (Cordarone, etc.)
• Amprenavir (Agenerase)
• Aprepitant (Emend)
• Atazanavir (Reyataz)
• Boceprevir (Victrelis)
• Ceritinib (Zykadia)
• Cobicistat (Stribild)
• Conivaptan (Vaprisol)
• Cyclosporine (Neoral, etc.)
• Darunavir (Prezista)
• Delavirdine (Rescriptor)
• Dronedarone (Multaq)
• Grapefruit
• Imatinib (Gleevec)
• Indinavir (Crixivan)
• Lapatinib (Tykerb)
• Lomitapide (Juxtapid)
• Mifepristone (Korlym)
• Nelfinavir (Viracept)
• Ritonavir (Norvir)
• Saquinavir (Invirase)
• Telaprevir (Incivek)

Comment:

Almotriptan and eletriptan are CYP3A4 substrates, and CYP3A4 inhibitors may increase the risk of toxicity. Hypertension, tachycardia or coronary vasospasm may occur if administered with CYP3A4 inhibitors.

Class 2: Use Only if Benefit Felt to Outweigh Risk

• Use Alternative:
• Grapefruit: Orange juice does not appear to inhibit CYP3A4.
• Monitor: If the combination is used, monitor for evidence of vasoconstriction such as hypertension.