inducer is discontinued.rifapentinerifapentine will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.rivaroxabanrivaroxaban, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.rolapitantrolapitant will increase the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.rucaparibrucaparib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.salsalatesalsalate, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.stiripentolstiripentol, vortioxetine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.sulindacsulindac, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.tazemetostattazemetostat will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimattecovirimat will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.tenecteplasetenecteplase, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.terbinafineterbinafine will increase the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.ticlopidineticlopidine increases effects of vortioxetine by anticoagulation. Use Caution/Monitor.tirofibantirofiban increases effects of vortioxetine by anticoagulation. Use Caution/Monitor.tolmetintolmetin, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.vitamin Evitamin E, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.vorapaxarvortioxetine, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.warfarinvortioxetine, warfarin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serotonin release by platelets plays an important role in hemostasis. SSRIs and SNRIs may increase anticoagulation effect of warfarin. .Minor (6)acetazolamideacetazolamide will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.anastrozoleanastrozole will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.larotrectiniblarotrectinib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.levoketoconazolelevoketoconazole will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ribociclibribociclib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abciximabMonitor Closely (1)abciximab, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.acetazolamideMinor (1)acetazolamide will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.alfentanilSerious - Use Alternative (1)alfentanil, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.almotriptanSerious - Use Alternative (1)almotriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.alteplaseMonitor Closely (1)alteplase, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.amitriptylineSerious - Use Alternative (1)amitriptyline, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.amoxapineSerious - Use Alternative (1)amoxapine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.anagrelideMonitor Closely (1)anagrelide, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.anastrozoleMinor (1)anastrozole will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.antithrombin IIIMonitor Closely (1)vortioxetine and antithrombin III both increase anticoagulation. Use Caution/Monitor.apalutamideSerious - Use Alternative (1)apalutamide will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.apixabanMonitor Closely (1)vortioxetine and apixaban both increase anticoagulation. Use Caution/Monitor.argatrobanMonitor Closely (1)vortioxetine and argatroban both increase anticoagulation. Use Caution/Monitor.aspirinMonitor Closely (1)aspirin, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Risk minimal with low-dose aspirin.aspirin rectalMonitor Closely (1)aspirin rectal, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Risk minimal with low-dose aspirin.betrixabanMonitor Closely (1)vortioxetine, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.bivalirudinMonitor Closely (1)vortioxetine and bivalirudin both increase anticoagulation. Use Caution/Monitor.bosentanMonitor Closely (2)bosentan will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. bosentan decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.bupropionSerious - Use Alternative (1)bupropion, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.carbamazepineMonitor Closely (1)carbamazepine decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.Serious - Use Alternative (1)carbamazepine will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.celecoxibMonitor Closely (1)celecoxib, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.chlorpromazineSerious - Use Alternative (1)chlorpromazine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.choline magnesium trisalicylateMonitor Closely (1)choline magnesium trisalicylate, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.cilostazolMonitor Closely (1)cilostazol, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.cinacalcetMonitor Closely (1)cinacalcet increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.citalopramSerious - Use Alternative (1)citalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.clomipramineSerious - Use Alternative (1)clomipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.clonidineMonitor Closely (1)clonidine, vortioxetine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.clopidogrelMonitor Closely (1)clopidogrel, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.cocaine topicalSerious - Use Alternative (1)cocaine topical increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.cyclobenzaprineSerious - Use Alternative (1)cyclobenzaprine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.cyclophosphamideMinor (1)cyclophosphamide will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dabigatranSerious - Use Alternative (1)vortioxetine and dabigatran both increase anticoagulation. Avoid or Use Alternate Drug.dabrafenibMonitor Closely (2)dabrafenib will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. dabrafenib decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dalteparinSerious - Use Alternative (1)vortioxetine and dalteparin both increase anticoagulation. Avoid or Use Alternate Drug.daridorexantMonitor Closely (1)vortioxetine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darunavirMonitor Closely (1)darunavir will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.desipramineSerious - Use Alternative (1)desipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.desirudinMonitor Closely (1)desirudin, vortioxetine. Either increases effects of the other by serotonin levels. Use Caution/Monitor.Serious - Use Alternative (1)vortioxetine and desirudin both increase anticoagulation. Avoid or Use Alternate Drug.desvenlafaxineSerious - Use Alternative (1)desvenlafaxine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.dexamethasoneMonitor Closely (1)dexamethasone decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.dexmedetomidineSerious - Use Alternative (1)dexmedetomidine increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Decrease vortioxetine dose by 50% when coadministered with strong CYP2D6 inhibitors.diazepam intranasalMonitor Closely (1)diazepam intranasal, vortioxetine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.diclofenacMonitor Closely (1)diclofenac, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and vortioxetine both increase sedation. Use Caution/Monitor.diflunisalMonitor Closely (1)diflunisal, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.dipyridamoleMonitor Closely (1)dipyridamole increases effects of vortioxetine by anticoagulation. Use Caution/Monitor.doxepinSerious - Use Alternative (1)doxepin, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.duloxetineSerious - Use Alternative (1)duloxetine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.efavirenzMonitor Closely (1)efavirenz decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.elagolixMonitor Closely (1)elagolix decreases levels of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.eletriptanSerious - Use Alternative (1)eletriptan, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.eliglustatMonitor Closely (1)eliglustat increases levels of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.encorafenibMonitor Closely (1)encorafenib, vortioxetine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. 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.enoxaparinMonitor Closely (1)vortioxetine and enoxaparin both increase anticoagulation. Use Caution/Monitor.enzalutamideMonitor Closely (1)enzalutamide decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.Serious - Use Alternative (1)enzalutamide will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.eptifibatideMonitor Closely (1)eptifibatide increases effects of vortioxetine by anticoagulation. Use Caution/Monitor.escitalopramSerious - Use Alternative (1)escitalopram, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate increases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose.etodolacMonitor Closely (1)etodolac, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.etravirineMonitor Closely (2)etravirine decreases levels of vortioxetine by increasing metabolism. Modify Therapy/Monitor Closely. Consider increasing the vortioxetine dose when coadministered with strong CYP inducers for >14 days; not to exceed 3 times original vortioxetine dose. etravirine will decrease the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fedratinibMonitor Closely (2)fedratinib will increase the level or effect of vortioxetine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary. fedratinib will increase the level or effect of vortioxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.fenfluramineMonitor Closely (1)fenfluramine, vortioxetine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.fenoprofenMonitor Closely (1)fenoprofen, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.fentanylSerious - Use Alternative (1)fentanyl, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.fentanyl intranasalSerious - Use Alternative (1)fentanyl intranasal, vortioxetine. Either increases toxicity of the