with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.loratadineMonitor Closely (1)brexpiprazole and loratadine both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)brexpiprazole and lorazepam both increase sedation. Use Caution/Monitor.lorcaserinMonitor Closely (1)lorcaserin will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP2D6 inhibitors. If also administered with a strong/moderate CYP3A4 inhibitor, administer a quarter of brexpiprazole dose. NOTE: In MDD clinical trials, brexpiprazole dosage was not adjusted for strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine); thus, CYP considerations are already factored into general dosing recommendations and brexpiprazole may be administered without dosage adjustment in patients with MDD.lorlatinibMonitor Closely (1)lorlatinib will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.loxapineMonitor Closely (1)brexpiprazole and loxapine both increase sedation. Use Caution/Monitor.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.lumateperoneMonitor Closely (1)brexpiprazole and lumateperone both increase sedation. Use Caution/Monitor.lurasidoneMonitor Closely (1)brexpiprazole and lurasidone both increase sedation. Use Caution/Monitor.maprotilineMonitor Closely (1)brexpiprazole and maprotiline both increase sedation. Use Caution/Monitor.meclizineMonitor Closely (1)brexpiprazole and meclizine both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)brexpiprazole and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)brexpiprazole and meprobamate both increase sedation. Use Caution/Monitor.metaxaloneMonitor Closely (1)brexpiprazole and metaxalone both increase sedation. Use Caution/Monitor.metforminMonitor Closely (1)brexpiprazole decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.methadoneMonitor Closely (1)methadone will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.Serious - Use Alternative (1)brexpiprazole and methadone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatemethimazoleMonitor Closely (1)methimazole will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.methocarbamolMonitor Closely (1)brexpiprazole and methocarbamol both increase sedation. Use Caution/Monitor.methohexitalMonitor Closely (1)brexpiprazole and methohexital both increase sedation. Use Caution/Monitor.methsuximideMonitor Closely (1)brexpiprazole and methsuximide both increase sedation. Use Caution/Monitor.metoclopramide intranasalSerious - Use Alternative (1)brexpiprazole, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.metronidazoleMonitor Closely (1)metronidazole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP3A4 inhibitor PLUS a strong/moderate CYP2D6 inhibitor.midazolamMonitor Closely (1)brexpiprazole and midazolam both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, brexpiprazole. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.mifepristoneMonitor Closely (1)mifepristone will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (1)brexpiprazole and mirtazapine both increase sedation. Use Caution/Monitor.mitotaneMonitor Closely (1)mitotane will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.molindoneMonitor Closely (1)brexpiprazole and molindone both increase sedation. Use Caution/Monitor.morphineSerious - Use Alternative (1)brexpiprazole and morphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatenafcillinMonitor Closely (1)nafcillin will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.nalbuphineMonitor Closely (1)brexpiprazole and nalbuphine both increase sedation. Use Caution/Monitor.nefazodoneMonitor Closely (2)nefazodone will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose. nefazodone will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.nelfinavirSerious - Use Alternative (1)nelfinavir will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.netupitant/palonosetronMonitor Closely (1)netupitant/palonosetron will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP3A4 inhibitor PLUS a strong/moderate CYP2D6 inhibitor.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.nicardipineMonitor Closely (2)nicardipine will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose. nicardipine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.nitrous oxideMonitor Closely (1)brexpiprazole and nitrous oxide both increase sedation. Use Caution/Monitor.nortriptylineMonitor Closely (1)brexpiprazole and nortriptyline both increase sedation. Use Caution/Monitor.olanzapineMonitor Closely (1)brexpiprazole and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (1)brexpiprazole and oliceridine both increase sedation. Use Caution/Monitor.olopatadine intranasalSerious - Use Alternative (1)brexpiprazole and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)Monitor Closely (2)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP2D6 inhibitors. If also administered with a strong/moderate CYP3A4 inhibitor, administer a quarter of brexpiprazole dose. NOTE: In MDD clinical trials, brexpiprazole dosage was not adjusted for strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine); thus, CYP considerations are already factored into general dosing recommendations and brexpiprazole may be administered without dosage adjustment in patients with MDD. ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.opicaponeMonitor Closely (1)brexpiprazole and opicapone both increase sedation. Use Caution/Monitor.opium tinctureMonitor Closely (1)brexpiprazole and opium tincture both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)brexpiprazole and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)brexpiprazole and oxazepam both increase sedation. Use Caution/Monitor.oxcarbazepineMonitor Closely (1)oxcarbazepine will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.oxycodoneSerious - Use Alternative (1)brexpiprazole and oxycodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequateoxymorphoneSerious - Use Alternative (1)brexpiprazole and oxymorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatepaliperidoneMonitor Closely (1)brexpiprazole and paliperidone both increase sedation. Use Caution/Monitor.panobinostatMonitor Closely (1)panobinostat will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.paroxetineMonitor Closely (1)paroxetine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP2D6 inhibitors. If also administered with a strong/moderate CYP3A4 inhibitor, administer a quarter of brexpiprazole dose. NOTE: In MDD clinical trials, brexpiprazole dosage was not adjusted for strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine); thus, CYP considerations are already factored into general dosing recommendations and brexpiprazole may be administered without dosage adjustment in patients with MDD.pentazocineMonitor Closely (1)brexpiprazole and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (2)pentobarbital will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer. brexpiprazole and pentobarbital both increase sedation. Use Caution/Monitor.perampanelMonitor Closely (1)brexpiprazole and perampanel both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)brexpiprazole and perphenazine both increase sedation. Use Caution/Monitor.pheniramineMonitor Closely (1)brexpiprazole and pheniramine both increase sedation. Use Caution/Monitor.phenobarbitalMonitor Closely (2)brexpiprazole and phenobarbital both increase sedation. Use Caution/Monitor. phenobarbital will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer.pimozideMonitor Closely (1)brexpiprazole and pimozide both increase sedation. Use Caution/Monitor.pomalidomideMonitor Closely (1)brexpiprazole and pomalidomide both increase sedation. Use Caution/Monitor.posaconazoleMonitor Closely (1)posaconazole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.pregabalinMonitor Closely (2)pregabalin, brexpiprazole. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. brexpiprazole and pregabalin both increase sedation. Use Caution/Monitor.primidoneMonitor Closely (2)primidone will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer. brexpiprazole and primidone both increase sedation. Use Caution/Monitor.prochlorperazineMonitor Closely (1)brexpiprazole and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)brexpiprazole and promethazine both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)brexpiprazole and propofol both increase sedation. Use Caution/Monitor.protriptylineMonitor Closely (1)brexpiprazole and protriptyline both increase sedation. Use Caution/Monitor.pyrilamineMonitor Closely (1)brexpiprazole and pyrilamine both increase sedation. Use Caution/Monitor.pyrimethamineMonitor Closely (1)pyrimethamine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.quazepamMonitor Closely (1)brexpiprazole and quazepam both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (1)brexpiprazole and quetiapine both increase sedation. Use Caution/Monitor.quinidineMonitor Closely (2)quinidine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP2D6 inhibitors. If also administered with a strong/moderate CYP3A4 inhibitor, administer a quarter of brexpiprazole dose. NOTE: In MDD clinical trials, brexpiprazole dosage was not adjusted for strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine); thus, CYP considerations are already factored into general dosing recommendations and brexpiprazole may be administered without dosage adjustment in patients with MDD. quinidine will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Administer half of the usual brexpiprazole dose when coadministered with strong CYP3A4 inhibitors. If also administered with a strong/moderate CYP2D6 inhibitor, administer a quarter of brexpiprazole dose.quinineMonitor Closely (1)quinine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.ramelteonMonitor Closely (1)brexpiprazole and ramelteon both increase sedation. Use Caution/Monitor.ranolazineMonitor Closely (1)ranolazine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.remifentanilSerious - Use Alternative (1)brexpiprazole and remifentanil both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequateremimazolamMonitor Closely (1)brexpiprazole and remimazolam both increase sedation. Use Caution/Monitor.reserpineMonitor Closely (1)brexpiprazole and reserpine both increase sedation. Use Caution/Monitor.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of brexpiprazole