and ganaxolone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)butabarbital will decrease the level or effect of ganaxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of ganaxolone with moderate or strong CYP3A4 inducers. If coadministration unavoidable, consider increasing ganaxolone dose; however, do not exceed maximum daily dose for weight.glasdegibSerious - Use Alternative (1)butabarbital will decrease the level or effect of glasdegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of glasdegib with strong CYP3A inducers.glecaprevir/pibrentasvirMonitor Closely (1)butabarbital will decrease the level or effect of glecaprevir/pibrentasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of drugs that induce CYP3A4 with glecaprevir/pibrentasvir may decrease glecaprevir/pibrentasvir plasma concentrations. Potential for loss of therapeutic effect.gotu kolaMonitor Closely (1)gotu kola increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.griseofulvinMinor (1)butabarbital decreases levels of griseofulvin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.guanfacineMonitor Closely (1)butabarbital will decrease the level or effect of guanfacine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Strong or moderate CYP3A4 inducers significantly reduce guanfacine plasma concentrations and elimination half-life. If coadministered, more frequent dosing of the IR product may be required to achieve or maintain the desired hypotensive response. For patients with ADHD, FDA-approved labeling for ER guanfacine recommends that, if coadministered, doubling the recommended dose of guanfacine should be considered.haloperidolMonitor Closely (1)butabarbital and haloperidol both increase sedation. Use Caution/Monitor.Minor (1)haloperidol, butabarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of hyperthermia if haloperidol admin. during barbiturate withdrawal.hawthornMonitor Closely (1)hawthorn increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.heminMonitor Closely (1)butabarbital decreases effects of hemin by pharmacodynamic antagonism. Use Caution/Monitor. Drugs that increase delta-aminolevulinic acid synthetase may decrease hemin effect.heparinSerious - Use Alternative (1)butabarbital decreases effects of heparin by increasing metabolism. Avoid or Use Alternate Drug.hopsMonitor Closely (1)hops increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.hydrocodoneSerious - Use Alternative (1)hydrocodone, butabarbital. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.hydrocortisoneMonitor Closely (1)butabarbital will decrease the level or effect of hydrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.hydromorphoneMonitor Closely (1)butabarbital and hydromorphone both increase sedation. Use Caution/Monitor.hydroxyprogesterone caproate (DSC)Monitor Closely (1)butabarbital will decrease the level or effect of hydroxyprogesterone caproate (DSC) by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and butabarbital both increase sedation. Use Caution/Monitor.ibuprofenMinor (1)butabarbital will decrease the level or effect of ibuprofen by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.ibuprofen IVMinor (1)butabarbital will decrease the level or effect of ibuprofen IV by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.ifosfamideMonitor Closely (2)butabarbital increases effects of ifosfamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. Coadministration of ifosfamide with CYP2B6 inducers may increase metabolism of ifosfamide to its metabolite. Monitor for increased effects/toxicities if combined with CYP2B6 inducers. butabarbital increases effects of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inducers may increase the metabolism of ifosfamide to its active alkylating metabolites. CYP3A4 inducers may increase the formation of the neurotoxic/nephrotoxic ifosfamide metabolite, chloroacetaldehyde. Closely monitor patients taking ifosfamide with CYP3A4 inducers for toxicities and consider dose adjustment.iloperidoneMonitor Closely (2)butabarbital will decrease the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. butabarbital and iloperidone both increase sedation. Use Caution/Monitor.imatinibMinor (1)butabarbital will decrease the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.imipramineMonitor Closely (4)butabarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. butabarbital will decrease the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. butabarbital will decrease the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. butabarbital and imipramine both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, imipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.indinavirMonitor Closely (1)butabarbital will decrease the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.infigratinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of infigratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.isavuconazonium sulfateContraindicated (1)butabarbital will decrease the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.isocarboxazidSerious - Use Alternative (1)isocarboxazid, butabarbital. Other (see comment). Contraindicated. Comment: CNS depressants such as barbiturates should not be used in combination with isocarboxazid.Minor (1)isocarboxazid increases levels of butabarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.isoproterenolMonitor Closely (1)butabarbital increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.isradipineMinor (1)butabarbital will decrease the level or effect of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.istradefyllineSerious - Use Alternative (1)butabarbital will decrease the level or effect of istradefylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of istradefylline with strong CYP3A4 inducers.ivosidenibSerious - Use Alternative (1)butabarbital will decrease the level or effect of ivosidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of ivosidenib with strong CYP3A4 inducers decreased ivosidenib plasma concentrations.ixabepiloneMonitor Closely (1)butabarbital will decrease the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.kavaMonitor Closely (1)kava increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.ketamineMonitor Closely (1)ketamine and butabarbital both increase sedation. Use Caution/Monitor.ketoconazoleMinor (2)butabarbital will decrease the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. butabarbital decreases levels of ketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.ketotifen, ophthalmicMonitor Closely (1)butabarbital and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.labetalolMonitor Closely (1)butabarbital decreases levels of labetalol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.lansoprazoleMinor (1)butabarbital will decrease the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.lapatinibMonitor Closely (1)butabarbital will decrease the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.larotrectinibSerious - Use Alternative (1)butabarbital will increase the level or effect of larotrectinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of larotrectinib with strong CYP3A4 inducers is unavoidable, double larotrectinib dose. Resume prior larotrectinib dose once CYP3A4 inducer discontinued for 3-5 half-lives.lasmiditanMonitor Closely (1)lasmiditan, butabarbital. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lefamulinSerious - Use Alternative (1)butabarbital will decrease the level or effect of lefamulin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lefamulin with strong or moderate CYP3A inducers unless the benefit outweighs risks. Monitor for reduced efficacy.lemborexantSerious - Use Alternative (2)butabarbital will decrease the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. lemborexant, butabarbital. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.lenacapavirSerious - Use Alternative (1)butabarbital will decrease the level or effect of lenacapavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lenacapavir with moderate CYP3A4 inducers.leniolisibSerious - Use Alternative (1)butabarbital will decrease the level or effect of leniolisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.levalbuterolMonitor Closely (1)butabarbital increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levamlodipineMonitor Closely (1)butabarbital will decrease the level or effect of levamlodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No information is available on the quantitative effects of CYP3A4 inducers on amlodipine. Closely monitor blood pressure when amlodipine is coadministered with CYP3A4 inducers.levoketoconazoleMinor (2)butabarbital will decrease the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. butabarbital decreases levels of levoketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.levonorgestrel oral/ethinylestradiol/ferrous bisglycinateMonitor Closely (1)butabarbital will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. The efficacy of hormonal contraceptives may be reduced. Use an alternative method of contraception or a backup method when enzyme inducers are used with combined hormonal contraceptives (CHCs), and continue backup contraception for 28 days after discontinuing enzyme inducer to ensure contraceptive reliability.levorphanolMonitor Closely (1)butabarbital and levorphanol both increase sedation. Use Caution/Monitor.levothyroxineMinor (1)butabarbital decreases levels of levothyroxine by increasing metabolism. Minor/Significance Unknown.lidocaineMonitor Closely (1)butabarbital will decrease the level or effect of lidocaine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.linezolidMinor (1)linezolid increases levels of butabarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.liothyronineMinor (1)butabarbital decreases levels of liothyronine by increasing metabolism. Minor/Significance Unknown.lisdexamfetamineMonitor Closely (1)butabarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lofepramineMonitor Closely (1)butabarbital and lofepramine both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, lofepramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.lofexidineMonitor Closely (1)butabarbital and lofexidine both increase sedation. Use Caution/Monitor.lonafarnibContraindicated (1)butabarbital will decrease the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lonafarnib is a sensitive CYP3A4 substrate. Coadministration with strong or moderate CYP3A4 inducers is contraindicated.lopinavirMonitor Closely (1)butabarbital will decrease the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.loprazolamMonitor Closely (1)butabarbital and loprazolam both increase sedation. Use Caution/Monitor.loratadineMonitor Closely (1)butabarbital will decrease the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lorazepamMonitor Closely (1)butabarbital and lorazepam both increase sedation. Use Caution/Monitor.lorlatinibContraindicated (1)butabarbital will decrease the level or effect of lorlatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of lorlatinib with strong CYP3A inducers is contraindicated. Discontinue the strong CYP3A inducer for 3 plasma half-lives before initiating lorlatinib.lormetazepamMonitor Closely (1)butabarbital and lormetazepam both increase sedation. Use Caution/Monitor.losartanMinor (1)butabarbital will decrease the level or effect of losartan by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.lovastatinSerious - Use Alternative (1)butabarbital will decrease the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.loxapineMonitor Closely (1)butabarbital and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)butabarbital and loxapine inhaled both increase sedation. Use Caution/Monitor.lumateperoneSerious - Use Alternative (1)butabarbital will decrease the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.lumefantrineMonitor Closely (1)butabarbital will decrease the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lurasidoneMonitor Closely (1)lurasidone, butabarbital. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.lurbinectedinSerious - Use Alternative (1)butabarbital will decrease the level or effect of lurbinectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.maprotilineMonitor Closely (1)butabarbital and maprotiline both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, maprotiline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.maravirocMonitor Closely (1)butabarbital will decrease the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.marijuanaMonitor Closely (1)butabarbital and marijuana both increase sedation. Use Caution/Monitor.mavacamtenContraindicated (1)butabarbital will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.melatoninMonitor Closely (1)butabarbital and melatonin both increase sedation. Use Caution/Monitor.meloxicamMinor (1)butabarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.meperidineMonitor Closely (1)butabarbital and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)butabarbital and meprobamate both increase sedation. Use Caution/Monitor.mestranolMonitor Closely (1)butabarbital will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)butabarbital decreases levels of mestranol by increasing metabolism. Avoid or Use Alternate Drug. May result in contraceptive failure.metaproterenolMonitor