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.stiripentolstiripentol, brexpiprazole. 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.sufentanilbrexpiprazole and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLbrexpiprazole and sufentanil SL both increase sedation. Use Caution/Monitor.suvorexantbrexpiprazole and suvorexant both increase sedation. Use Caution/Monitor.tapentadolbrexpiprazole and tapentadol both increase sedation. Use Caution/Monitor.tasimelteonbrexpiprazole and tasimelteon both increase sedation. Use Caution/Monitor.tazemetostattazemetostat will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimattecovirimat will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.temazepambrexpiprazole and temazepam both increase sedation. Use Caution/Monitor.terbinafineterbinafine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.tetrabenazinebrexpiprazole and tetrabenazine both increase sedation. Use Caution/Monitor.tetracyclinetetracycline 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.thioridazinethioridazine 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.brexpiprazole and thioridazine both increase sedation. Use Caution/Monitor.thiothixenebrexpiprazole and thiothixene both increase sedation. Use Caution/Monitor.tiagabinebrexpiprazole and tiagabine both increase sedation. Use Caution/Monitor.ticagrelorticagrelor 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.ticlopidineticlopidine 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.tipranavirtipranavir 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.tizanidinebrexpiprazole and tizanidine both increase sedation. Use Caution/Monitor.tolcaponebrexpiprazole and tolcapone both increase sedation. Use Caution/Monitor.topiramatebrexpiprazole and topiramate both increase sedation. Use Caution/Monitor.tramadolbrexpiprazole and tramadol both increase sedation. Use Caution/Monitor.tranylcyprominetranylcypromine 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.trazodonetrazodone 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.brexpiprazole and trazodone both increase sedation. Use Caution/Monitor.triazolambrexpiprazole and triazolam both increase sedation. Use Caution/Monitor.trifluoperazinebrexpiprazole and trifluoperazine both increase sedation. Use Caution/Monitor.triprolidinebrexpiprazole and triprolidine both increase sedation. Use Caution/Monitor.valproic acidbrexpiprazole and valproic acid both increase sedation. Use Caution/Monitor.verapamilverapamil 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.vigabatrinbrexpiprazole and vigabatrin both increase sedation. Use Caution/Monitor.voriconazolevoriconazole 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.zaleplonbrexpiprazole and zaleplon both increase sedation. Use Caution/Monitor.ziconotidebrexpiprazole and ziconotide both increase sedation. Use Caution/Monitor.zileutonzileuton 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.ziprasidonebrexpiprazole and ziprasidone both increase sedation. Use Caution/Monitor.zolpidembrexpiprazole and zolpidem both increase sedation. Use Caution/Monitor.zonisamidebrexpiprazole and zonisamide both increase sedation. Use Caution/Monitor.Minor (4)acetazolamideacetazolamide will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.anastrozoleanastrozole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.larotrectiniblarotrectinib will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of brexpiprazole 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.acetaminophen/phenyltoloxamineMonitor Closely (1)brexpiprazole and acetaminophen/phenyltoloxamine both increase sedation. Use Caution/Monitor.acetazolamideMinor (1)acetazolamide will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.acrivastineMonitor Closely (1)acrivastine and brexpiprazole both increase sedation. Use Caution/Monitor.alfentanilSerious - Use Alternative (1)brexpiprazole and alfentanil both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatealprazolamMonitor Closely (1)brexpiprazole and alprazolam both increase sedation. Use Caution/Monitor.amifostineMonitor Closely (1)amifostine, brexpiprazole. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor. Monitor blood pressure and adjust dose accordingly.amiodaroneMonitor Closely (2)amiodarone 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. amiodarone 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.amisulprideContraindicated (1)amisulpride, brexpiprazole. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.Monitor Closely (1)amisulpride and brexpiprazole both increase sedation. Use Caution/Monitor.amitriptylineMonitor Closely (1)brexpiprazole and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalMonitor Closely (2)amobarbital will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. brexpiprazole and amobarbital both increase sedation. Use Caution/Monitor.amoxapineMonitor Closely (1)brexpiprazole and amoxapine both increase sedation. Use Caution/Monitor.anastrozoleMinor (1)anastrozole will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.apalutamideSerious - Use Alternative (1)apalutamide will decrease the level or effect of brexpiprazole 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.aprepitantMonitor Closely (1)aprepitant 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.aripiprazoleMonitor Closely (1)brexpiprazole and aripiprazole both increase sedation. Use Caution/Monitor.asenapineMonitor Closely (1)asenapine and brexpiprazole both increase sedation. Use Caution/Monitor.asenapine transdermalMonitor Closely (1)asenapine transdermal and brexpiprazole both increase sedation. Use Caution/Monitor.atazanavirMonitor Closely (1)atazanavir 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.avapritinibMonitor Closely (1)avapritinib and brexpiprazole both increase sedation. Use Caution/Monitor.baclofenMonitor Closely (1)brexpiprazole and baclofen both increase sedation. Use Caution/Monitor.belzutifanMonitor Closely (1)belzutifan will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. benazeprilMonitor Closely (1)brexpiprazole increases toxicity of benazepril by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benzhydrocodone/acetaminophenSerious - Use Alternative (1)benzhydrocodone/acetaminophen and brexpiprazole both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebicalutamideMonitor Closely (1)bicalutamide 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.bortezomibMonitor Closely (1)bortezomib 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. bosentanMonitor Closely (1)bosentan 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.brexanoloneMonitor Closely (1)brexanolone, brexpiprazole. Either increases toxicity of the other by sedation. Use Caution/Monitor.brimonidineMonitor Closely (2)brimonidine and brexpiprazole both increase sedation. Use Caution/Monitor. brexpiprazole and brimonidine both increase sedation. Use Caution/Monitor.brivaracetamMonitor Closely (1)brexpiprazole and brivaracetam both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brexpiprazole and brompheniramine both increase sedation. Use Caution/Monitor.buprenorphineSerious - Use Alternative (1)brexpiprazole and buprenorphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine buccalSerious - Use Alternative (1)brexpiprazole and buprenorphine buccal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine subdermal implantSerious - Use Alternative (2)brexpiprazole and buprenorphine subdermal implant both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate buprenorphine subdermal implant and brexpiprazole both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalSerious - Use Alternative (1)brexpiprazole and buprenorphine transdermal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionSerious - Use Alternative (1)brexpiprazole and buprenorphine, long-acting injection both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebupropionMonitor Closely (1)bupropion 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.butabarbitalMonitor Closely (1)brexpiprazole and butabarbital both increase sedation. Use Caution/Monitor.butalbitalSerious - Use Alternative (1)brexpiprazole and butalbital both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebutorphanolMonitor Closely (1)brexpiprazole and butorphanol both increase sedation. Use Caution/Monitor.captoprilMonitor Closely (1)brexpiprazole, captopril. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbamazepineMonitor Closely (1)carbamazepine 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.carbinoxamineMonitor Closely (1)brexpiprazole and carbinoxamine both increase sedation. Use Caution/Monitor.cariprazineMonitor Closely (1)brexpiprazole and cariprazine both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)brexpiprazole and carisoprodol both increase sedation. Use Caution/Monitor.cenobamateMonitor Closely (2)cenobamate, brexpiprazole. Either increases effects of the other by sedation. Use Caution/Monitor. cenobamate will decrease the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.ceritinibMonitor Closely (1)ceritinib 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.cetirizineMonitor Closely (1)brexpiprazole and cetirizine both increase sedation. Use Caution/Monitor.chloramphenicolSerious - Use Alternative (1)chloramphenicol will increase the level or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.chlordiazepoxideMonitor Closely (1)brexpiprazole and chlordiazepoxide both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (1)chloroquine 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. chlorpheniramineMonitor Closely (1)brexpiprazole and chlorpheniramine both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (2)brexpiprazole and chlorpromazine both increase sedation. Use Caution/Monitor. chlorpromazine will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer half