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.indinavirbutabarbital will decrease the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isoproterenolbutabarbital increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ixabepilonebutabarbital will decrease the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.kavakava increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.ketamineketamine and butabarbital both increase sedation. Use Caution/Monitor.ketotifen, ophthalmicbutabarbital and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.labetalolbutabarbital 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.lapatinibbutabarbital will decrease the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lasmiditanlasmiditan, 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.levalbuterolbutabarbital increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.levamlodipinebutabarbital 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.levonorgestrel oral/ethinylestradiol/ferrous bisglycinatebutabarbital 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.levorphanolbutabarbital and levorphanol both increase sedation. Use Caution/Monitor.lidocainebutabarbital will decrease the level or effect of lidocaine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.lisdexamfetaminebutabarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lofepraminebutabarbital and lofepramine both increase sedation. Use Caution/Monitor.lofexidinebutabarbital and lofexidine both increase sedation. Use Caution/Monitor.lopinavirbutabarbital will decrease the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.loprazolambutabarbital and loprazolam both increase sedation. Use Caution/Monitor.loratadinebutabarbital will decrease the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lorazepambutabarbital and lorazepam both increase sedation. Use Caution/Monitor.lormetazepambutabarbital and lormetazepam both increase sedation. Use Caution/Monitor.loxapinebutabarbital and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledbutabarbital and loxapine inhaled both increase sedation. Use Caution/Monitor.lumefantrinebutabarbital will decrease the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lurasidonelurasidone, 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.maprotilinebutabarbital and maprotiline both increase sedation. Use Caution/Monitor.maravirocbutabarbital will decrease the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.marijuanabutabarbital and marijuana both increase sedation. Use Caution/Monitor.melatoninbutabarbital and melatonin both increase sedation. Use Caution/Monitor.meperidinebutabarbital and meperidine both increase sedation. Use Caution/Monitor.meprobamatebutabarbital and meprobamate both increase sedation. Use Caution/Monitor.mestranolbutabarbital will decrease the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metaproterenolbutabarbital increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxalonebutabarbital and metaxalone both increase sedation. Use Caution/Monitor.methadonebutabarbital will decrease the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butabarbital and methadone both increase sedation. Use Caution/Monitor.methamphetaminebutabarbital increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolbutabarbital and methocarbamol both increase sedation. Use Caution/Monitor.methylenedioxymethamphetaminebutabarbital increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylprednisolonebutabarbital will decrease the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metoprololbutabarbital decreases levels of metoprolol 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.mexiletinebutabarbital will decrease the level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.midazolambutabarbital will decrease the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butabarbital and midazolam both increase sedation. Use Caution/Monitor.midazolam intranasalmidazolam intranasal, butabarbital. 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.midodrinebutabarbital increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mirtazapinebutabarbital and mirtazapine both increase sedation. Use Caution/Monitor.modafinilbutabarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphinebutabarbital and morphine both increase sedation. Use Caution/Monitor.motherwortbutabarbital and motherwort both increase sedation. Use Caution/Monitor.moxonidinebutabarbital and moxonidine both increase sedation. Use Caution/Monitor.nabilonebutabarbital and nabilone both increase sedation. Use Caution/Monitor.nadololbutabarbital decreases levels of nadolol 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.nalbuphinebutabarbital and nalbuphine both increase sedation. Use Caution/Monitor.nateglinidebutabarbital will decrease the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.nebivololbutabarbital decreases levels of nebivolol 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.nelfinavirbutabarbital will decrease the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nicardipinebutabarbital will decrease the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibbutabarbital will decrease the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nisoldipinebutabarbital will decrease the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.norepinephrinebutabarbital increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.norgestrelbutabarbital will decrease the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Moderate CYP3A4 inducers may decrease progestin concentration; consider use of additional barrier methodsnortriptylinebutabarbital and nortriptyline both increase sedation. Use Caution/Monitor.olanzapinebutabarbital will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butabarbital and olanzapine both increase sedation. Use Caution/Monitor.oliceridinebutabarbital will decrease the level or effect of oliceridine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If coadministration with a CYP3A4 inducer is necessary, consider increasing oliceridine dose until stable drug effects are achieved; monitor for signs of opioid withdrawal. If inducer is discontinued, consider oliceridine dosage reduction and monitor for signs of respiratory depression.oliceridine, butabarbital. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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.omeprazolebutabarbital will decrease the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.ondansetronbutabarbital will decrease the level or effect of ondansetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. No dosage adjustment for ondansetron is recommended for patients on these drugs.opium tincturebutabarbital and opium tincture both increase sedation. Use Caution/Monitor.orphenadrinebutabarbital and orphenadrine both increase sedation. Use Caution/Monitor.osilodrostatbutabarbital will decrease the level or effect of osilodrostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor cortisol concentration and patient?s signs and symptoms during coadministration or discontinuation with strong CYP3A4 inducers. Adjust dose of osilodrostat if necessary.oxazepambutabarbital and oxazepam both increase sedation. Use Caution/Monitor.oxycodonebutabarbital and oxycodone both increase sedation. Use Caution/Monitor.oxymorphonebutabarbital and oxymorphone both increase sedation. Use Caution/Monitor.paliperidonebutabarbital and paliperidone both increase sedation. Use Caution/Monitor.pantoprazolebutabarbital will decrease the level or effect of pantoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.papaveretumbutabarbital and papaveretum both increase sedation. Use Caution/Monitor.papaverinebutabarbital and papaverine both increase sedation. Use Caution/Monitor.parecoxibbutabarbital will decrease the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.passion flowerpassion flower increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.pazopanibbutabarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.penbutololbutabarbital decreases levels of penbutolol 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.pentazocinebutabarbital and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalbutabarbital and pentobarbital both increase sedation. Use Caution/Monitor.perphenazinebutabarbital and perphenazine both increase sedation. Use Caution/Monitor.phendimetrazinebutabarbital increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalbutabarbital and phenobarbital both increase sedation. Use Caution/Monitor.phenterminebutabarbital increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrinebutabarbital increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine PObutabarbital increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinbutabarbital will decrease the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.pholcodinebutabarbital and pholcodine both increase sedation. Use Caution/Monitor.pimozidebutabarbital and pimozide both increase sedation. Use Caution/Monitor.pindololbutabarbital decreases levels of pindolol 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.pirbuterolbutabarbital increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pitolisantbutabarbital will decrease the level or effect of pitolisant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Pitolisant exposure is decreased by 50% if coadministered with strong CYP3A4 inducers. For patients stable on pitolisant 8.9 mg/day or 17.8 mg/day, double the pitolisant dose (ie, 17.8 mg or 35.6 mg, respectively) over 7 days. If the strong CYP3A4 inducer is discontinued, reduce pitolisant dosage by half.polatuzumab vedotinbutabarbital will decrease the level or effect of polatuzumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Polatuzumab undergoes catabolism to small peptides, amino acids, monomethyl auristatin E (MMAE), and unconjugated MMAE-related catabolites. MMAE is a CYP3A4 substrate. Coadministration of polatuzumab vedotin with a strong CYP3A4 inducer may decrease unconjugated MMAE AUC.prednisolonebutabarbital will decrease the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.prednisonebutabarbital will decrease the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pregabalinpregabalin, butabarbital. 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.primidonebutabarbital and primidone both increase sedation. Use Caution/Monitor.prochlorperazinebutabarbital and prochlorperazine both increase sedation. Use Caution/Monitor.promethazinepromethazine and butabarbital both increase sedation. Use Caution/Monitor.propafenonebutabarbital decreases levels of propafenone by increasing metabolism. Use Caution/Monitor.propofolpropofol and butabarbital both increase sedation. Use Caution/Monitor.propranololbutabarbital decreases levels of propranolol 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.propylhexedrinebutabarbital increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylinebutabarbital and protriptyline both increase sedation. Use Caution/Monitor.quazepambutabarbital and quazepam both increase sedation. Use Caution/Monitor.quetiapinebutabarbital will decrease the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.butabarbital and quetiapine both increase sedation. Use Caution/Monitor.quinidinebutabarbital will decrease the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ramelteonbutabarbital will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butabarbital and ramelteon both increase sedation. Use Caution/Monitor.remimazolamremimazolam, butabarbital. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.repaglinidebutabarbital will decrease the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifampinrifampin decreases levels of butabarbital by increasing metabolism. Use Caution/Monitor.risperidonebutabarbital and risperidone both increase sedation. Use Caution/Monitor.ritonavirbutabarbital will decrease the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.salmeterolbutabarbital increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirbutabarbital will decrease the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.scullcapbutabarbital and scullcap both increase sedation. Use Caution/Monitor.secobarbitalbutabarbital and secobarbital both increase