- Use Alternative (1)mifepristone will increase the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration with strong or moderate CYP3A4 inhibitors cannot be avoided, reduce selumetinib dosage (refer to selumetinib monograph for further information). After discontinuation of the strong or moderate CYP3A4 inhibitor for 3 elimination half-lives, resume selumetinib dose that was taken before initiating the inhibitor.sertralineMonitor Closely (1)mifepristone, sertraline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.sevofluraneSerious - Use Alternative (1)sevoflurane and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.sildenafilSerious - Use Alternative (1)mifepristone will increase the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.simvastatinContraindicated (2)mifepristone increases levels of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated due to increased risk of rhabdomyolysis. mifepristone increases toxicity of simvastatin by Other (see comment). Contraindicated. Comment: OATP1B1 inhibitors may increase risk of myopathy.siponimodSerious - Use Alternative (2)mifepristone will increase the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a moderate or strong CYP3A4 inhibitor PLUS a moderate or strong CYP2C9 inhibitor is not recommended. siponimod and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.sirolimusContraindicated (1)mifepristone increases levels of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated with CYP3A substrates that have a narrow therapeutic index .sitagliptinMonitor Closely (1)mifepristone will increase the level or effect of sitagliptin by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitorsofosbuvir/velpatasvirMonitor Closely (1)mifepristone will increase the level or effect of sofosbuvir/velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.solifenacinMonitor Closely (2)mifepristone will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. mifepristone, solifenacin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.sonidegibSerious - Use Alternative (1)mifepristone will increase the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.sorafenibMonitor Closely (2)mifepristone, sorafenib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. mifepristone will increase the level or effect of sorafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.sotalolMonitor Closely (1)mifepristone, sotalol. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.sparsentanSerious - Use Alternative (1)mifepristone, sparsentan. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. If unavoidable, interrupt treatment with sparsentan. When resuming sparsentan, consider dose titration. .St John's WortMonitor Closely (1)St John's Wort will decrease the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inducers have not been studied, coadministration not recommended by manufacturerstiripentolMonitor Closely (1)stiripentol, mifepristone. 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.Serious - Use Alternative (1)mifepristone will increase the level or effect of stiripentol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.sufentanilMonitor Closely (1)mifepristone will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. If coadministration necessary, consider reduced dose of sufentanil injection with frequent monitoring for respiratory depression and sedation if concurrent use of mifepristone is necessary; if mifepristone is discontinued, consider increasing sufentanil injection dose until stable drug effects are achieved and monitor for evidence of opioid withdrawalsufentanil SLMonitor Closely (1)mifepristone will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of sufentanil SL with any CYP3A4 inhibitor may increase sufentanil plasma concentration, and, thereby increase or prolonged adverse effects, including potentially fatal respiratory depression.sunitinibMonitor Closely (2)mifepristone, sunitinib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. mifepristone will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If concomitant use necessary, monitor patients for QT prolongation and consider reducing dose of sunitinib, based on individual safety and tolerability, in 12.5 mg decrements to minimum of 37.5 mg (GIST and RCC) or 25 mg (pNET) dailysuvorexantSerious - Use Alternative (1)mifepristone will increase the level or effect of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tacrolimusContraindicated (1)mifepristone increases levels of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Contraindicated with CYP3A substrates that have a narrow therapeutic index .tadalafilMonitor Closely (1)mifepristone will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tamoxifenMonitor Closely (1)mifepristone decreases effects of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. ketoconazole, tamoxifen. affecting hepatic/intestinal enzyme CYP3A4 metabolism. CYP3A4 inhibition decreases metabolism of tamoxifen to N-desmethyl tamoxifen (active metabolite with similar biologic activity).tamsulosinMonitor Closely (1)mifepristone will increase the level or effect of tamsulosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tasimelteonMonitor Closely (1)mifepristone will increase the level or effect of tasimelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tazemetostatMonitor Closely (1)tazemetostat will decrease the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)mifepristone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of tazemetostat with strong CYP3A4 inhibitors.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.telavancinMonitor Closely (1)mifepristone, telavancin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.temsirolimusMonitor Closely (1)mifepristone will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministration necessary, consider reducing dose of temsirolimus to 12.5 mg/ week; allow a period of approximately 1 week after discontinuing mifepristone before increasing temsirolimus to original doseterbinafineMonitor Closely (1)mifepristone will increase the level or effect of terbinafine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tetrabenazineSerious - Use Alternative (1)tetrabenazine and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.tezacaftorSerious - Use Alternative (1)mifepristone will increase the level or effect of tezacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.thioridazineContraindicated (1)mifepristone, thioridazine. QTc interval. Contraindicated.thiothixeneMonitor Closely (1)mifepristone, thiothixene. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.tiagabineSerious - Use Alternative (1)mifepristone will increase the level or effect of tiagabine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.ticagrelorMonitor Closely (1)mifepristone will increase the level or effect of ticagrelor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tinidazoleMonitor Closely (1)mifepristone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tinzaparinContraindicated (1)mifepristone, tinzaparin. Other (see comment). Contraindicated. Comment: Mifepristone may lead to excessive post abortion bleeding in pts. on anticoagulant therapy.tipranavirMonitor Closely (1)mifepristone will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)tipranavir will increase the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tisotumab vedotinMonitor Closely (1)mifepristone increases levels of tisotumab vedotin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tisotumab vedotin?s active metabolite (MMAE) is a CYP3A4 substrate. Coadministration with strong CYP3A4 inhibitors may increase unconjugated MMAE systemic exposure and increase risk of adverse effects.tofacitinibMonitor Closely (1)mifepristone will increase the level or effect of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If coadministration necessary, reduce dose of tofacitinib if chronic mifepristone therapy used; reduce to 5 mg twice daily in patients receiving 10 mg twice daily; reduce to 5 mg once daily in patients receiving 5 mg twice daily; change to 11 mg XR once daily in patients receiving 22 mg once daily of XR formulation; change to immediate-release formulation at dose of 5 mg once daily in patients receiving 11 mg XR once daily tolterodineSerious - Use Alternative (1)mifepristone will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration necessary in chronic mifepristone therapy, reduce dose of tolterodine IR to 1 mg twice daily and tolterodine ER to 2 mg once daily; monitor for QT prolongation tolvaptanSerious - Use Alternative (1)mifepristone will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.toremifeneMonitor Closely (1)mifepristone, toremifene. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.Serious - Use Alternative (1)mifepristone will increase the level or effect of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.trabectedinSerious - Use Alternative (1)mifepristone will increase the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.tramadolMonitor Closely (1)mifepristone will increase the level or effect of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.trazodoneSerious - Use Alternative (1)mifepristone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.treprostinilMonitor Closely (1)mifepristone will increase the level or effect of treprostinil by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitortretinoinMonitor Closely (1)mifepristone will increase the level or effect of tretinoin by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitortretinoin topicalMonitor Closely (1)mifepristone will increase the level or effect of tretinoin topical by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitortriamcinolone acetonide injectable suspensionContraindicated (1)mifepristone, triamcinolone acetonide injectable suspension. Mechanism: unknown. Contraindicated. Mfr. states that mifepristone is contraindicated in pts. on long term corticosteroid Tx.triazolamContraindicated (1)mifepristone will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.triclabendazoleMonitor Closely (1)triclabendazole and mifepristone both increase QTc interval. Use Caution/Monitor.trimipramineMonitor Closely (2)mifepristone will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. mifepristone, trimipramine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.triptorelinSerious - Use Alternative (1)triptorelin increases toxicity of mifepristone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.tucatinibSerious - Use Alternative (2)mifepristone will increase the level or effect of tucatinib by Other (see comment). Avoid or Use Alternate Drug. Coadministration of tucatinib (a CYP2C8 substrate) with a strong or moderate CYP2C8 inhibitors increases tucatinib plasma concentrations and risk of toxicities. tucatinib will increase the level or effect of mifepristone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.ubrogepantSerious - Use Alternative (1)mifepristone will increase the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.ulipristalSerious - Use Alternative (1)mifepristone will increase the level or effect of ulipristal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.umeclidinium bromide/vilanterol inhaledMonitor Closely (1)mifepristone will increase the level or effect of umeclidinium bromide/vilanterol inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)mifepristone increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.upadacitinibMonitor Closely (1)mifepristone will increase the level or effect of upadacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Caution if upadacitinib is coadministered with strong CYP3A4 inhibitors.valbenazineMonitor Closely (1)valbenazine and mifepristone both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)mifepristone will increase the level or effect of valbenazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.valsartanMonitor Closely (1)mifepristone will increase the level or effect of valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposurevandetanibMonitor Closely (1)mifepristone, vandetanib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.Serious - Use Alternative (1)mifepristone will increase the level or effect of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.vardenafilMonitor Closely (2)mifepristone, vardenafil. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available. mifepristone will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors velpatasvirMonitor Closely (1)mifepristone will increase the level or effect of velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.vemurafenibMonitor Closely (1)mifepristone, vemurafenib. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.Serious - Use Alternative (1)mifepristone will increase the level or effect of