enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ganaxoloneMonitor Closely (1)aripiprazole and ganaxolone both increase sedation. Use Caution/Monitor.gemifloxacinMonitor Closely (1)aripiprazole and gemifloxacin both increase QTc interval. Use Caution/Monitor.gemtuzumabMonitor Closely (1)aripiprazole and gemtuzumab both increase QTc interval. Use Caution/Monitor.gilteritinibMonitor Closely (1)aripiprazole and gilteritinib both increase QTc interval. Use Caution/Monitor.givosiranSerious - Use Alternative (1)givosiran will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.glasdegibSerious - Use Alternative (1)aripiprazole and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.glimepirideMonitor Closely (1)aripiprazole, glimepiride. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.glipizideMonitor Closely (1)aripiprazole, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.glyburideMonitor Closely (1)aripiprazole, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.glycopyrrolateMonitor Closely (1)aripiprazole increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.glycopyrrolate inhaledMonitor Closely (3)glycopyrrolate inhaled decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. glycopyrrolate inhaled decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.goserelinMonitor Closely (1)aripiprazole and goserelin both increase QTc interval. Use Caution/Monitor.granisetronMonitor Closely (1)aripiprazole and granisetron both increase QTc interval. Use Caution/Monitor.grapefruitMonitor Closely (1)grapefruit will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.griseofulvinMonitor Closely (1)griseofulvin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.guanfacineMonitor Closely (1)guanfacine, aripiprazole. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.haloperidolMonitor Closely (3)aripiprazole and haloperidol both increase QTc interval. Use Caution/Monitor. aripiprazole and haloperidol both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and haloperidol both increase sedation. Use Caution/Monitor.Minor (1)haloperidol will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.henbaneMonitor Closely (3)henbane decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. henbane decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.histrelinMonitor Closely (1)aripiprazole and histrelin both increase QTc interval. Use Caution/Monitor.homatropineMonitor Closely (3)homatropine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. homatropine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.hydrocodoneSerious - Use Alternative (1)hydrocodone, aripiprazole. 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)hydrocortisone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.hydromorphoneMonitor Closely (1)hydromorphone and aripiprazole both increase sedation. Use Caution/Monitor.hydroxychloroquine sulfateSerious - Use Alternative (1)aripiprazole and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.hydroxyzineMonitor Closely (2)aripiprazole and hydroxyzine both increase QTc interval. Use Caution/Monitor. hydroxyzine and aripiprazole both increase sedation. Use Caution/Monitor.hyoscyamineMonitor Closely (3)hyoscyamine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. hyoscyamine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.hyoscyamine sprayMonitor Closely (3)aripiprazole increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. hyoscyamine spray decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. hyoscyamine spray decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.ibuprofen/famotidineMinor (1)ibuprofen/famotidine decreases levels of aripiprazole by unspecified interaction mechanism. Minor/Significance Unknown.ibutilideSerious - Use Alternative (1)aripiprazole and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.idelalisibSerious - Use Alternative (1)idelalisib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substratesiloperidoneMonitor Closely (3)aripiprazole and iloperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and iloperidone both increase sedation. Use Caution/Monitor. iloperidone increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.Serious - Use Alternative (1)aripiprazole and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.imatinibMinor (1)imatinib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.imipramineMonitor Closely (1)aripiprazole and imipramine both increase sedation. Use Caution/Monitor.indacaterol, inhaledMonitor Closely (1)aripiprazole and indacaterol, inhaled both increase QTc interval. Use Caution/Monitor.indinavirMonitor Closely (1)indinavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.inotuzumabSerious - Use Alternative (1)aripiprazole and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.insulin aspartMonitor Closely (1)aripiprazole, insulin aspart. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin degludecMonitor Closely (1)aripiprazole decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.insulin degludec/insulin aspartMonitor Closely (1)aripiprazole decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.insulin detemirMonitor Closely (1)aripiprazole, insulin detemir. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin glargineMonitor Closely (1)aripiprazole, insulin glargine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin glulisineMonitor Closely (1)aripiprazole, insulin glulisine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin inhaledMonitor Closely (1)aripiprazole decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.insulin lisproMonitor Closely (1)aripiprazole, insulin lispro. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin NPHMonitor Closely (1)aripiprazole, insulin NPH. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.insulin regular humanMonitor Closely (1)aripiprazole, insulin regular human. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.ipratropiumMonitor Closely (3)ipratropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. ipratropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. aripiprazole increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.isofluraneSerious - Use Alternative (1)aripiprazole and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.isoniazidMonitor Closely (1)isoniazid will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isoproterenolMonitor Closely (1)aripiprazole increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.istradefyllineMonitor Closely (1)istradefylline will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.itraconazoleMonitor Closely (1)itraconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For aripiprazole oral formulations other than the extended-release injectable: Reduce aripiprazole dose by 50% of the usual dose when initiating concomitant therapy with a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (e.g., paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider reducing apixaban dose to up to 75% when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor. For extended-release injectable aripiprazole: Please refer to prescribing information.Serious - Use Alternative (1)aripiprazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.ivosidenibSerious - Use Alternative (2)ivosidenib will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. aripiprazole and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug.ketoconazoleMonitor Closely (1)ketoconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce aripiprazole oral dose by 50% of the usual dose when concomitantly using a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (eg, paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider dose reductions to 25% of the usual dose when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor initially and then adjusted to achieve a favorable clinical response.ketotifen, ophthalmicMonitor Closely (1)aripiprazole and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lapatinibMonitor Closely (2)lapatinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. aripiprazole and lapatinib both increase QTc interval. Use Caution/Monitor.larotrectinibMonitor Closely (1)larotrectinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lasmiditanMonitor Closely (1)lasmiditan, aripiprazole. 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)lefamulin and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.lemborexantMonitor Closely (1)lemborexant, aripiprazole. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lenacapavirMonitor Closely (1)lenacapavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates. lenvatinibSerious - Use Alternative (1)aripiprazole and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.letermovirMonitor Closely (1)letermovir increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.leuprolideMonitor Closely (1)aripiprazole and leuprolide both increase QTc interval. Use Caution/Monitor.levalbuterolMonitor Closely (2)aripiprazole increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. aripiprazole and levalbuterol both increase QTc interval. Use Caution/Monitor.levodopaSerious - Use Alternative (1)aripiprazole decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.levodopa inhaledSerious - Use Alternative (1)aripiprazole decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .levofloxacinMonitor Closely (1)aripiprazole and levofloxacin both increase QTc interval. Use Caution/Monitor.levoketoconazoleMonitor Closely (1)levoketoconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce aripiprazole oral dose by 50% of the usual dose when concomitantly using a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (eg,