Closely (1)butabarbital increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxaloneMonitor Closely (1)butabarbital and metaxalone both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (2)butabarbital 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.methamphetamineMonitor Closely (1)butabarbital increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methazolamideMinor (1)methazolamide, butabarbital. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of anticonvulsant induced osteomalacia.methocarbamolMonitor Closely (1)butabarbital and methocarbamol both increase sedation. Use Caution/Monitor.methoxyfluraneSerious - Use Alternative (1)butabarbital increases toxicity of methoxyflurane by increasing metabolism. Contraindicated. Increased metabolism of methoxyflurane to nephrotoxic compounds.methsuximideMinor (1)methsuximide decreases effects of butabarbital by pharmacodynamic antagonism. Minor/Significance Unknown.methylenedioxymethamphetamineMonitor Closely (1)butabarbital increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylprednisoloneMonitor Closely (1)butabarbital will decrease the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metoprololMonitor Closely (1)butabarbital 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.mexiletineMonitor Closely (1)butabarbital will decrease the level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.miconazole vaginalMinor (1)butabarbital decreases levels of miconazole vaginal by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.midazolamMonitor Closely (2)butabarbital 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 intranasalMonitor Closely (1)midazolam 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.midodrineMonitor Closely (1)butabarbital increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.midostaurinSerious - Use Alternative (1)butabarbital will decrease the level or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A4 inducers may decrease midostaurin concentrations resulting in reduced efficacy.mirtazapineMonitor Closely (1)butabarbital and mirtazapine both increase sedation. Use Caution/Monitor.mobocertinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of mobocertinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.modafinilMonitor Closely (1)butabarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.montelukastMinor (1)butabarbital will decrease the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.morphineMonitor Closely (1)butabarbital and morphine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)butabarbital and motherwort both increase sedation. Use Caution/Monitor.moxonidineMonitor Closely (1)butabarbital and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)butabarbital and nabilone both increase sedation. Use Caution/Monitor.nadololMonitor Closely (1)butabarbital 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.nalbuphineMonitor Closely (1)butabarbital and nalbuphine both increase sedation. Use Caution/Monitor.naldemedineSerious - Use Alternative (1)butabarbital will decrease the level or effect of naldemedine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with strong CYP3A4 inducers.nateglinideMonitor Closely (1)butabarbital will decrease the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.nebivololMonitor Closely (1)butabarbital 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.nelfinavirMonitor Closely (1)butabarbital will decrease the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.neratinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of neratinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of neratinib with strong/moderate CYP3A4 inducers.nettleMinor (1)nettle increases effects of butabarbital by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.nicardipineMonitor Closely (1)butabarbital will decrease the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nifedipineMinor (1)butabarbital will decrease the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nilotinibMonitor Closely (1)butabarbital will decrease the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nimodipineMinor (1)butabarbital will decrease the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nisoldipineMonitor Closely (1)butabarbital will decrease the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nitrendipineMinor (1)butabarbital will decrease the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.norepinephrineMonitor Closely (1)butabarbital increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.norgestrelMonitor Closely (1)butabarbital 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 methodsnortriptylineMonitor Closely (1)butabarbital and nortriptyline both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, nortriptyline. 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.olanzapineMonitor Closely (2)butabarbital 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.oliceridineMonitor Closely (2)butabarbital 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.olopatadine intranasalSerious - Use Alternative (1)butabarbital and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. olutasidenibSerious - Use Alternative (1)butabarbital will decrease the level or effect of olutasidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong or moderate CYP3A inducers decrease olutasidenib (a CYP3A4 substrate) plasma concentrations and efficacy.omaveloxoloneSerious - Use Alternative (1)butabarbital will decrease the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.omeprazoleMonitor Closely (1)butabarbital will decrease the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.ondansetronMonitor Closely (1)butabarbital 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.Minor (1)butabarbital will decrease the level or effect of ondansetron by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.opium tinctureMonitor Closely (1)butabarbital and opium tincture both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)butabarbital and orphenadrine both increase sedation. Use Caution/Monitor.osilodrostatMonitor Closely (1)butabarbital 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.oxazepamMonitor Closely (1)butabarbital and oxazepam both increase sedation. Use Caution/Monitor.oxybutyninMinor (1)butabarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.oxycodoneMonitor Closely (1)butabarbital and oxycodone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)butabarbital and oxymorphone both increase sedation. Use Caution/Monitor.paclitaxelMinor (1)butabarbital will decrease the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.paclitaxel protein boundMinor (1)butabarbital will decrease the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.paliperidoneMonitor Closely (1)butabarbital and paliperidone both increase sedation. Use Caution/Monitor.pantoprazoleMonitor Closely (1)butabarbital will decrease the level or effect of pantoprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.papaveretumMonitor Closely (1)butabarbital and papaveretum both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)butabarbital and papaverine both increase sedation. Use Caution/Monitor.parecoxibMonitor Closely (1)butabarbital will decrease the level or effect of parecoxib by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.Minor (1)butabarbital will decrease the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.passion flowerMonitor Closely (1)passion flower increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.pazopanibMonitor Closely (1)butabarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pemigatinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of pemigatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.penbutololMonitor Closely (1)butabarbital 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.pentazocineMonitor Closely (1)butabarbital and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)butabarbital and pentobarbital both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)butabarbital and perphenazine both increase sedation. Use Caution/Monitor.pexidartinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of pexidartinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.phendimetrazineMonitor Closely (1)butabarbital increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenelzineMinor (1)phenelzine increases levels of butabarbital by decreasing metabolism. Minor/Significance Unknown. Theoretical interaction.phenindioneSerious - Use Alternative (1)butabarbital decreases effects of phenindione by increasing metabolism. Avoid or Use Alternate Drug.phenobarbitalMonitor Closely (1)butabarbital and phenobarbital both increase sedation. Use Caution/Monitor.phentermineMonitor Closely (1)butabarbital increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineMonitor Closely (1)butabarbital increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (1)butabarbital increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinMonitor Closely (1)butabarbital will decrease the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)butabarbital and pholcodine both increase sedation. Use Caution/Monitor.pimozideMonitor Closely (1)butabarbital and pimozide both increase sedation. Use Caution/Monitor.Minor (1)butabarbital will decrease the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.pindololMonitor Closely (1)butabarbital 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.pioglitazoneMinor (1)butabarbital will decrease the level or effect of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.pirbuterolMonitor Closely (1)butabarbital increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.piroxicamMinor (1)butabarbital will decrease the level or effect of piroxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.pirtobrutinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of pirtobrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration unavoidable, increase pirtobrutinib dose to 300 mg qDay (if dose is 200 mg qDay) or increase pirtobrutinib dose by 50 mg (if current pirtobrutinib dose is 50 mg or 100 mg qDay).pitolisantMonitor Closely (1)butabarbital 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 vedotinMonitor Closely (1)butabarbital 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.posaconazoleMinor (1)butabarbital decreases levels of posaconazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.pralsetinibSerious - Use Alternative (1)butabarbital will decrease the level or effect of pralsetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If unable to avoid, double current pralsetinib dose starting on Day 7 of coadministration with strong CYP3A inducer. After inducer has been discontinued for at least 14 days, resume previous pralsetinib dose.prednisoloneMonitor Closely (1)butabarbital will decrease the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.prednisoneMonitor Closely (1)butabarbital will decrease the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, butabarbital. Either increases effects of the other by pharmacodynamic