Elevated levels of cisapride, pimozide. Altered metabolism of terfenadine, astemizole. Acute ergot toxicity w/ ergotamine or dihydroergotamine. Increased AUC of midazolam, alprazolam, triazolam; atazanavir. Increased plasma conc of lovastatin or simvastatin; omeprazole; theophylline or carbamazepine; phenytoin, valproate; itraconazole. Markedly increased transaminases w/ lomitapide. Induced metabolism w/ rifampicin, phenytoin, carbamazepine, phenobarb, St. John's wort. Decreased serum levels w/ rifabutin. Accelerated metabolism w/ efavirenz, nevirapine, rifampicin, rifabutin, rifapentine. Decreased exposure by etravirine. Increased mean C
min & AUC w/ fluconazole. Increased C
max, C
min & AUC w/ ritonavir. Torsade de pointes w/ antiarrhythmics eg, quinidine or disopyramide. Hypoglycemia w/ disopyramide & certain hypoglycemics eg, nateglanide, repaglinide or insulin. Monitor serum conc of CYP3A substrate w/ narrow safety margin eg, carbamazepine; CYP3A-metabolized drugs. High risk of bleeding w/ direct-acting oral anticoagulants eg, rivaroxaban, apixaban. Increased phosphodiesterase inhibitor exposure w/ sildenafil, tadalafil or vardenafil. Elevated serum conc of tolterodine; digoxin. CNS effects w/ triazolam. Increased exposure to colchicine. Decreased steady-state conc of zidovudine. Risk of hypotension w/ CYP3A4-metabolized Ca-channel blockers eg, verapamil, amlodipine, diltiazem. Increased AUC & C
max of saquinavir.