Increased inhibition of platelet aggregation w/ aspirin. May elevate plasma conc of certain HMG-CoA reductase inhibitors. Decreased C
ss,max & AUC w/ lovastatin. Clopidogrel. Increased plasma conc & decreased clearance w/ other CYP3A4 isoenzyme inhibitors including certain azole antifungals (eg, fluconazole, itraconazole, ketoconazole, miconazole), certain macrolide antibiotics (eg, erythromycin or clarithromycin but not azithromycin), certain SSRIs (eg, fluoxetine, fluvoxamine, nefazodone, sertraline), certain antiretroviral agents (eg, indinavir), metronidazole, diltiazem & danazol. Decreased metabolism w/ erythromycin & other macrolide antibiotics. Increased plasma conc by diltiazem. Metabolism may be inhibited & plasma conc may be elevated by omeprazole. Increased C
max w/ grapefruit juice. Synergistic effects w/
Ginkgo biloba. Decreased systemic exposure w/ tobacco smoking.
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