Increased exposure w/ potent CYP1A2 inhibitor (eg, fluvoxamine). Decreased oral bioavailability of midazolam. Potential interaction w/ substrates of UGT1A1 & medicinal products exclusively cleared by this pathway. Increased plasma conc w/ potent CYP3A4 inhibitors eg, azole antifungals, PIs, erythromycin, clarithromycin. Decreased plasma conc w/ potent CYP3A4 inducers eg, rifampicin, phenytoin, carbamazepine, barbiturates or St. John's Wort. Increased INR & bleeding events w/ coumarin-derived anticoagulants including warfarin. Increased potential for statin-induced myopathy, including rhabdomyolysis, w/ combination of Alvoceva & a statin. Reduced plasma conc in smokers. Altered distribution &/or altered elimination w/ P-gp inhibitors eg, cyclosporine, verapamil. Altered solubility w/ medicinal products that alter pH of the upper GI tract (eg, proton pump inhibitor, H2
-receptor antagonist). Increased platinum conc w/ carboplatin & paclitaxel. Increased conc w/ capecitabine. Proteasome inhibitors including bortezomib may be expected to influence effect of EGFR inhibitors including erlotinib.