Increased plasma conc of CYP3A4 substrate. Increased in the systemic exposure of dexamethasone. Increased systemic exposure of netupitant w/ midazolam & chemotherapy agents (eg, docetaxel, paclitaxel, etoposide, irinotecan, cyclophosphamide, ifosfamide, imatinib, vinorelbine, vinblastine & vincristine). Decreased efficacy in concomitant use w/ strong CYP3A4 inducer. Concomitant use w/ strong CYP3A4 inhibitor (eg, ketoconazole) may increase systemic exposure to the netupitant component.