Increased exposure w/ ciprofloxacin. Decreased oral bioavailability of midazolam. Increased serum conc of bilirubin w/ drugs that are UGT1A1 substrates. Decreased metabolism & increased plasma conc w/ potent CYP3A4 inhibitors eg, ketoconazole, itraconazole, voriconazole, PIs, erythromycin or clarithromycin. Increased metabolism & decrease plasma conc by potent CYP3A4 inducers (eg, rifampicin). Reduced exposure w/ phenytoin, carbamazepine, barbiturates or St. John's wort (Hypericum perforatum
). Increased INR & bleeding events w/ coumarin-derived anticoagulants including warfarin. May increase potential statin-induced myopathy, including rhabdomyolysis. May lead to altered distribution &/or altered elimination w/ P-gp inhibitors eg, cyclosporine & verapamil. Solubility & bioavailability may be altered by drugs that alter the pH of upper GI tract. Decreased exposure & Cmax
w/ omeprazole & ranitidine. Increased total platinum AUC0-48
w/ carboplatin/paclitaxel. May increase conc w/ capecitabine. Effect may be influenced by proteasome inhibitors (eg, bortezomib).