Selected Antipsychotics/Strong CYP3A4 Inducers Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Apalutamide, barbiturates, carbamazepine, enzalutamide, fosphenytoin, lumacaftor, mitotane, natisedine, phenytoin, primidone, rifampin, rifapentine and St. John's Wort may speed up how quickly your liver processes your antipsychotic medication.

What might happen:

The amount of medicine in your blood may decrease and it may not work as well.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together and if you notice any change in your condition. Your doctor may want to change the dose of your medicine while you are taking apalutamide, barbiturates, carbamazepine, enzalutamide, fosphenytoin, lumacaftor, mitotane, phenytoin, primidone, rifampin, rifapentine or St. John's wort.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
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  • 2.Aristada (aripiprazole lauroxil) extended-release injectable US prescribing information. Alkermes Inc. November, 2018.
  • 3.Rexulti (brexpiprazole) US prescribing information. Otsuka Pharmaceutical Co., Ltd. June, 2020.
  • 4.Invega (paliperidone) US prescribing information. Janssen Pharmaceuticals, Inc. February 23, 2017.
  • 5.Seroquel (quetiapine) US prescribing information. AstraZeneca Pharmaceuticals LP September, 2020.
  • 6.Risperdal Consta (risperidone long acting injection) US prescribing information. Janssen Pharmaceutical Ltd. September, 2011.
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  • 9.Invega Trinza (paliperidone palmitate) US prescribing information. Janssen Pharmaceuticals, Inc. August, 2021.
  • 10.Risperdal (risperidone) US prescribing information. Janssen Pharmaceutical Ltd. February 2021.
  • 11.Perseris (risperidone) extended-release injectable suspension US prescribing information. Indivior Inc. July, 2018.
  • 12.Uzedy (risperidone extended-release injectable suspension) US prescribing information. Teva Pharmaceuticals April, 2023.
  • 13.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and -drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 14.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.