Drug interactions
Efavirenz + Zuranolone
Severity: Major
Efavirenz and Zuranolone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Efavirenz induces CYP3A4 and can lower zuranolone exposure, which may reduce its antidepressant effect. Both drugs also act on the central nervous system, so additive sedation and psychomotor impairment are possible.
What this interaction means in plain words
Efavirenz and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Efavirenz belongs to Anti Virals; Zuranolone belongs to Central Nervous System.
Why it happens
Efavirenz induces CYP3A4-mediated metabolism of zuranolone and adds pharmacodynamic CNS depression.
What to do
Prefer an alternative to efavirenz or monitor closely for reduced zuranolone response and for excessive sedation. Counsel the patient about driving and other tasks needing alertness.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Other interactions of Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Efavirenz with Zuranolone?
MediHelp rates the interaction as major. Efavirenz and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Efavirenz induces CYP3A4 and can lower zuranolone exposure, which may reduce its antidepressant effect. Both drugs also act on the central nervous system, so additive sedation and psychomotor impairment are possible.
How serious is the interaction between Efavirenz and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative to efavirenz or monitor closely for reduced zuranolone response and for excessive sedation. Counsel the patient about driving and other tasks needing alertness.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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