Increased clearance & decreased blood conc w/ CYP3A4 inducers (eg, phenytoin, carbamazepine, rifampicin). Increased risk of QTc interval prolongation & Torsade de pointes w/ QTc-prolonging drugs. Avoid drugs that can disrupt electrolyte levels (eg, loop, thiazide & related diuretics, laxatives & enemas, amphotericin B, high dose corticosteroids). May reduce analgesic effect of tramadol. Profound hypotension & loss of consciousness w/ apomorphine HCl. Serotonin syndrome w/ serotonergic drugs (eg, triptans, SSRIs, SNRIs, lithium, sibutramine, fentanyl & its analogues, dextromethorphan, tramadol, tapentadol, meperidine, methadone, pertazocine. St. John's Wort), & w/ drugs which impair metabolism of serotonin (eg, MAOIs).