Quetiapine(continued)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure toquetiapine. Avoid.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toquetiapine.oStudy→Also seeTABLE 11p. 849
▶Antiepileptics(valproate)potentially increase the risk of
neutropenia when given withquetiapine.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toquetiapine. Avoid.
oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toquetiapine. Avoid.
rStudy
▶Aprepitantis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Bosentanis predicted to decrease the exposure toquetiapine.
oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toquetiapine. Avoid.oStudy→
Also seeTABLE 8p. 848
▶Cobicistatis predicted to increase the exposure toquetiapine.
Avoid.rStudy
▶Crizotinibis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Quetiapineis predicted to decrease the effects ofdopamine
receptor agonists. Avoid.oTheoretical→Also seeTABLE 8
p. 848
▶Efavirenzis predicted to decrease the exposure toquetiapine.
oStudy
▶Enzalutamideis predicted to decrease the exposure to
quetiapine.oStudy
▶Grapefruit juiceis predicted to increase the exposure to
quetiapine. Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toquetiapine. Avoid.rStudy
▶Idelalisibis predicted to increase the exposure toquetiapine.
Avoid.rStudy
▶Imatinibis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Quetiapinedecreases the effects oflevodopa.r
Anecdotal→Also seeTABLE 8p. 848
▶Quetiapinepotentially increases the risk of neurotoxicity
when given withlithium.rAnecdotal
▶Macrolides(clarithromycin)are predicted to increase the
exposure toquetiapine. Avoid.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure toquetiapine. Avoid.oStudy
▶Mitotaneis predicted to decrease the exposure toquetiapine.
oStudy
▶Netupitantis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Nevirapineis predicted to decrease the exposure toquetiapine.
oStudy
▶Nilotinibis predicted to increase the exposure toquetiapine.
Avoid.oStudy
▶Ribociclib(high-dose) is predicted to increase the exposure to
quetiapine. Avoid.oTheoretical
▶Rifampicinis predicted to decrease the exposure toquetiapine.
oStudy
▶St John’s Wortis predicted to decrease the exposure to
quetiapine.oStudy
Quinagolide→see dopamine receptor agonists
Quinapril→see ACE inhibitors
Quinine→see antimalarials
Quinolones→seeTABLE 9p. 849 (QT-interval prolongation)
ciprofloxacin.levofloxacin.moxifloxacin.norfloxacin.ofloxacin..ROUTE-SPECIFIC INFORMATIONSince systemic absorption can
follow topical application, the possibility of interactions
should be borne in mind.
▶Ciprofloxacinis predicted to increase the exposure to
agomelatine.oStudy▶Quinolones(ciprofloxacin, norfloxacin)are predicted to increase
the exposure toaminophylline. Adjust dose.o
Theoretical
▶Ciprofloxacinis predicted to increase the exposure to
anagrelide.oTheoretical
▶Antacidsdecrease the absorption ofquinolones.Quinolones
should be taken 2 hours before or 4 hours afterantacids.
oStudy
▶Ciprofloxacinslightly increases the exposure toantiarrhythmics
(lidocaine).nStudy
▶Ciprofloxacinaffects the concentration ofantiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
dose.rStudy
▶Calcium salts(calcium carbonate)decrease the absorption of
ciprofloxacin. Separate administration by 2 hours.o
Study
▶Calcium salts(calcium carbonate)decrease the absorption of
norfloxacin.Norfloxacinshould be taken 2 hours before or
4 hours aftercalcium carbonate.oStudy
▶Ciprofloxacinincreases the concentration ofclozapine.
Monitor side effects and adjust dose.rStudy
▶Quinolonesincrease the anticoagulant effect ofcoumarins.
rAnecdotal
▶Didanosine(buffered) is predicted to greatly decrease the
exposure to oralquinolones.Didanosineshould be taken
2 hours after quinolones.oStudy
▶Ciprofloxacinis predicted to increase the exposure todopamine
receptor agonists(ropinirole). Adjust dose.oStudy
▶Ciprofloxacinis predicted to increase the exposure to
duloxetine. Avoid.oTheoretical
▶Ciprofloxacinis predicted to increase the exposure to
eliglustat. Avoid or adjust dose—consult product literature.
rTheoretical
▶Enteral feedsdecrease the exposure tociprofloxacin.o
Study
▶Ciprofloxacinslightly increases the exposure toerlotinib.
Monitor side effects and adjust dose.oStudy
▶Ciprofloxacinis predicted to increase the exposure toibrutinib.
Adjustibrutinibdose.rTheoretical
▶Iron (oral)decreases the exposure toquinolones. Separate
administration by at least 2 hours.oStudy
▶Lanthanummoderately decreases the exposure toquinolones.
Quinolonesshould be taken 2 hours before or 4 hours after
lanthanum.oStudy
▶Ciprofloxacinis predicted to increase the exposure toloxapine.
Avoid.qTheoretical
▶Ciprofloxacinis predicted to increase the exposure to
melatonin.oTheoretical
▶Ciprofloxacinpotentially increases the risk of toxicity when
given withmethotrexate. Avoid.rAnecdotal
▶Ciprofloxacinslightly increases the exposure tomonoamine-
oxidase B inhibitors(rasagiline).oStudy
▶NSAIDspotentially increase the risk of seizures when given
withquinolones.rTheoretical
▶Ciprofloxacinvery slightly increases the exposure to
pentoxifylline.oStudy
▶Ciprofloxacinis predicted to increase the exposure to
pirfenidone. Use with caution and adjust dose.oStudy
▶Ciprofloxacinis predicted to increase the exposure to
pomalidomide. Adjustpomalidomidedose.oTheoretical
▶Ciprofloxacinis predicted to increase the exposure to
roflumilast.oTheoretical
▶Sucralfatedecreases the exposure toquinolones. Separate
administration by 2 hours.oStudy
▶Ciprofloxacinis predicted to increase the exposure to
theophylline. Monitor and adjust dose.oTheoretical
▶Norfloxacinis predicted to increase the exposure to
theophylline. Adjust dose.oAnecdotal
▶Ciprofloxacinincreases the exposure totizanidine. Avoid.
oStudy
▶Zincis predicted to decrease the exposure toquinolones.
Separate administration by 2 hours.oStudy
▶Ciprofloxacinis predicted to increase the exposure to
zolmitriptan. Adjustzolmitriptandose,p. 292.o
Theoretical978 Quetiapine—Quinolones BNFC 2018 – 2019
Interactions|Appendix 1A1