▶Antiepileptics(fosphenytoin, phenytoin)moderately decrease
the exposure totizanidine.nStudy
▶Combined hormonal contraceptivesincrease the exposure to
tizanidine. Avoid.oStudy
▶HIV-protease inhibitors(ritonavir)moderately decrease the
exposure totizanidine.nStudy
▶Iron chelators(deferasirox)are predicted to increase the
exposure totizanidine. Avoid.oTheoretical
▶Leflunomidemoderately decreases the exposure totizanidine.
nStudy
▶Obeticholic acidis predicted to increase the exposure to
tizanidine.rTheoretical
▶Quinolones(ciprofloxacin)increase the exposure totizanidine.
Avoid.oStudy
▶Rifampicinmoderately decreases the exposure totizanidine.
nStudy
▶SSRIs(fluvoxamine)very markedly increase the exposure to
tizanidine. Avoid.rStudy
▶Teriflunomidemoderately decreases the exposure to
tizanidine.nStudy
Tobramycin→see aminoglycosides
Tocilizumab→see monoclonal antibodies
Tofacitinib
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure totofacitinib.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
totofacitinib. Avoid.rStudy
▶Antifungals, azoles(fluconazole, itraconazole, ketoconazole,
voriconazole)are predicted to increase the exposure to
tofacitinib. Adjusttofacitinibdose.oStudy
▶Antifungals, azoles(isavuconazole)are predicted to increase the
exposure totofacitinib.oStudy
▶Antifungals, azoles(posaconazole)are predicted to increase the
exposure totofacitinib.oTheoretical
▶Aprepitantis predicted to increase the exposure totofacitinib.
oStudy
▶Bosentanis predicted to decrease the exposure totofacitinib.
oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totofacitinib.oStudy
▶Ciclosporinincreases the exposure totofacitinib. Avoid.r
Study
▶Cobicistatis predicted to increase the exposure totofacitinib.
Adjusttofacitinibdose.oStudy
▶Crizotinibis predicted to increase the exposure totofacitinib.
oStudy
▶Efavirenzis predicted to decrease the exposure totofacitinib.
oStudy
▶Enzalutamideis predicted to decrease the exposure to
tofacitinib. Avoid.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totofacitinib. Adjusttofacitinibdose.oStudy
▶Idelalisibis predicted to increase the exposure totofacitinib.
Adjusttofacitinibdose.oStudy
▶Imatinibis predicted to increase the exposure totofacitinib.
oStudy
▶Live vaccinespotentially increase the risk of generalised
infection (possibly life-threatening) when given with
tofacitinib. Avoid.rTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure totofacitinib. Adjusttofacitinibdose.oStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure totofacitinib.oStudy
▶Mitotaneis predicted to decrease the exposure totofacitinib.
Avoid.rStudy
▶Netupitantis predicted to increase the exposure totofacitinib.
oStudy
▶Nevirapineis predicted to decrease the exposure totofacitinib.
oStudy
▶Nilotinibis predicted to increase the exposure totofacitinib.
oStudy
▶Rifampicinis predicted to decrease the exposure totofacitinib.
Avoid.rStudy
▶St John’sWortis predicted to decrease the exposure to
tofacitinib.oStudy
▶Tacrolimusincreases the exposure totofacitinib. Avoid.r
Study
Tolbutamide→see sulfonylureas
Tolcapone
▶Tolcaponeincreases the exposure tolevodopa. Monitor and
adjust dose.oStudy
▶Tolcaponeis predicted to increase the effects ofmonoamine-
oxidase A and B inhibitors, irreversible. Avoid.rTheoretical
▶Tolcaponeis predicted to increase the risk of cardiovascular
side-effects when given withsympathomimetics, inotropic.
oTheoretical
▶Tolcaponeis predicted to increase the effects of
sympathomimetics, vasoconstrictor(adrenaline/epinephrine,
noradrenaline/norepinephrine).oTheoretical
Tolfenamic acid→see NSAIDs
Tolterodine→seeTABLE 9p. 849 (QT-interval prolongation),TABLE 10
p. 849 (antimuscarinics)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure totolterodine.nTheoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure totolterodine.n
Theoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure totolterodine. Avoid.
rStudy→Also seeTABLE 9p. 849
▶Aprepitantis predicted to increase the exposure totolterodine.
nTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totolterodine.nTheoretical
▶Cobicistatis predicted to increase the exposure totolterodine.
Avoid.rStudy
▶Crizotinibis predicted to increase the exposure totolterodine.
nTheoretical→Also seeTABLE 9p. 849
▶Eliglustatis predicted to increase the exposure totolterodine.
Adjust dose.oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
totolterodine. Avoid.rStudy→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure totolterodine.
Avoid.rStudy
▶Imatinibis predicted to increase the exposure totolterodine.
nTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure totolterodine. Avoid.rStudy→Also seeTABLE 9
p. 849
▶Macrolides(erythromycin)are predicted to increase the
exposure totolterodine.nTheoretical→Also seeTABLE 9p. 849
▶Netupitantis predicted to increase the exposure totolterodine.
nTheoretical
▶Nilotinibis predicted to increase the exposure totolterodine.
nTheoretical→Also seeTABLE 9p. 849
Tolvaptan→seeTABLE 16p. 851 (increased serum potassium)
GENERAL INFORMATIONAvoid concurrent use of drugs that
increase serum-sodium concentrations.
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure totolvaptan. Adjust dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
totolvaptan. Avoid.rStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure totolvaptan. Adjust
dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure totolvaptan. Adjust dose.
rStudy
▶Aprepitantis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Bosentanis predicted to decrease the exposure totolvaptan.
oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totolvaptan. Adjust dose.o
Study
▶Cobicistatis predicted to increase the exposure totolvaptan.
Adjust dose.rStudyBNFC 2018 – 2019 Tizanidine—Tolvaptan 1003
Interactions|Appendix 1A1