Tolvaptan(continued)
▶Crizotinibis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Tolvaptanincreases the concentration ofdigoxin.nStudy
▶Efavirenzis predicted to decrease the exposure totolvaptan.
oTheoretical
▶Enzalutamideis predicted to decrease the exposure to
tolvaptan. Avoid.rStudy
▶Grapefruit juiceincreases the exposure totolvaptan. Avoid.
oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totolvaptan. Adjust dose.rStudy
▶Idelalisibis predicted to increase the exposure totolvaptan.
Adjust dose.rStudy
▶Imatinibis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Tolvaptanis predicted to increase the exposure tolomitapide.
Separate administration by 12 hours.oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure totolvaptan. Adjust dose.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure totolvaptan. Adjust dose.oStudy
▶Mitotaneis predicted to decrease the exposure totolvaptan.
Avoid.rStudy
▶Netupitantis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Nevirapineis predicted to decrease the exposure totolvaptan.
oTheoretical
▶Nilotinibis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure totolvaptan.
Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
tolvaptan.oTheoretical
Topiramate→see antiepileptics
Topotecan→seeTABLE 15p. 850 (myelosuppression)
▶Antiarrhythmics(amiodarone, dronedarone)are predicted to
increase the exposure totopotecan.rStudy
▶Antiepileptics(fosphenytoin, phenytoin)increase the clearance
oftopotecan.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
increase the exposure totopotecan.rStudy
▶Calcium channel blockers(verapamil)are predicted to increase
the exposure totopotecan.rStudy
▶Ceritinibis predicted to increase the exposure totopotecan.
oTheoretical→Also seeTABLE 15p. 850
▶Ciclosporinis predicted to increase the exposure totopotecan.
rStudy
▶Eliglustatis predicted to increase the exposure totopotecan.
Adjust dose.oStudy
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the exposure totopotecan.rStudy
▶Lapatinibis predicted to increase the exposure totopotecan.
rStudy
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
topotecan. Public Health England advises avoid (refer to Green
Book).rTheoretical
▶Macrolidesare predicted to increase the exposure to
topotecan.rStudy
▶Mirabegronis predicted to increase the exposure totopotecan.
nTheoretical
▶Ranolazineis predicted to increase the exposure totopotecan.
rStudy
▶Rolapitantis predicted to increase the exposure totopotecan.
Avoid or monitor.oStudy
▶St John’s Wortis predicted to decrease the exposure to
topotecan.rTheoretical
▶Tedizolidis predicted to increase the exposure totopotecan.
Avoid.oTheoretical
▶Velpatasviris predicted to increase the exposure totopotecan.
rTheoretical
▶Vemurafenibis predicted to increase the exposure to
topotecan.rStudy
Torasemide→see loop diureticsToremifene→seeTABLE 5p. 847 (thromboembolism),TABLE 9p. 849
(QT-interval prolongation)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
totoremifene. Adjust dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure totoremifene.o
Theoretical→Also seeTABLE 9p. 849
▶Cobicistatis predicted to increase the exposure totoremifene.
oTheoretical
▶Toremifeneis predicted to increase the anticoagulant effect of
coumarins.rTheoretical
▶Enzalutamideis predicted to decrease the exposure to
toremifene. Adjust dose.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
totoremifene.oTheoretical→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure totoremifene.
oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure totoremifene.oTheoretical→Also seeTABLE 9
p. 849
▶Mitotaneis predicted to decrease the exposure totoremifene.
Adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure totoremifene.
Adjust dose.oStudy
▶Thiazide diureticsare predicted to increase the risk of
hypercalcaemia when given withtoremifene.rTheoretical
Trabectedin→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
totrabectedin. Avoid.rTheoretical→Also seeTABLE 1p. 847
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure totrabectedin. Avoid or
adjust dose.rTheoretical→Also seeTABLE 1p. 847
▶Cobicistatis predicted to increase the exposure totrabectedin.
Avoid or adjust dose.rTheoretical
▶Enzalutamideis predicted to decrease the exposure to
trabectedin. Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
totrabectedin. Avoid or adjust dose.rTheoretical
▶Idelalisibis predicted to increase the exposure totrabectedin.
Avoid or adjust dose.rTheoretical→Also seeTABLE 15p. 850
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
trabectedin. Public Health England advises avoid (refer to
Green Book).rTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure totrabectedin. Avoid or adjust dose.r
Theoretical
▶Mitotaneis predicted to decrease the exposure totrabectedin.
Avoid.rTheoretical→Also seeTABLE 15p. 850
▶Rifampicinis predicted to decrease the exposure to
trabectedin. Avoid.rTheoretical
Tramadol→see opioids
Trametinib
▶Antiarrhythmics(amiodarone, dronedarone)are predicted to
increase the concentration oftrametinib.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
increase the concentration oftrametinib.oTheoretical
▶Calcium channel blockers(verapamil)are predicted to increase
the concentration oftrametinib.oTheoretical
▶Ciclosporinis predicted to increase the concentration of
trametinib.oTheoretical
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the concentration oftrametinib.
oTheoretical
▶Lapatinibis predicted to increase the concentration of
trametinib.oTheoretical
▶Macrolidesare predicted to increase the concentration of
trametinib.oTheoretical
▶Ranolazineis predicted to increase the concentration of
trametinib.oTheoretical
▶Vemurafenibis predicted to increase the concentration of
trametinib.oTheoretical1004 Tolvaptan—Trametinib BNFC 2018 – 2019
Interactions|Appendix 1A1