▶Enzalutamideis predicted to decrease the exposure tovinca
alkaloids(vinblastine, vincristine, vindesine).rTheoretical
▶Enzalutamideis predicted to decrease the exposure to
vinflunine. Avoid.rTheoretical
▶Enzalutamideis predicted to decrease the exposure to
vinorelbine. Use with caution or avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
tovinca alkaloids.rTheoretical→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure tovinca
alkaloids.rTheoretical→Also seeTABLE 15p. 850
▶Imatinibis predicted to increase the exposure tovinca
alkaloids.rTheoretical→Also seeTABLE 15p. 850
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given withvinca
alkaloids. Public Health England advises avoid (refer to Green
Book).rTheoretical
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the exposure tovinca alkaloids.rTheoretical→
Also seeTABLE 9p. 849
▶Mitotaneis predicted to decrease the exposure tovinca
alkaloids(vinblastine, vincristine, vindesine).rTheoretical→
Also seeTABLE 15p. 850
▶Mitotaneis predicted to decrease the exposure tovinflunine.
Avoid.rTheoretical→Also seeTABLE 15p. 850
▶Mitotaneis predicted to decrease the exposure tovinorelbine.
Use with caution or avoid.rTheoretical→Also seeTABLE 15
p. 850
▶Netupitantis predicted to increase the exposure tovinca
alkaloids.rTheoretical
▶Nilotinibis predicted to increase the exposure tovinca
alkaloids.rTheoretical→Also seeTABLE 15p. 850→Also see
TABLE 9p. 849
▶Pegaspargasepotentially increases the risk of neurotoxicity
when given withvincristine.Vincristineshould be taken
3 to 24 hours beforepegaspargase.rAnecdotal→Also see
TABLE 1p. 847→Also seeTABLE 15p. 850
▶Rifampicinis predicted to decrease the exposure tovinca
alkaloids(vinblastine, vincristine, vindesine).rTheoretical
▶Rifampicinis predicted to decrease the exposure tovinflunine.
Avoid.rTheoretical
▶Rifampicinis predicted to decrease the exposure to
vinorelbine. Use with caution or avoid.rTheoretical
Vincristine→see vinca alkaloids
Vindesine→see vinca alkaloids
Vinflunine→see vinca alkaloids
Vinorelbine→see vinca alkaloids
Vismodegib→seeTABLE 15p. 850 (myelosuppression)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovismodegib. Avoid.oTheoretical
▶Enzalutamideis predicted to decrease the exposure to
vismodegib. Avoid.oTheoretical
▶Mitotaneis predicted to decrease the exposure tovismodegib.
Avoid.oTheoretical→Also seeTABLE 15p. 850
▶Rifampicinis predicted to decrease the exposure to
vismodegib. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
vismodegib. Avoid.oTheoretical
Vitamin A
▶Retinoids(acitretin, alitretinoin, isotretinoin)are predicted to
increase the risk of vitamin A toxicity when given withvitamin
A. Avoid.rTheoretical
▶Retinoids(bexarotene)are predicted to increase the risk of
toxicity when given withvitamin A. Adjust dose.o
Theoretical
▶Retinoids(tretinoin)are predicted to increase the risk of
vitamin A toxicity when given withvitamin A. Avoid.r
Study
Vitamin D substances
alfacalcidol.calcipotriol.calcitriol.colecalciferol.
dihydrotachysterol.ergocalciferol.paricalcitol.tacalcitol..▶Antiepileptics(carbamazepine)are predicted to decrease the
effects ofvitamin D substances.oStudy
▶Antiepileptics(fosphenytoin, phenytoin)decrease the effects of
vitamin D substances.oStudy
▶Antiepileptics(phenobarbital, primidone)are predicted to
decrease the effects ofvitamin D substances.o
Theoretical
▶Antifungals, azoles(clotrimazole, ketoconazole)are predicted to
decrease the exposure tocolecalciferol.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toparicalcitol.o
Study
▶Cobicistatis predicted to increase the exposure toparicalcitol.
oStudy
▶Vitamin D substancesare predicted to increase the risk of
toxicity when given withdigoxin.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toparicalcitol.oStudy
▶Idelalisibis predicted to increase the exposure toparicalcitol.
oStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure toparicalcitol.oStudy
▶Thiazide diureticsincrease the risk of hypercalcaemia when
given withvitamin D substances.oTheoretical
Vitamin E substances
alpha tocopherol.alpha tocopheryl acetate..
▶Vitamin E substancesaffect the exposure tociclosporin.
oStudy
Volatile halogenated anaesthetics→seeTABLE 8p. 848
(hypotension),TABLE 11p. 849 (CNS depressant effects)
desflurane.isoflurane.methoxyflurane.sevoflurane..
▶Antiepileptics(phenobarbital, primidone)potentially increase
the risk of nephrotoxicity when given withmethoxyflurane.
Avoid.rTheoretical→Also seeTABLE 11p. 849
▶Isoniazidpotentially increases the risk of nephrotoxicity when
given withmethoxyflurane. Avoid.rTheoretical
▶Rifampicinpotentially increases the risk of nephrotoxicity
when given withmethoxyflurane. Avoid.rTheoretical
Voriconazole→see antifungals, azoles
Vortioxetine→seeTABLE 13p. 850 (serotonin syndrome),TABLE 4
p. 847 (antiplatelet effects)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tovortioxetine. Monitor and adjust dose.oStudy
▶Bupropionis predicted to increase the exposure to
vortioxetine. Monitor and adjust dose.oStudy→Also
seeTABLE 13p. 850
▶Cinacalcetis predicted to increase the exposure tovortioxetine.
Monitor and adjust dose.oStudy
▶Enzalutamideis predicted to decrease the exposure to
vortioxetine. Monitor and adjust dose.oStudy
▶Mitotaneis predicted to decrease the exposure tovortioxetine.
Monitor and adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure to
vortioxetine. Monitor and adjust dose.oStudy
▶SSRIs(fluoxetine, paroxetine)are predicted to increase the
exposure tovortioxetine. Monitor and adjust dose.o
Study→Also seeTABLE 13p. 850→Also seeTABLE 4p. 847
▶Terbinafineis predicted to increase the exposure to
vortioxetine. Monitor and adjust dose.oStudy
Voxilaprevir
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the
concentration ofvoxilaprevir. Avoid.rStudy
▶Antiepileptics(oxcarbazepine)are predicted to decrease the
concentration ofvoxilaprevir. Avoid.rTheoretical
▶Bosentanis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Ciclosporinincreases the concentration ofvoxilaprevir. Avoid.
rStudy
▶Voxilapreviris predicted to increase the concentration of
dabigatran. Avoid.rStudy
▶Voxilapreviris predicted to increase the concentration of
edoxaban. Avoid.rTheoretical
▶Efavirenzis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Enzalutamideis predicted to decrease the concentration of
voxilaprevir. Avoid.rStudyBNFC 2018 – 2019 Vinca alkaloids—Voxilaprevir 1009
Interactions|Appendix 1A1