List of drug interactions
The following is an alphabetical list of drugs and their
interactions; to avoid excessive cross-referencing each drug
or group is listed twice: in the alphabetical list and also
against the drug or group with which it interacts.Abacavir
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toabacavir.oTheoretical
▶HIV-protease inhibitors(tipranavir)slightly decrease the
exposure toabacavir. Avoid.rStudy
Abatacept
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
abatacept. Public Health England advises avoid (refer to Green
Book).rTheoretical
Abciximab→seeTABLE 4p. 847 (antiplatelet effects)
Abiraterone
GENERAL INFORMATIONCaution with concurrent
chemotherapy—safety and efficacy not established.
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toabiraterone. Avoid.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toabiraterone.r
Theoretical
▶Abirateroneis predicted to increase the exposure tobeta
blockers, selective(metoprolol).oStudy
▶Cobicistatis predicted to increase the exposure toabiraterone.
rTheoretical
▶Abirateroneis predicted to increase the exposure toeliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶Enzalutamideis predicted to decrease the exposure to
abiraterone. Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toabiraterone.rTheoretical
▶Idelalisibis predicted to increase the exposure toabiraterone.
rTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure toabiraterone.rTheoretical
▶Mitotaneis predicted to decrease the exposure toabiraterone.
Avoid.rTheoretical
▶Abirateroneis predicted to increase the exposure topitolisant.
Use with caution and adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure to
abiraterone. Avoid.rTheoretical
▶Abirateronepotentially increases the exposure tovenlafaxine.
rTheoretical
Acarbose→seeTABLE 14p. 850 (antidiabetic drugs)
▶Acarbosedecreases the concentration ofdigoxin.o
Study
▶Pancreatinis predicted to decrease the effects ofacarbose.
Avoid.oTheoretical
ACE inhibitors→seeTABLE 7p. 848 (first-dose hypotension),TABLE 8
p. 848 (hypotension),TABLE 16p. 851 (increased serum potassium)
captopril.enalapril.fosinopril.imidapril.lisinopril.perindopril.
quinapril.ramipril.trandolapril..
▶ACE inhibitorsincrease the risk of renal impairment when
given withaliskiren. Use with caution or avoidaliskirenin
selected patients.rStudy→Also seeTABLE 8p. 848→Also
seeTABLE 16p. 851
▶ACE inhibitorsare predicted to increase the risk of
hypersensitivity and haematological reactions when given
withallopurinol.rAnecdotal
▶ACE inhibitorsare predicted to increase the risk of anaemia
and/or leucopenia when given withazathioprine.r
Anecdotal
▶ACE inhibitorsare predicted to decrease the efficacy of
icatibantandicatibantis predicted to decrease the efficacy of
ACE inhibitors. Avoid.oTheoretical
▶ACE inhibitorsare predicted to increase the concentration of
lithium. Monitor and adjust dose.rAnecdotal▶ACE inhibitorsare predicted to increase the risk of
hypersensitivity when given withsodium aurothiomalate.
rAnecdotal
▶Quinapril(tablet) decreases the absorption of oraltetracyclines
(tetracycline). Avoid.oStudy
Acebutolol→see beta blockers, selective
Aceclofenac→see NSAIDs
Acemetacin→see NSAIDs
Acenocoumarol→see coumarins
Acetazolamide
▶Acetazolamidepotentially increases the risk of toxicity when
given withantiepileptics(valproate).rStudy
▶Acetazolamidepotentially increases the risk of overheating
and dehydration when given withantiepileptics(zonisamide).
Avoid in children.rTheoretical
▶Acetazolamideincreases the risk of severe toxic reaction when
given withaspirin(high-dose).rStudy
▶Acetazolamidealters the concentration oflithium.r
Anecdotal
▶Acetazolamideis predicted to decrease the efficacy of
methenamine. Avoid.oTheoretical
▶Acetazolamideincreases the urinary excretion of
methotrexate.oStudy
Aciclovir→seeTABLE 2p. 847 (nephrotoxicity)
ROUTE-SPECIFIC INFORMATIONSince systemic absorption can
follow topical application, the possibility of interactions
should be borne in mind.
▶Aciclovirincreases the exposure toaminophylline. Monitor and
adjust dose.rAnecdotal
▶Mycophenolateis predicted to increase the risk of
haematological toxicity when given withaciclovir.o
Theoretical
▶Acicloviris predicted to increase the exposure totheophylline.
Monitor and adjust dose.rTheoretical
Acitretin→see retinoids
Aclidinium→seeTABLE 10p. 849 (antimuscarinics)
Acrivastine→see antihistamines, non-sedating
Adalimumab→see monoclonal antibodies
Adapalene→see retinoids
Adefovir
▶Atalurenincreases the exposure toadefovir.oStudy
Adenosine→see antiarrhythmics
Adrenaline/epinephrine→see sympathomimetics, vasoconstrictor
Afatinib→seeTABLE 15p. 850 (myelosuppression)
▶Antiarrhythmics(amiodarone, dronedarone)are predicted to
increase the exposure toafatinib. Separate administration by
12 hours.oStudy
▶Antiepileptics(carbamazepine)are predicted to decrease the
exposure toafatinib.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
increase the exposure toafatinib. Separate administration by
12 hours.oStudy
▶Calcium channel blockers(verapamil)are predicted to increase
the exposure toafatinib. Separate administration by 12 hours.
oStudy
▶Ciclosporinis predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the exposure toafatinib. Separate
administration by 12 hours.oStudy
▶Lapatinibis predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶Macrolidesare predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶Ranolazineis predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶Rifampicinis predicted to decrease the exposure toafatinib.
oStudy
▶St John’s Wortis predicted to decrease the exposure to
afatinib.oStudy
▶Vemurafenibis predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
Aflibercept→seeTABLE 15p. 850 (myelosuppression)852 Abacavir—Aflibercept BNFC 2018 – 2019
Interactions|Appendix 1A1