Aminoglycosides→seeTABLE 2p. 847 (nephrotoxicity),TABLE 19
p. 851 (ototoxicity),TABLE 20p. 851 (neuromuscular blocking effects)
amikacin.gentamicin.streptomycin.tobramycin..
▶Aminoglycosidesare predicted to decrease the effects of
agalsidase. Avoid.oTheoretical
▶Antifungals, azoles(miconazole)potentially decrease the
exposure totobramycin.oAnecdotal
▶Atalurenis predicted to increase the risk of nephrotoxicity
when given with intravenousaminoglycosides. Avoid.r
Study
▶Aminoglycosidesincrease the risk of hypocalcaemia when
given withbisphosphonates.oAnecdotal→Also see
TABLE 2p. 847
▶Aminoglycosidespotentially increase the concentration of
digoxin. Monitor and adjust dose.nStudy
▶Loop diureticsincrease the risk of nephrotoxicity when given
withaminoglycosides. Avoid.oStudy→Also seeTABLE 19
p. 851
▶Aminoglycosidesare predicted to decrease the effects of
neostigmine.oTheoretical→Also seeTABLE 20p. 851
▶Aminoglycosidesare predicted to decrease the effects of
pyridostigmine.oTheoretical→Also seeTABLE 20p. 851
Aminophylline→seeTABLE 17p. 851 (reduced serum potassium)
FOOD AND LIFESTYLESmoking can increase aminophylline
clearance and increased doses of aminophylline are therefore
required; dose adjustments are likely to be necessary if
smoking started or stopped during treatment.
▶Aciclovirincreases the exposure toaminophylline. Monitor and
adjust dose.rAnecdotal
▶Aminophyllineis predicted to decrease the efficacy of
antiarrhythmics(adenosine). Separate administration by
24 hours.nTheoretical
▶Antiepileptics(fosphenytoin)are predicted to decrease the
exposure toaminophylline. Adjust dose.oStudy
▶Antiepileptics(phenobarbital)are predicted to decrease the
exposure toaminophylline. Adjust dose.oTheoretical
▶Antiepileptics(phenytoin)decrease the exposure to
aminophylline. Adjust dose.oStudy
▶Antiepileptics(primidone)are predicted to increase the
clearance ofaminophylline. Adjust dose.oTheoretical
▶Antiepileptics(stiripentol)are predicted to increase the
exposure toaminophylline. Avoid.oTheoretical
▶Beta blockers, non-selectiveare predicted to increase the risk
of bronchospasm when given withaminophylline. Avoid.
rTheoretical
▶Beta blockers, selectiveare predicted to increase the risk of
bronchospasm when given withaminophylline. Avoid.r
Theoretical
▶Combined hormonal contraceptivesare predicted to increase
the exposure toaminophylline. Adjust dose.o
Theoretical
▶Aminophyllineincreases the risk of agitation when given with
doxapram.oStudy
▶H 2 receptor antagonists(cimetidine)increase the concentration
ofaminophylline. Adjust dose.rStudy
▶HIV-protease inhibitors(ritonavir)decrease the exposure to
aminophylline. Adjust dose.oStudy
▶Interferonsare predicted to slightly increase the exposure to
aminophylline. Adjust dose.oTheoretical
▶Iron chelators(deferasirox)are predicted to increase the
exposure toaminophylline. Avoid.oTheoretical
▶Isoniazidis predicted to affect the clearance ofaminophylline.
rTheoretical
▶Leflunomidedecreases the exposure toaminophylline. Adjust
dose.oStudy
▶Aminophyllineis predicted to decrease the concentration of
lithium.oTheoretical
▶Macrolides(azithromycin)are predicted to increase the
exposure toaminophylline.oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure toaminophylline. Adjust dose.oTheoretical
▶Aminophyllineis predicted to decrease the exposure to
macrolides(erythromycin). Adjust dose.rStudy▶Methotrexateis predicted to decrease the clearance of
aminophylline.oTheoretical
▶Monoclonal antibodies(blinatumomab)are predicted to
transiently increase the exposure toaminophylline. Monitor
and adjust dose.oTheoretical
▶Monoclonal antibodies(sarilumab)potentially affect the
exposure toaminophylline. Monitor and adjust dose.o
Theoretical
▶Monoclonal antibodies(tocilizumab)are predicted to decrease
the exposure toaminophylline. Monitor and adjust dose.
oTheoretical
▶Pentoxifyllineis predicted to increase the concentration of
aminophylline. Use with caution or avoid.rTheoretical
▶Quinolones(ciprofloxacin, norfloxacin)are predicted to increase
the exposure toaminophylline. Adjust dose.o
Theoretical
▶Rifampicindecreases the exposure toaminophylline. Adjust
dose.oStudy
▶Aminophyllineis predicted to slightly increase the exposure to
roflumilast. Avoid.oTheoretical
▶SSRIs(fluvoxamine)moderately to markedly increase the
exposure toaminophylline. Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
aminophylline.rTheoretical
▶Sympathomimetics, vasoconstrictor(ephedrine)increase the risk
of side-effects when given withaminophylline. Avoid in
children.oStudy
▶Teriflunomidedecreases the exposure toaminophylline. Adjust
dose.oStudy
▶Valacicloviris predicted to increase the exposure to
aminophylline.rAnecdotal
Aminosalicylic acid
▶Aminosalicylic acidis predicted to increase the risk of
methaemoglobinaemia when given with topicalanaesthetics,
local(prilocaine). Use with caution or avoid.rTheoretical
▶Aminosalicylic acidis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
Amiodarone→see antiarrhythmics
Amisulpride→seeTABLE 9p. 849 (QT-interval prolongation),TABLE 11
p. 849 (CNS depressant effects)
▶Amisulprideis predicted to decrease the effects ofdopamine
receptor agonists. Avoid.oTheoretical→Also seeTABLE 9
p. 849
▶Amisulprideis predicted to decrease the effects oflevodopa.
Avoid.rTheoretical
Amitriptyline→see tricyclic antidepressants
Amlodipine→see calcium channel blockers
Amoxicillin→see penicillins
Amphotericin→seeTABLE 2p. 847 (nephrotoxicity),TABLE 17p. 851
(reduced serum potassium)
▶Amphotericinincreases the risk of toxicity when given with
flucytosine.rStudy
▶Micafunginslightly increases the exposure toamphotericin.
Avoid or monitor toxicity.oStudy
▶Sodium stibogluconateincreases the risk of cardiovascular
side-effects when given withamphotericin. Separate
administration by 14 days.rStudy
Ampicillin→see penicillins
Amsacrine→seeTABLE 15p. 850 (myelosuppression)
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
amsacrine. Public Health England advises avoid (refer to
Green Book).rTheoretical
Anaesthetics, local→seeTABLE 11p. 849 (CNS depressant effects)
bupivacaine.levobupivacaine.mepivacaine.oxybuprocaine.
prilocaine.proxymetacaine.ropivacaine.tetracaine..
▶Aminosalicylic acidis predicted to increase the risk of
methaemoglobinaemia when given with topicalprilocaine.
Use with caution or avoid.rTheoretical
▶Anaesthetics, localare predicted to increase the risk of
cardiodepression when given withantiarrhythmics.r
Theoretical→Also seeTABLE 11p. 849
▶Antiepileptics(fosphenytoin, phenobarbital, phenytoin,
primidone)are predicted to increase the risk of856 Aminoglycosides—Anaesthetics, local BNFC 2018 – 2019
Interactions|Appendix 1A1