Asparaginase(continued)
▶Asparaginaseis predicted to increase the risk of hepatotoxicity
when given withimatinib.rTheoretical→Also seeTABLE 15
p. 850
▶Asparaginaseaffects the efficacy ofmethotrexate.r
Anecdotal→Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
▶Asparaginasepotentially increases the risk of neurotoxicity
when given withvinca alkaloids(vincristine).Vincristineshould
be taken 3 to 24 hours beforeasparaginase,p. 550.r
Anecdotal→Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
Aspirin→seeTABLE 4p. 847 (antiplatelet effects)
▶Acetazolamideincreases the risk of severe toxic reaction when
given withaspirin(high-dose).rStudy
▶Antacidsdecrease the absorption ofaspirin(high-dose).
oStudy
▶Aspirin(high-dose) is predicted to increase the risk of
gastrointestinal irritation when given withbisphosphonates
(alendronic acid, ibandronic acid).oStudy
▶Aspirin(high-dose) is predicted to increase the risk of renal
impairment when given withbisphosphonates(sodium
clodronate).rTheoretical
▶Corticosteroidsare predicted to decrease the concentration of
aspirin(high-dose) andaspirin(high-dose) increases the risk
of gastrointestinal bleeding when given withcorticosteroids.
oStudy
▶Aspirin(high-dose) increases the risk of renal impairment
when given withdaptomycin.oTheoretical
▶Erlotinibis predicted to increase the risk of gastrointestinal
perforation when given withaspirin(high-dose).r
Theoretical
▶Aspirin(high-dose) is predicted to increase the risk of
gastrointestinal bleeds when given withiron chelators
(deferasirox).rTheoretical
▶Aspirin(high-dose) is predicted to increase the risk of toxicity
when given withmethotrexate.rTheoretical
▶Aspirinis predicted to increase the risk of gastrointestinal
perforation when given withnicorandil.rTheoretical
▶Aspirin(high-dose) potentially increases the exposure to
pemetrexed. Use with caution or avoid.rTheoretical
▶Aspirindecreases the effects ofsulfinpyrazone.o
Study→Also seeTABLE 4p. 847
▶Aspirin(high-dose) increases the risk of acute renal failure
when given withthiazide diuretics.rTheoretical
▶Zidovudineincreases the risk of haematological toxicity when
given withaspirin(high-dose).rStudy
Ataluren
▶Atalurenincreases the exposure toadefovir.oStudy
▶Atalurenis predicted to increase the risk of nephrotoxicity
when given with intravenousaminoglycosides. Avoid.r
Study
▶Rifampicindecreases the exposure toataluren.oStudy
Atazanavir→see HIV-protease inhibitors
Atenolol→see beta blockers, selective
Atezolizumab→see monoclonal antibodies
Atomoxetine
▶Amfetaminesare predicted to increase the risk of side-effects
when given withatomoxetine.rTheoretical
▶Atomoxetineis predicted to increase the risk of cardiovascular
side-effects when given withbeta 2 agonists(high-dose).
oStudy
▶Bupropionis predicted to markedly increase the exposure to
atomoxetine. Adjust dose.rStudy
▶Cinacalcetis predicted to markedly increase the exposure to
atomoxetine. Adjust dose.rStudy
▶Eliglustatis predicted to increase the exposure toatomoxetine.
Adjust dose.oTheoretical
▶Monoamine-oxidase A and B inhibitors, irreversibleare
predicted to increase the risk of side-effects when given with
atomoxetine. Avoid and for 2 weeks after stopping the MAOI.
rTheoretical
▶Panobinostatis predicted to increase the exposure to
atomoxetine. Monitor and adjust dose.rTheoretical
▶SSRIs(fluoxetine, paroxetine)are predicted to markedly
increase the exposure toatomoxetine. Adjust dose.r
Study▶Terbinafineis predicted to markedly increase the exposure to
atomoxetine. Adjust dose.rStudy
Atorvastatin→see statins
Atovaquone→see antimalarials
Atracurium→see neuromuscular blocking drugs, non-depolarising
Atropine→seeTABLE 10p. 849 (antimuscarinics)
▶Atropineincreases the risk of severe hypertension when given
withsympathomimetics, vasoconstrictor(phenylephrine).r
Study
Avanafil→see phosphodiesterase type-5 inhibitors
Avelumab→see monoclonal antibodies
Axitinib→seeTABLE 15p. 850 (myelosuppression)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure toaxitinib.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toaxitinib. Avoid or adjust dose.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure toaxitinib.o
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toaxitinib. Avoid or adjust
dose.oStudy
▶Aprepitantis predicted to increase the exposure toaxitinib.
oTheoretical
▶Bosentanis predicted to decrease the exposure toaxitinib.
oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toaxitinib.oTheoretical
▶Cobicistatis predicted to increase the exposure toaxitinib.
Avoid or adjust dose.oStudy
▶Axitinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Crizotinibis predicted to increase the exposure toaxitinib.
oTheoretical→Also seeTABLE 15p. 850
▶Efavirenzis predicted to decrease the exposure toaxitinib.
oTheoretical
▶Enzalutamideis predicted to decrease the exposure toaxitinib.
Avoid or adjust dose.oStudy
▶Grapefruit juiceis predicted to increase the exposure to
axitinib.oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
toaxitinib. Avoid or adjust dose.oStudy
▶Idelalisibis predicted to increase the exposure toaxitinib.
Avoid or adjust dose.oStudy→Also seeTABLE 15p. 850
▶Imatinibis predicted to increase the exposure toaxitinib.
oTheoretical→Also seeTABLE 15p. 850
▶Macrolides(clarithromycin)are predicted to increase the
exposure toaxitinib. Avoid or adjust dose.oStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure toaxitinib.oTheoretical
▶Mitotaneis predicted to decrease the exposure toaxitinib.
Avoid or adjust dose.oStudy→Also seeTABLE 15p. 850
▶Netupitantis predicted to increase the exposure toaxitinib.
oTheoretical
▶Nevirapineis predicted to decrease the exposure toaxitinib.
oTheoretical
▶Nilotinibis predicted to increase the exposure toaxitinib.
oTheoretical→Also seeTABLE 15p. 850
▶Axitinibis predicted to increase the risk of bleeding events
when given withphenindione.rTheoretical
▶Rifampicinis predicted to decrease the exposure toaxitinib.
Avoid or adjust dose.oStudy
▶St John’s Wortis predicted to decrease the exposure toaxitinib.
oTheoretical
Azacitidine→seeTABLE 15p. 850 (myelosuppression)
Azathioprine→seeTABLE 15p. 850 (myelosuppression)
▶ACE inhibitorsare predicted to increase the risk of anaemia
and/or leucopenia when given withazathioprine.r
Anecdotal
▶Allopurinolpotentially increases the risk of haematological
toxicity when given withazathioprine. Adjustazathioprine
dose,p. 518.rStudy
▶Azathioprinedecreases the anticoagulant effect ofcoumarins.
oStudy882 Asparaginase—Azathioprine BNFC 2018 – 2019
Interactions|Appendix 1A1