Calcium channel blockers(continued)
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toopioids(methadone, sufentanil).
oTheoretical→Also seeTABLE 6p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tooxybutynin.nTheoretical
▶Verapamilis predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure topazopanib.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tophosphodiesterase type-5 inhibitors
(avanafil). Adjustavanafildose.oTheoretical→Also see
TABLE 8p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tophosphodiesterase type-5 inhibitors
(sildenafil). Monitor or adjustsildenafildose with moderate
inhibitors of CYP3A4,p. 120.oStudy→Also seeTABLE 8
p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tophosphodiesterase type-5 inhibitors
(tadalafil).rTheoretical→Also seeTABLE 8p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tophosphodiesterase type-5 inhibitors
(vardenafil). Adjust dose.rTheoretical→Also seeTABLE 8
p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure topimozide. Avoid.rTheoretical→
Also seeTABLE 8p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toquetiapine. Avoid.oStudy→
Also seeTABLE 8p. 848
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toranolazine.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toribociclib.oStudy
▶Rifampicinis predicted to decrease the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nimodipine). Monitor and adjust
dose.oStudy
▶Rifampicingreatly decreases the exposure tocalcium channel
blockers(diltiazem, verapamil).rStudy
▶Rifampicinmoderately decreases the exposure tonifedipine.
Avoid.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toruxolitinib.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tosaxagliptin.nStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tosimeprevir. Avoid.rStudy
▶Calcium channel blockers(diltiazem, verapamil)increase the
concentration ofsirolimus. Monitor and adjust dose.o
Study
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toSSRIs(dapoxetine). Adjustdapoxetine
dose with moderate inhibitors of CYP3A4.oTheoretical
▶St John’s Wortis predicted to decrease the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
adjust dose.oTheoretical
▶St John’s Wortis predicted to decrease the exposure tocalcium
channel blockers(diltiazem, verapamil).oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tostatins(atorvastatin). Monitor and
adjust dose.rStudy
▶Amlodipineslightly increases the exposure tostatins
(simvastatin). Adjustsimvastatindose,p. 134.nStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tostatins(simvastatin). Use with caution
and adjustsimvastatindose,p. 134.rStudy
▶Sulfinpyrazonedecreases the exposure toverapamil.o
Study
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tosunitinib.oTheoretical▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the concentration oftacrolimus.rStudy
▶Nicardipinepotentially increases the concentration of
tacrolimus. Monitor concentration and adjust dose.r
Anecdotal
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totaxanes(cabazitaxel).o
Theoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the concentration oftemsirolimus.o
Theoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totofacitinib.oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totolterodine.nTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totolvaptan. Adjust dose.o
Study
▶Verapamilis predicted to increase the exposure totopotecan.
rStudy
▶Verapamilis predicted to increase the concentration of
trametinib.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure totrazodone.oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure toulipristal. Avoid if used for uterine
fibroids.oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tovenetoclax. Avoid moderate
inhibitors of CYP3A4 or adjustvenetoclaxdose.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tovinca alkaloids.rTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tozopiclone. Adjust dose.oStudy
Calcium chloride→see calcium salts
Calcium gluconate→see calcium salts
Calcium lactate→see calcium salts
Calcium phosphate→see calcium salts
Calcium salts
calcium acetate.calcium carbonate.calcium chloride.calcium
gluconate.calcium lactate.calcium phosphate..SEPARATION OF ADMINISTRATIONCalcium carbonate-
containing antacids should preferably not be taken at the
same time as other drugs since they might impair
absorption. Antacids might damage enteric coatings designed
to prevent dissolution in the stomach.
▶Oralcalcium saltsdecrease the absorption ofalkylating agents
(estramustine).rStudy
▶Calcium carbonatedecreases the absorption ofantimalarials
(chloroquine). Separate administration by at least 4 hours.
oStudy
▶Calcium carbonateis predicted to decrease the absorption of
antimalarials(proguanil). Separate administration by at least
2 hours.oStudy
▶Oralcalcium saltsdecrease the absorption ofbisphosphonates
(alendronic acid).Alendronic acidshould be taken at least
30 minutes beforecalcium salts.oStudy
▶Oralcalcium saltsare predicted to decrease the absorption of
oralbisphosphonates(ibandronic acid). Avoidcalcium saltsfor
at least 6 hours before or 1 hour afteribandronic acid.
oTheoretical
▶Oralcalcium saltsdecrease the absorption ofbisphosphonates
(risedronate). Separate administration by at least 2 hours.
oStudy
▶Oralcalcium saltsdecrease the absorption ofbisphosphonates
(sodium clodronate). Avoidcalcium saltsfor 2 hours before or
1 hour aftersodium clodronate.oStudy
▶Cephalosporins(ceftriaxone)increase the risk of cardio-
respiratory arrest when given withcalcium chloride. Avoid.
rAnecdotal
▶Cephalosporins(ceftriaxone)increase the risk of cardio-
respiratory arrest when given with intravenouscalcium
gluconate. Avoid.rAnecdotal892 Calcium channel blockers—Calcium salts BNFC 2018 – 2019
Interactions|Appendix 1A1