BNF for Children (BNFC) 2018-2019

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▶Chloramphenicolpotentially increases the anticoagulant effect
ofcoumarins.oAnecdotal
▶Chloramphenicolis predicted to increase the exposure to
guanfacine. Adjustguanfacinedose,p. 231.oTheoretical
▶Chloramphenicoldecreases the efficacy of intravenousiron
(injectable).oAnecdotal
▶Chloramphenicoldecreases the efficacy of oraliron (oral).
oTheoretical
▶Rifampicindecreases the concentration ofchloramphenicol.
oStudy
▶Chloramphenicolis predicted to increase the exposure to
sulfonylureas.rStudy
▶Chloramphenicolincreases the concentration oftacrolimus.
rStudy
Chlordiazepoxide→seeTABLE 11p. 849 (CNS depressant effects)
▶Chlordiazepoxideaffects the concentration ofantiepileptics
(fosphenytoin, phenytoin).rStudy
▶Rifampicinis predicted to decrease the exposure to
chlordiazepoxide.oTheoretical
Chloroquine→see antimalarials
Chlorothiazide→seeTABLE 18p. 851 (hyponatraemia),TABLE 8p. 848
(hypotension),TABLE 17p. 851 (reduced serum potassium)
Chlorphenamine→see antihistamines, sedating
Chlorpromazine→see phenothiazines
Chlortalidone→see thiazide diuretics
Cholera vaccine
▶Antimalarials(chloroquine)decrease the efficacy of oralcholera
vaccine.oStudy
▶Hydroxychloroquineis predicted to decrease the efficacy of
oralcholera vaccine.oTheoretical
Cholic acid
▶Antacidsare predicted to decrease the absorption ofcholic
acid. Separate administration by 5 hours.nTheoretical
▶Antiepileptics(phenobarbital)decrease the effects ofcholic acid.
Avoid.oStudy
▶Ciclosporinaffects the concentration ofcholic acid. Avoid.
oStudy
Choline salicylate
▶Corticosteroidsare predicted to decrease the concentration of
choline salicylate.oStudy
Ciclesonide→see corticosteroids
Ciclosporin→seeTABLE 2p. 847 (nephrotoxicity),TABLE 16p. 851
(increased serum potassium)
▶Pomelo juice is predicted to increase ciclosporin exposure,
and purple grape juice is predicted to decrease ciclosporin
exposure.
▶Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.


▶Ciclosporinis predicted to increase the exposure toafatinib.
Separate administration by 12 hours.oStudy
▶Ciclosporinmarkedly increases the exposure toaliskiren.
Avoid.rStudy→Also seeTABLE 16p. 851
▶Ciclosporinmoderately increases the exposure toambrisentan.
Adjustambrisentandose.oStudy
▶Ciclosporinincreases the concentration ofanthracyclines
(daunorubicin, doxorubicin, epirubicin, idarubicin,
mitoxantrone).rStudy
▶Antiarrhythmics(amiodarone)increase the concentration of
ciclosporin. Monitor concentration and adjust dose.r
Study
▶Antiarrhythmics(dronedarone)increase the concentration of
ciclosporin.rStudy
▶Ciclosporinincreases the exposure toantiarrhythmics
(dronedarone). Avoid.rTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the concentration of
ciclosporin.rStudy
▶Antiepileptics(oxcarbazepine)decrease the concentration of
ciclosporin.rAnecdotal
▶Antifungals, azoles(fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole)increase the
concentration ofciclosporin.rStudy
▶Antifungals, azoles(miconazole)increase the concentration of
ciclosporin. Monitor and adjust dose.rAnecdotal


▶Aprepitantincreases the concentration ofciclosporin.r
Study
▶Ciclosporinis predicted to increase the exposure tobeta
blockers, non-selective(nadolol).oStudy
▶Bosentanmoderately decreases the exposure tociclosporin
andciclosporinmoderately increases the exposure to
bosentan. Avoid.rStudy
▶Calcium channel blockers(diltiazem, nicardipine, verapamil)
increase the concentration ofciclosporin.rStudy
▶Ciclosporinmoderately increases the exposure tocalcium
channel blockers(lercanidipine). Use with caution or avoid.
rStudy
▶Ciclosporinslightly increases the exposure tocaspofungin.
rStudy
▶Ceritinibis predicted to increase the exposure tociclosporin.
Avoid.rTheoretical
▶Ciclosporinis predicted to affect the efficacy of
chenodeoxycholic acid. Monitor and adjust dose.o
Theoretical
▶Ciclosporinaffects the concentration ofcholic acid. Avoid.
oStudy
▶Cobicistatincreases the concentration ofciclosporin.r
Study
▶Ciclosporinincreases the exposure tocolchicine. Avoid or
adjustcolchicinedose.rStudy
▶Crizotinibincreases the concentration ofciclosporin.r
Study
▶Ciclosporinis predicted to increase the exposure todabigatran.
Avoid.rTheoretical
▶Danazolincreases the concentration ofciclosporin.r
Study
▶Ciclosporinis predicted to increase the risk of rhabdomyolysis
when given withdaptomycin.rTheoretical
▶Ciclosporinis predicted to increase the exposure to
darifenacin. Avoid.oTheoretical
▶Ciclosporinincreases the concentration ofdigoxin. Monitor
and adjust dose.rTheoretical
▶Ciclosporinslightly increases the exposure toedoxaban. Adjust
edoxabandose.rStudy
▶Efavirenzdecreases the concentration ofciclosporin. Monitor
concentration and adjust dose.oStudy
▶Ciclosporinincreases the exposure toeluxadoline. Avoid.
oStudy
▶Enzalutamidedecreases the concentration ofciclosporin.
rStudy
▶Ciclosporinis predicted to increase the exposure toerlotinib.
oTheoretical
▶Ciclosporinincreases the exposure toetoposide. Monitor and
adjust dose.rStudy
▶Ciclosporinmoderately increases the exposure toeverolimus.
Avoid or adjust dose.rStudy
▶Ciclosporinmoderately increases the exposure toezetimibe
andezetimibeslightly increases the exposure tociclosporin.
oStudy
▶Fibrates(bezafibrate)are predicted to increase the risk of
nephrotoxicity when given withciclosporin.rTheoretical
▶Fibrates(fenofibrate)increase the risk of nephrotoxicity when
given withciclosporin.rStudy
▶Ciclosporinis predicted to increase the exposure to
fidaxomicin. Avoid.oStudy
▶Ciclosporinincreases the exposure toglecaprevir. Avoid or
monitor.rStudy
▶Grapefruit juiceincreases the concentration ofciclosporin.
Avoid.rStudy
▶Ciclosporingreatly increases the exposure tograzoprevir.
Avoid.rStudy
▶H 2 receptor antagonists(cimetidine)increase the concentration
ofciclosporin.nStudy
▶HIV-protease inhibitorsincrease the concentration of
ciclosporin.rStudy
▶Idelalisibincreases the concentration ofciclosporin.r
Study
▶Imatinibincreases the concentration ofciclosporin.r
Study

BNFC 2018 – 2019 Chloramphenicol—Ciclosporin 895


Interactions

|Appendix 1

A1

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