BNF for Children (BNFC) 2018-2019

▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocinacalcet. Monitor and adjust dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure tocinacalcet.
Adjust dose.oStudy
▶Cinacalcetis predicted to moderately increase the exposure to
aripiprazole. Adjustaripiprazoledose,p. 249.oStudy
▶Cinacalcetis predicted to markedly increase the exposure to
atomoxetine. Adjust dose.rStudy
▶Cinacalcetis predicted to increase the exposure tobeta
blockers, selective(metoprolol, nebivolol).oStudy
▶Cobicistatis predicted to moderately increase the exposure to
cinacalcet. Adjust dose.oStudy
▶Cinacalcetis predicted to slightly increase the exposure to
darifenacin.nStudy
▶Cinacalcetis predicted to increase the exposure toeliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶Enzalutamideis predicted to decrease the exposure to
cinacalcet. Monitor and adjust dose.oStudy
▶Cinacalcetincreases the risk of hypocalcaemia when given
withetelcalcetide. Avoid.rTheoretical
▶HIV-protease inhibitorsare predicted to moderately increase
the exposure tocinacalcet. Adjust dose.oStudy
▶Idelalisibis predicted to moderately increase the exposure to
cinacalcet. Adjust dose.oStudy
▶Macrolides(clarithromycin)are predicted to moderately
increase the exposure tocinacalcet. Adjust dose.o
Study
▶Mitotaneis predicted to decrease the exposure tocinacalcet.
Monitor and adjust dose.oStudy
▶Cinacalcetis predicted to decrease the efficacy ofopioids
(codeine).oTheoretical
▶Cinacalcetis predicted to decrease the efficacy ofopioids
(tramadol).rStudy
▶Cinacalcetis predicted to moderately increase the exposure to
pitolisant. Use with caution and adjust dose.oStudy
▶Rifampicinis predicted to decrease the exposure tocinacalcet.
Monitor and adjust dose.oStudy
▶Cinacalcetis predicted to increase the exposure torisperidone.
Adjust dose.oStudy
▶SSRIs(fluvoxamine)are predicted to increase the exposure to
cinacalcet. Adjust dose.oTheoretical
▶Cinacalcetis predicted to increase the exposure toSSRIs
(dapoxetine).oTheoretical
▶Cinacalcetis predicted to decrease the efficacy oftamoxifen.
Avoid.rStudy
▶Cinacalcetis predicted to increase the exposure totricyclic
antidepressants. Monitor for toxicity and adjust dose.r
Study
▶Cinacalcetis predicted to increase the exposure tovortioxetine.
Monitor and adjust dose.oStudy
Cinnarizine→see antihistamines, sedating
Ciprofibrate→see fibrates
Ciprofloxacin→see quinolones
Cisatracurium→see neuromuscular blocking drugs, non-depolarising
Cisplatin→see platinum compounds
Citalopram→see SSRIs
Cladribine→seeTABLE 15p. 850 (myelosuppression)

SEPARATION OF ADMINISTRATIONOral cladribine might affect

the absorption of concurrently administered drugs—consider

separating administration by at least 3 hours.

▶Antiepileptics(carbamazepine)are predicted to increase the risk
of haematological toxicity when given with oralcladribine.
oTheoretical
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
cladribine. Public Health England advises avoid (refer to Green
Book).rTheoretical
Clarithromycin→see macrolides
Clavulanic acid→seeTABLE 1p. 847 (hepatotoxicity)
Clemastine→see antihistamines, sedating
Clevidipine→see calcium channel blockers

Clindamycin

ROUTE-SPECIFIC INFORMATIONSince systemic absorption can

follow topical application, the possibility of interactions

should be borne in mind.

▶Clindamycinincreases the effects ofneuromuscular blocking

drugs, non-depolarising.rAnecdotal

▶Clindamycinincreases the effects ofsuxamethonium.r

Anecdotal

Clobazam→seeTABLE 11p. 849 (CNS depressant effects)

▶Antiepileptics(stiripentol)increase the concentration of

clobazam.rStudy

▶Clobazampotentially affects the concentration ofantiepileptics

(fosphenytoin, phenytoin).rAnecdotal

▶Antifungals, azoles(fluconazole, voriconazole)potentially

increase the exposure toclobazam. Adjust dose.o

Theoretical

▶Moclobemidepotentially increases the exposure toclobazam.

Adjust dose.oTheoretical

▶Proton pump inhibitors(esomeprazole, omeprazole)potentially

increase the exposure toclobazam. Adjust dose.o

Theoretical

▶SSRIs(fluoxetine, fluvoxamine)potentially increase the

exposure toclobazam. Adjust dose.oTheoretical

Clofarabine→seeTABLE 15p. 850 (myelosuppression)

▶Live vaccinesare predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

clofarabine. Public Health England advises avoid (refer to

Green Book).rTheoretical

Clofazimine

▶Clofaziminepotentially increases the risk of QT-prolongation

when given withbedaquiline.rStudy

Clomethiazole→seeTABLE 11p. 849 (CNS depressant effects)

▶Alcohol (beverage)causes serious, potentially fatal, CNS

depression when given withclomethiazole. Avoid.r

Study→Also seeTABLE 11p. 849

▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone)decrease the exposure toclomethiazole.

Monitor and adjust dose.oStudy→Also seeTABLE 11

p. 849

▶Enzalutamidedecreases the exposure toclomethiazole.

Monitor and adjust dose.oStudy

▶Mitotanedecreases the exposure toclomethiazole. Monitor

and adjust dose.oStudy

▶Rifampicindecreases the exposure toclomethiazole. Monitor

and adjust dose.oStudy

Clomipramine→see tricyclic antidepressants

Clonazepam→seeTABLE 11p. 849 (CNS depressant effects)

▶Clonazepampotentially affects the concentration of

antiepileptics(fosphenytoin, phenytoin).rAnecdotal

Clonidine→seeTABLE 6p. 848 (bradycardia),TABLE 8p. 848

(hypotension),TABLE 11p. 849 (CNS depressant effects)

▶Tricyclic antidepressantsdecrease the antihypertensive effects

ofclonidine. Monitor and adjust dose.oAnecdotal→

Also seeTABLE 8p. 848

Clopamide→see thiazide diuretics

Clopidogrel→seeTABLE 4p. 847 (antiplatelet effects)

▶Antifungals, azoles(fluconazole)are predicted to decrease the

efficacy ofclopidogrel. Avoid.rTheoretical

▶Antifungals, azoles(voriconazole)are predicted to decrease the

efficacy ofclopidogrel. Avoid.oStudy

▶Clopidogrelis predicted to increase the exposure to

dabrafenib.oTheoretical

▶Clopidogrelmoderately increases the exposure to

enzalutamide. Avoid or adjustenzalutamidedose.rStudy

▶Grapefruit juicemarkedly decreases the exposure to

clopidogrel.rStudy

▶Moclobemideis predicted to decrease the efficacy of

clopidogrel. Avoid.oStudy

▶Clopidogrelis predicted to moderately increase the exposure

tomontelukast.oStudy

▶Clopidogrelincreases the exposure topioglitazone. Monitor

blood glucose and adjust dose.rStudy

▶Proton pump inhibitors(esomeprazole, omeprazole)are

predicted to decrease the efficacy ofclopidogrel. Avoid.

oStudy

BNFC 2018 – 2019 Cinacalcet—Clopidogrel 897

Interactions

|Appendix 1

A1