Deflazacort→see corticosteroids
Delamanid→seeTABLE 9p. 849 (QT-interval prolongation)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to slightly decrease the
exposure todelamanid. Avoid.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)
very slightly increase the exposure todelamanid.r
Study→Also seeTABLE 9p. 849
▶Cobicistatvery slightly increases the exposure todelamanid.
rStudy
▶Enzalutamideis predicted to slightly decrease the exposure to
delamanid. Avoid.oStudy
▶HIV-protease inhibitorsvery slightly increase the exposure to
delamanid.rStudy→Also seeTABLE 9p. 849
▶Idelalisibvery slightly increases the exposure todelamanid.
rStudy
▶Macrolides(clarithromycin)very slightly increase the exposure
todelamanid.rStudy→Also seeTABLE 9p. 849
▶Mitotaneis predicted to slightly decrease the exposure to
delamanid. Avoid.oStudy
▶Rifampicinis predicted to slightly decrease the exposure to
delamanid. Avoid.oStudy
Demeclocycline→see tetracyclines
Desferrioxamine→see iron chelators
Desflurane→see volatile halogenated anaesthetics
Desloratadine→see antihistamines, non-sedating
Desmopressin→seeTABLE 18p. 851 (hyponatraemia)
▶Antiepileptics(lamotrigine)are predicted to increase the risk of
hyponatraemia when given withdesmopressin.r
Theoretical
▶Loperamidegreatly increases the absorption of oral
desmopressin(and possibly sublingual).oStudy
▶Phenothiazines(chlorpromazine)are predicted to increase the
risk of hyponatraemia when given withdesmopressin.r
Theoretical
Desogestrel
▶Antiepileptics(carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate)are predicted to decrease
the efficacy ofdesogestrel. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶Desogestrelis predicted to increase the exposure to
antiepileptics(lamotrigine).oStudy
▶Aprepitantis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Bosentanis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Efavirenzis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Fosaprepitantis predicted to decrease the efficacy of
desogestrel. For FSRH guidance, seeContraceptives,
interactionsp. 497.rTheoretical
▶Griseofulvinpotentially decreases the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rAnecdotal
▶HIV-protease inhibitors(ritonavir)are predicted to decrease the
efficacy ofdesogestrel. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶Modafinilis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Nevirapineis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Rifabutinis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶Rifampicinis predicted to decrease the efficacy ofdesogestrel.
For FSRH guidance, seeContraceptives, interactionsp. 497.
rTheoretical
▶St John’sWortis predicted to decrease the efficacy of
desogestrel. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶Sugammadexis predicted to decrease the exposure to
desogestrel. Refer to patient information leaflet for missed pill
advice.rTheoretical
▶Ulipristalis predicted to decrease the efficacy ofdesogestrel.
Avoid.rTheoretical
Dexamethasone→see corticosteroids
Dexamfetamine→see amfetamines
Dexibuprofen→see NSAIDs
Dexketoprofen→see NSAIDs
Dexmedetomidine→seeTABLE 11p. 849 (CNS depressant effects)
Dexrazoxane→see iron chelators
Diamorphine→see opioids
Diazepam→seeTABLE 11p. 849 (CNS depressant effects)
▶Diazepampotentially affects the concentration ofantiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
dose.rStudy
▶Antifungals, azoles(fluconazole, voriconazole)moderately
increase the exposure todiazepam. Monitor and adjust dose.
oStudy
▶HIV-protease inhibitors(ritonavir)are predicted to increase the
exposure todiazepam. Avoid.oTheoretical
▶Monoclonal antibodies(tocilizumab)are predicted to decrease
the exposure todiazepam. Monitor and adjust dose.o
Theoretical
▶Rifampicinmoderately decreases the exposure todiazepam.
Avoid.oStudy
▶SSRIs(fluvoxamine)moderately increase the exposure to
diazepam.oStudy
Diazoxide→seeTABLE 8p. 848 (hypotension)
▶Diazoxidedecreases the concentration ofantiepileptics
(fosphenytoin, phenytoin)andantiepileptics(fosphenytoin,
phenytoin)are predicted to decrease the effects ofdiazoxide.
Monitor concentration and adjust dose.oAnecdotal
▶Diazoxideincreases the risk of severe hypotension when given
withhydralazine.rStudy→Also seeTABLE 8p. 848
Diclofenac→see NSAIDs
Dicycloverine→seeTABLE 10p. 849 (antimuscarinics)
Didanosine→seeTABLE 1p. 847 (hepatotoxicity),TABLE 12p. 850
(peripheral neuropathy)
ROUTE-SPECIFIC INFORMATIONAntacids in tablet formulation
might affect absorption of other drugs—give at least 2 hours
apart.
▶Allopurinolmoderately increases the exposure todidanosine.
Avoid.rStudy
▶Didanosine(buffered) decreases the exposure toantifungals,
azoles(itraconazole, ketoconazole). Separate administration by
2 hours.rStudy→Also seeTABLE 1p. 847
▶Febuxostatis predicted to increase the exposure todidanosine.
rTheoretical
▶Gancicloviris predicted to increase the exposure todidanosine.
oStudy
▶HIV-protease inhibitors(tipranavir)decrease the exposure to
didanosine. Separate administration by 2 hours.oStudy
▶Didanosine(buffered) decreases the exposure toHIV-protease
inhibitors(atazanavir).Didanosineshould be taken 2 hours
afteratazanavir.rStudy
▶Didanosine(buffered) is predicted to decrease the exposure to
HIV-protease inhibitors(darunavirboosted with ritonavir).
Didanosineshould be taken 1 hour before or 2 hours after
darunavir.oTheoretical
▶Hydroxycarbamideincreases the risk of toxicity when given
withdidanosine. Avoid.rStudy
▶Isoniazidis predicted to increase the risk of peripheral
neuropathy when given withdidanosine.rTheoretical→
Also seeTABLE 1p. 847→Also seeTABLE 12p. 850
▶Didanosineis predicted to increase the risk of pancreatitis
when given withpentamidine. Avoid.rStudy
▶Didanosine(buffered) is predicted to greatly decrease the
exposure to oralquinolones.Didanosineshould be taken
2 hours after quinolones.oStudy
▶Ribavirinis predicted to increase the exposure todidanosine.
Avoid.rStudyBNFC 2018 – 2019 Deflazacort—Didanosine 909
Interactions|Appendix 1A1