▶St John’s Wortis predicted to decrease the exposure to
lapatinib. Avoid.rStudy
▶Lapatinibslightly increases the exposure totaxanes
(paclitaxel).rStudy
▶Tedizolidis predicted to increase the exposure tolapatinib.
Avoid.oTheoretical
▶Lapatinibis predicted to increase the exposure totopotecan.
rStudy
▶Lapatinibis predicted to increase the concentration of
trametinib.oTheoretical
▶Lapatinibis predicted to increase the exposure tovenetoclax.
Avoid or monitor for toxicity.rTheoretical
Laronidase
▶Antimalarials(chloroquine)are predicted to decrease the
exposure tolaronidase. Avoid simultaneous administration.
rTheoretical
▶Hydroxychloroquineis predicted to decrease the exposure to
laronidase. Avoid simultaneous administration.r
Theoretical
Ledipasvir
▶Antacidsare predicted to decrease the exposure toledipasvir.
Separate administration by 4 hours.oTheoretical
▶Ledipasvirincreases the risk of severe bradycardia or heart
block when given withantiarrhythmics(amiodarone). Refer to
specialist literature.rAnecdotal
▶Antiepileptics(carbamazepine)are predicted to decrease the
exposure toledipasvir. Avoid.rTheoretical
▶Calcium salts(calcium carbonate)are predicted to decrease the
exposure toledipasvir. Separate administration by 4 hours.
oTheoretical
▶H 2 receptor antagonistsare predicted to decrease the exposure
toledipasvir. Adjust dose, seeledipasvir with sofosbuvirp. 401.
oStudy
▶Proton pump inhibitorsare predicted to decrease the exposure
toledipasvir. Adjust dose, seeledipasvir with sofosbuvirp. 401.
oTheoretical
▶Rifampicinis predicted to decrease the exposure toledipasvir.
Avoid.rTheoretical
▶Ledipasvirmoderately increases the exposure tosimeprevir
andsimeprevirslightly increases the exposure toledipasvir.
Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
ledipasvir. Avoid.rTheoretical
▶Ledipasviris predicted to increase the exposure tostatins
(atorvastatin, fluvastatin, pravastatin, simvastatin). Monitor
and adjust dose.oTheoretical
▶Ledipasviris predicted to increase the exposure tostatins
(rosuvastatin). Avoid.rTheoretical
▶Ledipasvir(with sofosbuvir) slightly increases the exposure to
tenofovir disoproxil.oStudy
Leflunomide→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
PHARMACOLOGYLeflunomide has a long half-life; washout
procedure recommended before switching to other DMARDs
(consult product literature).
▶Leflunomideis predicted to decrease the exposure to
agomelatine.oTheoretical
▶Leflunomidedecreases the exposure toaminophylline. Adjust
dose.oStudy
▶Leflunomideis predicted to decrease the exposure to
anaesthetics, local(ropivacaine).oTheoretical
▶Leflunomidepotentially increases the exposure tobaricitinib.
oTheoretical
▶Leflunomideis predicted to moderately increase the clearance
ofcaffeine citrate. Monitor and adjust dose.oStudy
▶Leflunomideis predicted to decrease the exposure toclozapine.
oTheoretical→Also seeTABLE 15p. 850
▶Leflunomideincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶Leflunomideis predicted to decrease the exposure to
duloxetine.oTheoretical
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
leflunomide. Public Health England advises avoid (refer to
Green Book).rTheoretical
▶Leflunomideis predicted to decrease the exposure to
melatonin.oTheoretical
▶Leflunomideis predicted to increase the exposure to
montelukast.oTheoretical
▶Leflunomideis predicted to decrease the exposure to
olanzapine. Monitor and adjust dose.oStudy→Also see
TABLE 15p. 850
▶Leflunomideis predicted to increase the exposure to
pioglitazone.oStudy
▶Leflunomideis predicted to decrease the exposure to
pirfenidone.oTheoretical
▶Leflunomideis predicted to increase the exposure to
repaglinide.oStudy
▶Leflunomideis predicted to increase the exposure toselexipag.
Adjust dose.oTheoretical
▶Leflunomideis predicted to increase the exposure tostatins
(rosuvastatin). Adjust dose.oStudy→Also seeTABLE 1
p. 847
▶Leflunomideis predicted to increase the concentration of
taxanes(paclitaxel).rAnecdotal→Also seeTABLE 15p. 850
▶Leflunomideis predicted to decrease the exposure to
theophylline. Adjust dose.oStudy
▶Leflunomidemoderately decreases the exposure totizanidine.
nStudy
Lenalidomide→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression),TABLE 5p. 847 (thromboembolism)
▶Combined hormonal contraceptivesare predicted to increase
the risk of venous thromboembolism when given with
lenalidomide. Avoid.rTheoretical
▶Hormone replacement therapyis predicted to increase the risk
of venous thromboembolism when given withlenalidomide.
rTheoretical
Lercanidipine→see calcium channel blockers
Levamisole
▶Albendazoleslightly decreases the exposure tolevamisoleand
levamisolemoderately decreases the exposure toalbendazole.
oStudy
▶Alcohol (beverage)potentially causes a disulfiram-like
reaction when given withlevamisole.oStudy
▶Levamisoleincreases the exposure toivermectin.o
Study
Levetiracetam→see antiepileptics
Levobunolol→see beta blockers, non-selective
Levobupivacaine→see anaesthetics, local
Levocetirizine→see antihistamines, non-sedating
Levodopa→seeTABLE 8p. 848 (hypotension)
GENERAL INFORMATIONDrugs with antimuscarinic effects
might reduce the absorption of levodopa.
▶Amisulprideis predicted to decrease the effects oflevodopa.
Avoid.rTheoretical
▶Antiepileptics(fosphenytoin, phenytoin)decrease the effects of
levodopa.oStudy
▶Aripiprazoleis predicted to decrease the effects oflevodopa.
rTheoretical→Also seeTABLE 8p. 848
▶Asenapineis predicted to decrease the effects oflevodopa.
Adjust dose.rTheoretical→Also seeTABLE 8p. 848
▶Baclofenis predicted to increase the risk of side-effects when
given withlevodopa.rAnecdotal→Also seeTABLE 8p. 848
▶Benperidolis predicted to decrease the effects oflevodopa.
rStudy→Also seeTABLE 8p. 848
▶Bupropionincreases the risk of side-effects when given with
levodopa.oStudy
▶Clozapineis predicted to decrease the effects oflevodopa.
rTheoretical→Also seeTABLE 8p. 848
▶Droperidoldecreases the effects oflevodopa.rStudy→
Also seeTABLE 8p. 848
▶Entacaponeincreases the exposure tolevodopa. Monitor side
effects and adjust dose.oStudy
▶Flupentixoldecreases the effects oflevodopa. Avoid or monitor
worsening parkinsonian symptoms.rTheoretical→Also
seeTABLE 8p. 848
▶Haloperidoldecreases the effects oflevodopa.rStudy→
Also seeTABLE 8p. 848
▶Iron (oral)decreases the absorption oflevodopa.o
StudyBNFC 2018 – 2019 Lapatinib—Levodopa 941
Interactions|Appendix 1A1