Midostaurin(continued)
▶HIV-protease inhibitorsare predicted to very markedly increase
the exposure tomidostaurin. Avoid or monitor for toxicity.
rStudy
▶Idelalisibis predicted to very markedly increase the exposure
tomidostaurin. Avoid or monitor for toxicity.rStudy
▶Imatinibis predicted to increase the exposure tomidostaurin.
oTheoretical
▶Macrolides(clarithromycin)are predicted to very markedly
increase the exposure tomidostaurin. Avoid or monitor for
toxicity.rStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure tomidostaurin.oTheoretical
▶Mitotaneis predicted to decrease the exposure tomidostaurin.
Avoid.rStudy
▶Netupitantis predicted to increase the exposure to
midostaurin.oTheoretical
▶Nilotinibis predicted to increase the exposure tomidostaurin.
oTheoretical
▶Rifampicinis predicted to decrease the exposure to
midostaurin. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
midostaurin. Avoid.rTheoretical
Mifamurtide
▶Ciclosporinis predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
▶Corticosteroidsare predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
▶NSAIDs(high-dose) are predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
▶Pimecrolimusis predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
▶Sirolimusis predicted to decrease the efficacy ofmifamurtide.
Avoid.rTheoretical
▶Tacrolimusis predicted to affect the efficacy ofmifamurtide.
Avoid.rTheoretical
Mifepristone
▶Mifepristoneis predicted to decrease the efficacy of
corticosteroids. Use with caution and adjust dose.o
Theoretical
Minocycline→see tetracyclines
Minoxidil→seeTABLE 8p. 848 (hypotension)
Mirabegron
▶Mirabegronis predicted to increase the exposure toaliskiren.
nTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomirabegron. Adjust
mirabegrondose in hepatic and renal impairment.o
Study
▶Mirabegronis predicted to increase the exposure to
antihistamines, non-sedating(fexofenadine).nTheoretical
▶Mirabegronis predicted to increase the exposure tobeta
blockers, selective(metoprolol).oStudy
▶Cobicistatis predicted to increase the exposure tomirabegron.
Adjustmirabegrondose in hepatic and renal impairment.
oStudy
▶Mirabegronis predicted to increase the exposure tocolchicine.
nTheoretical
▶Mirabegronis predicted to increase the exposure to
dabigatran.rTheoretical
▶Mirabegronslightly increases the exposure todigoxin. Monitor
concentration and adjust dose.rStudy
▶Mirabegronis predicted to increase the exposure toedoxaban.
nTheoretical
▶Mirabegronis predicted to increase the exposure toeliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶Mirabegronis predicted to increase the exposure to
everolimus.nTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
tomirabegron. Adjustmirabegrondose in hepatic and renal
impairment.oStudy
▶Idelalisibis predicted to increase the exposure tomirabegron.
Adjustmirabegrondose in hepatic and renal impairment.
oStudy▶Mirabegronis predicted to increase the exposure to
loperamide.nTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure tomirabegron. Adjustmirabegrondose in hepatic
and renal impairment.oStudy
▶Mirabegronis predicted to increase the exposure topitolisant.
Use with caution and adjust dose.oStudy
▶Mirabegronis predicted to increase the exposure tosirolimus.
nTheoretical
▶Mirabegronis predicted to increase the exposure totaxanes
(paclitaxel).nTheoretical
▶Mirabegronis predicted to increase the exposure totopotecan.
nTheoretical
Mirtazapine→seeTABLE 13p. 850 (serotonin syndrome),TABLE 11
p. 849 (CNS depressant effects)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tomirtazapine. Adjust dose.oStudy→Also seeTABLE 11
p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tomirtazapine.o
Study
▶Cobicistatis predicted to increase the exposure tomirtazapine.
oStudy
▶Enzalutamideis predicted to decrease the exposure to
mirtazapine. Adjust dose.oStudy
▶H 2 receptor antagonists(cimetidine)slightly increase the
exposure tomirtazapine. Use with caution and adjust dose.
oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
tomirtazapine.oStudy
▶Idelalisibis predicted to increase the exposure tomirtazapine.
oStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure tomirtazapine.oStudy
▶Mitotaneis predicted to decrease the exposure tomirtazapine.
Adjust dose.oStudy
▶Mirtazapineis predicted to decrease the efficacy ofpitolisant.
qTheoretical
▶Rifampicinis predicted to decrease the exposure to
mirtazapine. Adjust dose.oStudy
Mitomycin→seeTABLE 15p. 850 (myelosuppression),TABLE 5p. 847
(thromboembolism)
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
mitomycin. Public Health England advises avoid (refer to
Green Book).rTheoretical
Mitotane→seeTABLE 15p. 850 (myelosuppression)
▶Mitotaneis predicted to decrease the exposure toabiraterone.
Avoid.rTheoretical
▶Aldosterone antagonists(spironolactone)are predicted to
decrease the effects ofmitotane. Avoid.rAnecdotal
▶Mitotaneis predicted to decrease the exposure toaldosterone
antagonists(eplerenone). Avoid.oTheoretical
▶Mitotaneis predicted to decrease the exposure toalprazolam.
Adjust dose.oTheoretical
▶Mitotaneis predicted to decrease the exposure to
antiarrhythmics(disopyramide, dronedarone). Avoid.r
Study
▶Mitotaneis predicted to decrease the efficacy ofantiarrhythmics
(propafenone).oStudy
▶Mitotaneis predicted to decrease the exposure to
anticholinesterases, centrally acting(donepezil).nStudy
▶Mitotaneis predicted to decrease the exposure toantiepileptics
(perampanel). Monitor and adjust dose.oStudy
▶Mitotaneis predicted to decrease the exposure toantifungals,
azoles(isavuconazole). Avoid.rStudy
▶Mitotaneis predicted to decrease the exposure toantimalarials
(artemether)(with lumafantrine). Avoid.rStudy
▶Mitotaneis predicted to decrease the concentration of
antimalarials(piperaquine). Avoid.oTheoretical
▶Mitotaneis predicted to moderately decrease the exposure to
apixaban. Use with caution or avoid.rStudy
▶Mitotanemoderately decreases the exposure toapremilast.
Avoid.rStudy954 Midostaurin—Mitotane BNFC 2018 – 2019
Interactions|Appendix 1A1