BNF for Children (BNFC) 2018-2019

▶Nilotinibis predicted to increase the exposure toSSRIs
(dapoxetine). Adjustdapoxetinedose with moderate inhibitors
of CYP3A4.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
nilotinib. Avoid.rTheoretical
▶Nilotinibis predicted to increase the exposure tostatins
(atorvastatin). Monitor and adjust dose.rStudy
▶Nilotinibis predicted to increase the exposure tostatins
(simvastatin). Use with caution and adjustsimvastatindose,
p. 134.rStudy
▶Nilotinibis predicted to increase the exposure tosunitinib.
oTheoretical→Also seeTABLE 15p. 850→Also seeTABLE 9
p. 849
▶Nilotinibis predicted to increase the concentration of
tacrolimus.rStudy
▶Nilotinibis predicted to increase the exposure totaxanes
(cabazitaxel).oTheoretical→Also seeTABLE 15p. 850
▶Nilotinibis predicted to increase the concentration of
temsirolimus.oTheoretical→Also seeTABLE 15p. 850
▶Nilotinibis predicted to increase the exposure totofacitinib.
oStudy
▶Nilotinibis predicted to increase the exposure totolterodine.
nTheoretical→Also seeTABLE 9p. 849
▶Nilotinibis predicted to increase the exposure totolvaptan.
Adjust dose.oStudy
▶Nilotinibis predicted to increase the exposure totrazodone.
oTheoretical
▶Nilotinibis predicted to increase the exposure toulipristal.
Avoid if used for uterinefibroids.oStudy
▶Nilotinibis predicted to increase the exposure tovenetoclax.
Avoid moderate inhibitors of CYP3A4 or adjustvenetoclax
dose.rStudy
▶Nilotinibis predicted to increase the exposure tovinca
alkaloids.rTheoretical→Also seeTABLE 15p. 850→Also see
TABLE 9p. 849
▶Nilotinibis predicted to increase the exposure tozopiclone.
Adjust dose.oStudy
Nimodipine→see calcium channel blockers
Nintedanib
▶Antiarrhythmics(amiodarone, dronedarone)are predicted to
increase the exposure tonintedanib.oStudy
▶Antiepileptics(carbamazepine)are predicted to decrease the
exposure tonintedanib.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole)are predicted to
increase the exposure tonintedanib.oStudy
▶Calcium channel blockers(verapamil)are predicted to increase
the exposure tonintedanib.oStudy
▶Ciclosporinis predicted to increase the exposure tonintedanib.
oStudy
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to increase the exposure tonintedanib.o
Study
▶Lapatinibis predicted to increase the exposure tonintedanib.
oStudy
▶Macrolidesare predicted to increase the exposure to
nintedanib.oStudy
▶Ranolazineis predicted to increase the exposure tonintedanib.
oStudy
▶Rifampicinis predicted to decrease the exposure tonintedanib.
oStudy
▶St John’s Wortis predicted to decrease the exposure to
nintedanib.oStudy
▶Vemurafenibis predicted to increase the exposure to
nintedanib.oStudy
Nitisinone
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tonitisinone. Adjust dose.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tonitisinone. Adjust dose.
oTheoretical
▶Cobicistatis predicted to increase the exposure tonitisinone.
Adjust dose.oTheoretical
▶Enzalutamideis predicted to decrease the exposure to
nitisinone. Adjust dose.oTheoretical

▶HIV-protease inhibitorsare predicted to increase the exposure

tonitisinone. Adjust dose.oTheoretical

▶Idelalisibis predicted to increase the exposure tonitisinone.

Adjust dose.oTheoretical

▶Macrolides(clarithromycin)are predicted to increase the

exposure tonitisinone. Adjust dose.oTheoretical

▶Mitotaneis predicted to decrease the exposure tonitisinone.

Adjust dose.oTheoretical

▶Rifampicinis predicted to decrease the exposure tonitisinone.

Adjust dose.oTheoretical

Nitrates→seeTABLE 7p. 848 (first-dose hypotension),TABLE 8p. 848

(hypotension)

glyceryl trinitrate.isosorbide dinitrate.isosorbide mononitrate..

PHARMACOLOGYDrugs with antimuscarinic effects can cause

dry mouth, which can reduce the effectiveness of sublingual

glyceryl trinitrate tablets.

▶Nitratesare predicted to increase the risk of

methaemoglobinaemia when given with topicalanaesthetics,

local(prilocaine). Avoid.rTheoretical

▶Nitratesare predicted to increase the risk of

methaemoglobinaemia when given withdapsone.r

Theoretical

▶Nitratespotentially increase the risk of hypotension when

given withphosphodiesterase type-5 inhibitors. Avoid.r

Study→Also seeTABLE 8p. 848

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

▶Rifampicinincreases the clearance ofnitrazepam.o

Study

Nitrofurantoin→seeTABLE 12p. 850 (peripheral neuropathy)

▶Nitrofurantoinis predicted to increase the risk of

methaemoglobinaemia when given with topicalanaesthetics,

local(prilocaine). Use with caution or avoid.rTheoretical

▶Antacids(magnesium trisilicate)decrease the absorption of

nitrofurantoin.oStudy

▶Nitrofurantoinis predicted to increase the risk of

methaemoglobinaemia when given withdapsone.r

Theoretical

Nitrous oxide→seeTABLE 8p. 848 (hypotension),TABLE 11p. 849 (CNS

depressant effects)

Nivolumab→see monoclonal antibodies

Nizatidine→see H 2 receptor antagonists

Noradrenaline/norepinephrine→see sympathomimetics,

vasoconstrictor

Norethisterone

▶Antiepileptics(carbamazepine, eslicarbazepine, fosphenytoin,

oxcarbazepine, perampanel, phenobarbital, phenytoin,

primidone, rufinamide, topiramate)are predicted to decrease

the efficacy ofnorethisterone. For FSRH guidance, see

Contraceptives, interactionsp. 497.rAnecdotal

▶Aprepitantis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶Bosentanis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶Efavirenzis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶Fosaprepitantis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶Griseofulvinpotentially decreases the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶HIV-protease inhibitors(ritonavir)are predicted to decrease the

efficacy ofnorethisterone. For FSRH guidance, see

Contraceptives, interactionsp. 497.rAnecdotal

▶Modafinilis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

▶Nevirapineis predicted to decrease the efficacy of

norethisterone. For FSRH guidance, seeContraceptives,

interactionsp. 497.rAnecdotal

BNFC 2018 – 2019 Nilotinib—Norethisterone 965

Interactions

|Appendix 1

A1