BNF for Children (BNFC) 2018-2019

▶Palbociclibis predicted to increase the exposure toopioids
(alfentanil, fentanyl). Adjust dose.oTheoretical
▶Pitolisantis predicted to decrease the exposure tomorphine.
qTheoretical
▶Ribociclibis predicted to increase the exposure toopioids
(alfentanil, fentanyl). Use with caution and adjust dose.
oTheoretical
▶Rifampicinis predicted to decrease the exposure to
buprenorphine. Monitor and adjust dose.oTheoretical
▶Rifampicindecreases the exposure tomethadone. Monitor and
adjust dose.rStudy
▶Rifampicinis predicted to decrease the exposure toopioids
(alfentanil, fentanyl).oStudy
▶Rifampicindecreases the exposure toopioids(codeine,
morphine).oStudy
▶Rifampicinis predicted to decrease the exposure tooxycodone.
Monitor and adjust dose.oStudy
▶SSRIs(fluoxetine, paroxetine)are predicted to decrease the
efficacy ofcodeine.oTheoretical
▶SSRIs(fluoxetine, paroxetine)are predicted to decrease the
efficacy oftramadol.rStudy→Also seeTABLE 13p. 850
▶St John’s Wortdecreases the exposure tomethadone. Monitor
and adjust dose.rStudy→Also seeTABLE 13p. 850
▶St John’s Wortmoderately decreases the exposure to
oxycodone. Adjust dose.oStudy
▶Terbinafineis predicted to decrease the efficacy ofcodeine.
oTheoretical
▶Terbinafineis predicted to decrease the efficacy oftramadol.
rStudy
Orlistat

SEPARATION OF ADMINISTRATIONOrlistat might affect the

absorption of concurrently administered drugs—consider

separating administration. Particular care should be taken

with antiepileptics, antiretrovirals, and drugs that have a

narrow therapeutic index.

Orphenadrine→seeTABLE 10p. 849 (antimuscarinics)
Osimertinib→seeTABLE 9p. 849 (QT-interval prolongation)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to moderately decrease
the exposure toosimertinib. Avoid.oStudy
▶Bosentanis predicted to decrease the exposure toosimertinib.
oTheoretical
▶Efavirenzis predicted to decrease the exposure toosimertinib.
oTheoretical→Also seeTABLE 9p. 849
▶Enzalutamideis predicted to moderately decrease the
exposure toosimertinib. Avoid.oStudy
▶Mitotaneis predicted to moderately decrease the exposure to
osimertinib. Avoid.oStudy
▶Nevirapineis predicted to decrease the exposure to
osimertinib.rTheoretical
▶Rifampicinis predicted to moderately decrease the exposure
toosimertinib. Avoid.oStudy
▶St John’s Wortis predicted to decrease the exposure to
osimertinib. Avoid.oTheoretical
▶Osimertinibslightly increases the exposure tostatins
(rosuvastatin).oStudy
Oxaliplatin→see platinum compounds
Oxazepam→seeTABLE 11p. 849 (CNS depressant effects)
Oxcarbazepine→see antiepileptics
Oxprenolol→see beta blockers, non-selective
Oxybuprocaine→see anaesthetics, local
Oxybutynin→seeTABLE 10p. 849 (antimuscarinics)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tooxybutynin.nTheoretical
▶Oxybutyninpotentially increases the risk of overheating and
dehydration when given withantiepileptics(zonisamide). Avoid
in children.rTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tooxybutynin.n
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tooxybutynin.nStudy
▶Aprepitantis predicted to increase the exposure tooxybutynin.
nTheoretical

▶Calcium channel blockers(diltiazem, verapamil)are predicted to

increase the exposure tooxybutynin.nTheoretical

▶Cobicistatis predicted to increase the exposure tooxybutynin.

nStudy

▶Crizotinibis predicted to increase the exposure tooxybutynin.

nTheoretical

▶HIV-protease inhibitorsare predicted to increase the exposure

tooxybutynin.nStudy

▶Idelalisibis predicted to increase the exposure tooxybutynin.

nStudy

▶Imatinibis predicted to increase the exposure tooxybutynin.

nTheoretical

▶Macrolides(clarithromycin)are predicted to increase the

exposure tooxybutynin.nStudy

▶Macrolides(erythromycin)are predicted to increase the

exposure tooxybutynin.nTheoretical

▶Netupitantis predicted to increase the exposure tooxybutynin.

nTheoretical

▶Nilotinibis predicted to increase the exposure tooxybutynin.

nTheoretical

Oxycodone→see opioids

Oxymetholone

▶Oxymetholoneincreases the anticoagulant effect ofcoumarins.

rAnecdotal

▶Oxymetholoneincreases the anticoagulant effect of

phenindione.rAnecdotal

Oxytetracycline→see tetracyclines

Paclitaxel→see taxanes

Palbociclib

▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone)are predicted to decrease the exposure

topalbociclib. Avoid.rStudy

▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are

predicted to increase the exposure topalbociclib. Avoid or

adjustpalbociclibdose.rStudy

▶Palbociclibis predicted to increase the exposure tociclosporin.

Adjust dose.oTheoretical

▶Cobicistatis predicted to increase the exposure topalbociclib.

Avoid or adjustpalbociclibdose.rStudy

▶Enzalutamideis predicted to decrease the exposure to

palbociclib. Avoid.rStudy

▶Palbociclibis predicted to increase the exposure to

ergotamine. Adjust dose.oTheoretical

▶Palbociclibis predicted to increase the exposure toeverolimus.

Adjust dose.oTheoretical

▶Grapefruit juiceis predicted to increase the exposure to

palbociclib. Avoid.rTheoretical

▶HIV-protease inhibitorsare predicted to increase the exposure

topalbociclib. Avoid or adjustpalbociclibdose.rStudy

▶Idelalisibis predicted to increase the exposure topalbociclib.

Avoid or adjustpalbociclibdose.rStudy

▶Macrolides(clarithromycin)are predicted to increase the

exposure topalbociclib. Avoid or adjustpalbociclibdose.

rStudy

▶Palbociclibincreases the exposure tomidazolam.o

Study

▶Mitotaneis predicted to decrease the exposure topalbociclib.

Avoid.rStudy

▶Palbociclibis predicted to increase the exposure toopioids

(alfentanil, fentanyl). Adjust dose.oTheoretical

▶Palbociclibis predicted to increase the exposure topimozide.

Adjust dose.oTheoretical

▶Rifampicinis predicted to decrease the exposure topalbociclib.

Avoid.rStudy

▶Palbociclibis predicted to increase the exposure tosirolimus.

Adjust dose.oTheoretical

▶St John’sWortis predicted to decrease the exposure to

palbociclib. Avoid.rTheoretical

▶Palbociclibis predicted to increase the exposure totacrolimus.

Adjust dose.oTheoretical

Paliperidone→seeTABLE 8p. 848 (hypotension),TABLE 9p. 849 (QT-

interval prolongation),TABLE 11p. 849 (CNS depressant effects)

▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone)are predicted to decrease the exposure

topaliperidone. Monitor and adjust dose.rStudy→Also

seeTABLE 11p. 849

BNFC 2018 – 2019 Opioids—Paliperidone 969

Interactions

|Appendix 1

A1