Pitolisant(continued)
▶Pitolisantis predicted to decrease the exposure toefavirenz.
qTheoretical
▶Enzalutamideis predicted to moderately decrease the
exposure topitolisant.oStudy
▶Pitolisantis predicted to decrease the exposure toeverolimus.
Avoid.rTheoretical
▶HIV-protease inhibitors(ritonavir)are predicted to increase the
exposure topitolisant. Use with caution and adjust dose.
oStudy
▶Pitolisantis predicted to decrease the exposure toirinotecan.
qTheoretical
▶Pitolisantis predicted to increase the exposure tometformin.
qTheoretical
▶Mianserinis predicted to decrease the efficacy ofpitolisant.
qTheoretical
▶Mirabegronis predicted to increase the exposure topitolisant.
Use with caution and adjust dose.oStudy
▶Mirtazapineis predicted to decrease the efficacy ofpitolisant.
qTheoretical
▶Mitotaneis predicted to moderately decrease the exposure to
pitolisant.oStudy
▶Pitolisantis predicted to decrease the exposure toopioids
(morphine).qTheoretical
▶Pitolisantis predicted to decrease the exposure to
paracetamol.qTheoretical
▶Pitolisantis predicted to decrease the exposure topimozide.
Avoid.rTheoretical
▶Pitolisantis predicted to decrease the exposure torepaglinide.
qTheoretical
▶Rifampicinis predicted to moderately decrease the exposure
topitolisant.oStudy
▶Pitolisantis predicted to decrease the exposure tosirolimus.
Avoid.rTheoretical
▶SSRIs(fluoxetine, paroxetine)are predicted to moderately
increase the exposure topitolisant. Use with caution and
adjust dose.oStudy
▶St John’s Wortis predicted to decrease the exposure to
pitolisant. Monitor and adjust dose.oTheoretical
▶Pitolisantis predicted to decrease the exposure totacrolimus.
Avoid.rTheoretical
▶Pitolisantis predicted to decrease the exposure totaxanes
(docetaxel). Avoid.rTheoretical
▶Pitolisantis predicted to decrease the exposure to
temsirolimus. Avoid.rTheoretical
▶Terbinafineis predicted to moderately increase the exposure
topitolisant. Use with caution and adjust dose.oStudy
▶Tricyclic antidepressantsare predicted to decrease the efficacy
ofpitolisant.nTheoretical
Pivmecillinam→see penicillins
Pixantrone→see anthracyclines
Pizotifen→see antihistamines, sedating
Platinum compounds→seeTABLE 15p. 850 (myelosuppression),
TABLE 2p. 847 (nephrotoxicity),TABLE 19p. 851 (ototoxicity),TABLE 12
p. 850 (peripheral neuropathy)
carboplatin.cisplatin.oxaliplatin..
▶Cisplatinincreases the risk of pulmonary toxicity when given
withbleomycin.rStudy→Also seeTABLE 15p. 850
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given withplatinum
compounds. Public Health England advises avoid (refer to
Green Book).rTheoretical
Polymyxins→seeTABLE 2p. 847 (nephrotoxicity),TABLE 20p. 851
(neuromuscular blocking effects)
Polysaccharide-iron complex→see iron (oral)
Polystyrene sulfonate
▶Antacidsincrease the risk of metabolic alkalosis when given
withpolystyrene sulfonate.rAnecdotal
▶Polystyrene sulfonateis predicted to decrease the absorption
ofthyroid hormones(levothyroxine). Separate administration by
at least 4 hours.oTheoretical
Pomalidomide→seeTABLE 15p. 850 (myelosuppression),TABLE 5
p. 847 (thromboembolism)▶Combined hormonal contraceptivesare predicted to increase
the risk of venous thromboembolism when given with
pomalidomide. Avoid.rTheoretical
▶Hormone replacement therapyis predicted to increase the risk
of venous thromboembolism when given withpomalidomide.
rTheoretical
▶Quinolones(ciprofloxacin)are predicted to increase the
exposure topomalidomide. Adjustpomalidomidedose.
oTheoretical
▶SSRIs(fluvoxamine)moderately increase the exposure to
pomalidomide. Adjustpomalidomidedose.oStudy
Ponatinib
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toponatinib. Avoid.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to slightly increase the exposure toponatinib.
Monitor and adjustponatinibdose.oStudy
▶Cobicistatis predicted to slightly increase the exposure to
ponatinib. Monitor and adjustponatinibdose.oStudy
▶Ponatinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Enzalutamideis predicted to decrease the exposure to
ponatinib. Avoid.oTheoretical
▶Grapefruit juiceis predicted to increase the exposure to
ponatinib.oTheoretical
▶HIV-protease inhibitorsare predicted to slightly increase the
exposure toponatinib. Monitor and adjustponatinibdose.
oStudy
▶Idelalisibis predicted to slightly increase the exposure to
ponatinib. Monitor and adjustponatinibdose.oStudy
▶Macrolides(clarithromycin)are predicted to slightly increase
the exposure toponatinib. Monitor and adjustponatinibdose.
oStudy
▶Mitotaneis predicted to decrease the exposure toponatinib.
Avoid.oTheoretical
▶Ponatinibis predicted to increase the risk of bleeding events
when given withphenindione.rTheoretical
▶Rifampicinis predicted to decrease the exposure toponatinib.
Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
ponatinib. Avoid.rTheoretical
Posaconazole→see antifungals, azoles
Potassium canrenoate→seeTABLE 16p. 851 (increased serum
potassium)
Potassium chloride→seeTABLE 16p. 851 (increased serum potassium)
Potassium citrate
▶Potassium citrateis predicted to decrease the efficacy of
methenamine. Avoid.oTheoretical
▶Potassium citrateincreases the risk of side-effects when given
withsucralfate. Avoid.oTheoretical
Potassium-sparing diuretics→seeTABLE 18p. 851 (hyponatraemia),
TABLE 16p. 851 (increased serum potassium)
amiloride.triamterene..
▶Triamterenepotentially increases the clearance oflithium.
oStudy
Pramipexole→see dopamine receptor agonists
Prasugrel→seeTABLE 4p. 847 (antiplatelet effects)
Pravastatin→see statins
Praziquantel
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to markedly decrease the
exposure topraziquantel. Avoid.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure to
praziquantel.nStudy
▶Antimalarials(chloroquine)moderately decrease the exposure
topraziquantel. Use with caution and adjust dose.o
Study
▶Cobicistatis predicted to moderately increase the exposure to
praziquantel.nStudy
▶Corticosteroids(dexamethasone)decrease the exposure to
praziquantel.oStudy
▶Enzalutamideis predicted to markedly decrease the exposure
topraziquantel. Avoid.oStudy976 Pitolisant—Praziquantel BNFC 2018 – 2019
Interactions|Appendix 1A1