▶Rifampicinvery markedly decreases the exposure to
simvastatin.oStudy
▶Rolapitantis predicted to increase the exposure to
rosuvastatin. Monitor and adjust dose.rStudy
▶Sacubitrilis predicted to increase the exposure tostatins.
rStudy
▶Simeprevirmoderately increases the exposure toatorvastatin.
Monitor and adjust dose.oStudy
▶Simepreviris predicted to increase the exposure to
pravastatin. Monitor and adjust dose.rTheoretical
▶Simeprevirmoderately increases the exposure torosuvastatin.
Adjustrosuvastatindose,p. 133.oStudy
▶Simeprevirslightly increases the exposure tosimvastatin.
Monitor and adjust dose.oStudy
▶St John’s Wortslightly decreases the exposure toatorvastatin.
nStudy
▶St John’s Wortmoderately decreases the exposure to
simvastatin.oStudy
▶Sulfinpyrazoneis predicted to increase the exposure to
fluvastatin.rTheoretical
▶Fluvastatinslightly increases the exposure tosulfonylureas
(glibenclamide).nStudy
▶Tedizolidincreases the exposure torosuvastatin. Avoid.
oStudy
▶Teriflunomidemoderately increases the exposure to
rosuvastatin. Adjustrosuvastatindose,p. 133.oStudy
▶Ticagrelorslightly increases the exposure tosimvastatin.
Adjustsimvastatindose,p. 134.oStudy
▶Tivozanibis predicted to decrease the exposure to
rosuvastatin.oTheoretical
▶Velpatasvirincreases the exposure torosuvastatin. Adjust
rosuvastatindose and monitor side effects,p. 133.rStudy
▶Velpatasviris predicted to increase the exposure tostatins
(atorvastatin, simvastatin). Monitor side effects and adjust
dose.rTheoretical
▶Voxilapreviris predicted to increase the exposure to
pravastatin. Monitor and adjustpravastatindose,p. 133.r
Study
▶Voxilapreviris predicted to increase the exposure to
rosuvastatin. Avoid.rStudy
▶Voxilapreviris predicted to increase the exposure tostatins
(atorvastatin, fluvastatin, simvastatin). Avoid.rTheoretical
Stavudine→seeTABLE 12p. 850 (peripheral neuropathy)
▶Didanosineincreases the risk of toxicity when given with
stavudine. Avoid.rStudy→Also seeTABLE 12p. 850
▶Hydroxycarbamideincreases the risk of toxicity when given
withstavudine. Avoid.rStudy
▶Isoniazidis predicted to increase the risk of peripheral
neuropathy when given withstavudine.rTheoretical→
Also seeTABLE 12p. 850
▶Ribavirinincreases the risk of toxicity when given with
stavudine. Avoid.rStudy
▶Zidovudineis predicted to decrease the efficacy ofstavudine.
Avoid.rTheoretical
Stiripentol→see antiepileptics
Streptokinase→seeTABLE 3p. 847 (anticoagulant effects)
Streptomycin→see aminoglycosides
Sucralfate
▶Sucralfatepotentially decreases the effects ofcoumarins
(warfarin). Separate administration by 2 hours.o
Anecdotal
▶Sucralfatedecreases the absorption ofdigoxin. Separate
administration by 2 hours.rAnecdotal
▶Sucralfatedecreases the absorption ofdolutegravir.o
Study
▶Sucralfateincreases the risk of blocked enteral or nasogastric
tubes when given withenteral feeds. Separate administration
by 1 hour.oStudy
▶Potassium citrateincreases the risk of side-effects when given
withsucralfate. Avoid.oTheoretical
▶Sucralfatedecreases the exposure toquinolones. Separate
administration by 2 hours.oStudy
▶Sodium citrateis predicted to increase the risk of side-effects
when given withsucralfate. Avoid.oTheoretical
▶Sucralfatedecreases the absorption ofsulpiride. Separate
administration by 2 hours.oStudy
▶Sucralfatepotentially decreases the absorption of
theophylline. Separate administration by at least 2 hours.
oStudy
▶Sucralfatedecreases the absorption ofthyroid hormones
(levothyroxine). Separate administration by at least 4 hours.
oStudy
▶Sucralfateis predicted to decrease the absorption oftricyclic
antidepressants.oStudy
Sufentanil→see opioids
Sugammadex
▶Sugammadexis predicted to decrease the exposure to oral
combined hormonal contraceptives. Refer to patient
information leaflet for missed pill advice.rTheoretical
▶Sugammadexis predicted to decrease the exposure to
desogestrel. Refer to patient information leaflet for missed pill
advice.rTheoretical
▶Sugammadexis predicted to decrease the efficacy of
etonogestrel. Use additional contraceptive precautions.r
Theoretical
▶Sugammadexis predicted to decrease the exposure to
levonorgestrel. Use additional contraceptive precautions.
rTheoretical
▶Sugammadexis predicted to decrease the exposure to
medroxyprogesterone. Use additional contraceptive
precautions.rTheoretical
▶Sugammadexis predicted to decrease the exposure to
norethisterone. Use additional contraceptive precautions.
rTheoretical
Sulfadiazine→see sulfonamides
Sulfadoxine→see sulfonamides
Sulfamethoxazole→see sulfonamides
Sulfasalazine→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
▶Sulfasalazinedecreases the concentration ofdigoxin.o
Study
▶Sulfasalazineis predicted to decrease the absorption offolates.
oStudy
▶Rolapitantincreases the exposure tosulfasalazine.rStudy
▶Tedizolidis predicted to increase the exposure tosulfasalazine.
Avoid.oTheoretical
Sulfinpyrazone→seeTABLE 4p. 847 (antiplatelet effects)
▶Sulfinpyrazoneincreases the concentration ofantiepileptics
(fosphenytoin, phenytoin).oStudy
▶Aspirindecreases the effects ofsulfinpyrazone.o
Study→Also seeTABLE 4p. 847
▶Sulfinpyrazonedecreases the exposure tocalcium channel
blockers(verapamil).oStudy
▶Sulfinpyrazonedecreases the concentration ofciclosporin.
rStudy
▶Sulfinpyrazoneincreases the anticoagulant effect of
coumarins. Avoid.rStudy
▶Sulfinpyrazoneslightly increases the exposure tonateglinide.
nStudy
▶Pyrazinamideis predicted to decrease the effects of
sulfinpyrazone.oTheoretical
▶Sulfinpyrazoneis predicted to increase the exposure to
retinoids(alitretinoin). Adjustalitretinoindose.o
Theoretical
▶Sulfinpyrazoneis predicted to increase the exposure tostatins
(fluvastatin).rTheoretical
▶Sulfinpyrazoneis predicted to increase the exposure to
sulfonylureas. Use with caution and adjust dose.o
Study
Sulfonamides→seeTABLE 15p. 850 (myelosuppression)
co-trimoxazole.sulfadiazine.sulfadoxine.sulfamethoxazole..
▶Sulfonamidespotentially increase the risk of
methaemoglobinaemia when given with topicalanaesthetics,
local(prilocaine). Use with caution or avoid.rAnecdotal
▶Sulfadiazineis predicted to increase the concentration of
antiepileptics(fosphenytoin). Monitor and adjust dose.
oStudy
▶Sulfadiazineincreases the concentration ofantiepileptics
(phenytoin). Monitor and adjust dose.oStudyBNFC 2018 – 2019 Statins—Sulfonamides 995
Interactions|Appendix 1A1