Sulfonamides(continued)
▶Antimalarials(pyrimethamine)increase the risk of side-effects
when given withsulfonamides.rStudy→Also seeTABLE 15
p. 850
▶Sulfadiazineis predicted to increase the anticoagulant effect
ofcoumarins.rTheoretical
▶Sulfamethoxazoleincreases the anticoagulant effect of
coumarins.rStudy
▶Sulfonamidesare predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Sulfonamidesare predicted to increase the exposure to
methotrexate. Use with caution or avoid.rTheoretical→
Also seeTABLE 15p. 850
▶Sulfonamidesare predicted to increase the exposure to
sulfonylureas.oStudy
▶Sulfonamidesare predicted to increase the effects of
thiopental.oTheoretical
Sulfonylureas→seeTABLE 14p. 850 (antidiabetic drugs)
glibenclamide.gliclazide.glimepiride.glipizide.tolbutamide..
▶Antiarrhythmics(amiodarone)are predicted to increase the
exposure tosulfonylureas. Use with caution and adjust dose.
oStudy
▶Antifungals, azoles(fluconazole, miconazole)are predicted to
increase the exposure tosulfonylureas. Use with caution and
adjust dose.oStudy
▶Antifungals, azoles(voriconazole)are predicted to increase the
concentration ofsulfonylureas. Use with caution and adjust
dose.oStudy
▶Bosentanincreases the risk of hepatotoxicity when given with
glibenclamide. Avoid.rStudy
▶Cephalosporins(ceftobiprole)are predicted to increase the
concentration ofglibenclamide.oTheoretical
▶Ceritinibis predicted to increase the exposure toglimepiride.
Adjust dose.oTheoretical
▶Chloramphenicolis predicted to increase the exposure to
sulfonylureas.rStudy
▶Fibratesare predicted to increase the risk of hypoglycaemia
when given withsulfonylureas.oTheoretical
▶Macrolides(clarithromycin)are predicted to slightly increase
the exposure tosulfonylureas.oTheoretical
▶Rifampicinis predicted to decrease the exposure to
sulfonylureas.oStudy
▶Statins(fluvastatin)slightly increase the exposure to
glibenclamide.nStudy
▶Sulfinpyrazoneis predicted to increase the exposure to
sulfonylureas. Use with caution and adjust dose.o
Study
▶Sulfonamidesare predicted to increase the exposure to
sulfonylureas.oStudy
Sulindac→see NSAIDs
Sulpiride→seeTABLE 8p. 848 (hypotension),TABLE 9p. 849 (QT-
interval prolongation),TABLE 11p. 849 (CNS depressant effects)
▶Antacidsdecrease the absorption ofsulpiride. Separate
administration by 2 hours.oStudy
▶Sulpirideis predicted to decrease the effects ofdopamine
receptor agonists. Avoid.oTheoretical→Also seeTABLE 8
p. 848→Also seeTABLE 9p. 849
▶Sulpirideis predicted to decrease the effects oflevodopa.
Avoid.rTheoretical→Also seeTABLE 8p. 848
▶Sulpiridepotentially increases the risk of neurotoxicity when
given withlithium.rAnecdotal→Also seeTABLE 9p. 849
▶Sucralfatedecreases the absorption ofsulpiride. Separate
administration by 2 hours.oStudy
Sumatriptan→seeTABLE 13p. 850 (serotonin syndrome)
▶Sumatriptanincreases the risk of vasoconstriction when given
withergotamine.Ergotamineshould be taken at least 24 hours
before or 6 hours aftersumatriptan.rStudy
▶Moclobemidemoderately increases the exposure to
sumatriptan. Avoid.oStudy→Also seeTABLE 13p. 850
▶Monoamine-oxidase A and B inhibitors, irreversibleare
predicted to increase the exposure tosumatriptan. Avoid and
for 14 days after stopping the MAOI.rTheoretical→Also
seeTABLE 13p. 850Sunitinib→seeTABLE 15p. 850 (myelosuppression),TABLE 9p. 849 (QT-
interval prolongation)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tosunitinib.oTheoretical→Also seeTABLE 9
p. 849
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tosunitinib. Avoid or adjustsunitinibdose.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tosunitinib.o
Theoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to slightly increase the exposure tosunitinib. Avoid
or adjustsunitinibdose.oStudy→Also seeTABLE 9p. 849
▶Aprepitantis predicted to increase the exposure tosunitinib.
oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tosunitinib.oTheoretical
▶Cobicistatis predicted to slightly increase the exposure to
sunitinib. Avoid or adjustsunitinibdose.oStudy
▶Sunitinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Crizotinibis predicted to increase the exposure tosunitinib.
oTheoretical→Also seeTABLE 15p. 850→Also seeTABLE 9
p. 849
▶Elbasviris predicted to increase the concentration ofsunitinib.
Use with caution and adjust dose.oTheoretical
▶Enzalutamideis predicted to decrease the exposure to
sunitinib. Avoid or adjustsunitinibdose.oStudy
▶Grapefruit juiceis predicted to increase the exposure to
sunitinib. Avoid.oTheoretical
▶Grazopreviris predicted to increase the concentration of
sunitinib. Use with caution and adjust dose.o
Theoretical
▶HIV-protease inhibitorsare predicted to slightly increase the
exposure tosunitinib. Avoid or adjustsunitinibdose.o
Study→Also seeTABLE 9p. 849
▶Idelalisibis predicted to slightly increase the exposure to
sunitinib. Avoid or adjustsunitinibdose.oStudy→Also
seeTABLE 15p. 850
▶Imatinibis predicted to increase the exposure tosunitinib.
oTheoretical→Also seeTABLE 15p. 850
▶Macrolides(clarithromycin)are predicted to slightly increase
the exposure tosunitinib. Avoid or adjustsunitinibdose.
oStudy→Also seeTABLE 9p. 849
▶Macrolides(erythromycin)are predicted to increase the
exposure tosunitinib.oTheoretical→Also seeTABLE 9
p. 849
▶Mitotaneis predicted to decrease the exposure tosunitinib.
Avoid or adjustsunitinibdose.oStudy→Also see
TABLE 15p. 850
▶Netupitantis predicted to increase the exposure tosunitinib.
oTheoretical
▶Nilotinibis predicted to increase the exposure tosunitinib.
oTheoretical→Also seeTABLE 15p. 850→Also seeTABLE 9
p. 849
▶Sunitinibis predicted to increase the risk of bleeding events
when given withphenindione.rTheoretical
▶Rifampicinis predicted to decrease the exposure tosunitinib.
Avoid or adjustsunitinibdose.oStudy
Suxamethonium→seeTABLE 20p. 851 (neuromuscular blocking
effects)
▶Alkylating agents(cyclophosphamide)increase the risk of
prolonged neuromuscular blockade when given with
suxamethonium.oStudy
▶Antiarrhythmics(lidocaine)are predicted to increase the effects
ofsuxamethonium.oStudy
▶Anticholinesterases, centrally actingincrease the effects of
suxamethonium.oTheoretical
▶Antiepileptics(carbamazepine)increase the risk of prolonged
neuromuscular blockade when given withsuxamethonium.
oStudy
▶Antiepileptics(fosphenytoin, phenytoin)increase the effects of
suxamethonium.oStudy996 Sulfonamides—Suxamethonium BNFC 2018 – 2019
Interactions|Appendix 1A1