Voxilaprevir(continued)
▶HIV-protease inhibitors(atazanavir)(boosted with ritonavir)
increase the concentration ofvoxilaprevir. Avoid.rStudy
▶HIV-protease inhibitors(lopinavir)are predicted to increase the
concentration ofvoxilaprevir. Avoid.rTheoretical
▶Mitotaneis predicted to decrease the concentration of
voxilaprevir. Avoid.rStudy
▶Modafinilis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Nevirapineis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Proton pump inhibitorsare predicted to decrease the exposure
tovoxilaprevir. Adjust dose, seesofosbuvir with velpatasvir
and voxilaprevir.oStudy
▶Rifabutinis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Rifampicinis predicted to decrease the concentration of
voxilaprevir. Avoid.rStudy
▶St John’s Wortis predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶Voxilapreviris predicted to increase the exposure tostatins
(atorvastatin, fluvastatin, simvastatin). Avoid.rTheoretical
▶Voxilapreviris predicted to increase the exposure tostatins
(pravastatin). Monitor and adjustpravastatindose.r
Study
▶Voxilapreviris predicted to increase the exposure tostatins
(rosuvastatin). Avoid.rStudy
▶Voxilapreviris predicted to increase the exposure totenofovir
disoproxil.rStudy
Warfarin→see coumarins
Wasp venom extract
GENERAL INFORMATIONDesensitising vaccines should be
avoided in patients taking beta-blockers (adrenaline might be
ineffective in case of a hypersensitivity reaction) or ACE
inhibitors (risk of severe anaphylactoid reactions).Xipamide→see thiazide diuretics
Xylometazoline→see sympathomimetics, vasoconstrictor
Yellow fever vaccine, live→see live vaccines
Zaleplon→seeTABLE 11p. 849 (CNS depressant effects)
▶Rifampicinmarkedly decreases the exposure tozaleplon.
oStudy
Zidovudine→seeTABLE 15p. 850 (myelosuppression),TABLE 2p. 847
(nephrotoxicity)
▶Antiepileptics(valproate)slightly increase the exposure to
zidovudine.oStudy
▶Antimalarials(pyrimethamine)are predicted to increase the risk
of side-effects when given withzidovudine.rTheoretical→
Also seeTABLE 15p. 850
▶Zidovudineincreases the risk of haematological toxicity when
given withaspirin(high-dose).rStudy
▶HIV-protease inhibitors(tipranavir)slightly decrease the
exposure tozidovudine. Avoid.oStudy
▶Macrolides(clarithromycin)decrease the absorption of
zidovudine. Separate administration by at least 2 hours.
oStudy
▶Nevirapineis predicted to decrease the concentration of
zidovudine. Refer to specialist literature.rTheoretical
▶Zidovudineincreases the risk of haematological toxicity when
given withNSAIDs.rStudy→Also seeTABLE 2p. 847
▶Ribavirinincreases the risk of anaemia and/or leucopenia
when given withzidovudine. Avoid.rStudy
▶Zidovudineis predicted to decrease the efficacy ofstavudine.
Avoid.rTheoretical
Zinc
▶Oralzincdecreases the absorption of oralbisphosphonates
(alendronic acid).Zincshould be taken at least 30 minutes
beforealendronic acid.oStudy
▶Oralzincis predicted to decrease the absorption of oral
bisphosphonates(ibandronic acid). Avoidzincfor at least
6 hours before or 1 hour afteribandronic acid.o
Theoretical
▶Oralzincdecreases the absorption of oralbisphosphonates
(risedronate). Separate administration by at least 2 hours.
oStudy▶Oralzincdecreases the absorption of oralbisphosphonates
(sodium clodronate). Avoidzincfor 2 hours before or 1 hour
aftersodium clodronate.oStudy
▶Oralcalcium saltsdecrease the absorption ofzinc.o
Study
▶Zincis predicted to decrease the absorption ofeltrombopag.
Eltrombopagshould be taken 2 hours before or 4 hours after
zinc.rTheoretical
▶Zincis predicted to decrease the efficacy ofiron (oral)andiron
(oral)is predicted to decrease the efficacy ofzinc.o
Study
▶Zincis predicted to decrease the absorption ofpenicillamine.
nTheoretical
▶Zincis predicted to decrease the exposure toquinolones.
Separate administration by 2 hours.oStudy
▶Oralzincis predicted to decrease the absorption of
tetracyclines. Separate administration by 2 to 3 hours.
oTheoretical
▶Trientinepotentially decreases the absorption ofzinc.
oTheoretical
Zoledronic acid→see bisphosphonates
Zolmitriptan→seeTABLE 13p. 850 (serotonin syndrome)
▶Combined hormonal contraceptivesare predicted to increase
the exposure tozolmitriptan. Adjustzolmitriptandose,p. 292.
oTheoretical
▶H 2 receptor antagonists(cimetidine)slightly increase the
exposure tozolmitriptan. Adjustzolmitriptandose,p. 292.n
Study
▶Moclobemideslightly increases the exposure tozolmitriptan.
Adjustzolmitriptandose,p. 292.oStudy→Also see
TABLE 13p. 850
▶Monoamine-oxidase A and B inhibitors, irreversibleare
predicted to increase the exposure tozolmitriptan.r
Theoretical→Also seeTABLE 13p. 850
▶Quinolones(ciprofloxacin)are predicted to increase the
exposure tozolmitriptan. Adjustzolmitriptandose,p. 292.
oTheoretical
▶SSRIs(fluvoxamine)are predicted to increase the exposure to
zolmitriptan. Adjustzolmitriptandose,p. 292.r
Theoretical→Also seeTABLE 13p. 850
Zolpidem→seeTABLE 11p. 849 (CNS depressant effects)
▶Antiepileptics(carbamazepine)moderately decrease the
exposure tozolpidem.oStudy
▶Rifampicinmoderately decreases the exposure tozolpidem.
oStudy
Zonisamide→see antiepileptics
Zopiclone→seeTABLE 11p. 849 (CNS depressant effects)
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tozopiclone. Adjust dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tozopiclone. Adjust dose.oStudy→Also seeTABLE 11
p. 849
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tozopiclone. Adjust
dose.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tozopiclone. Adjust dose.
oTheoretical
▶Aprepitantis predicted to increase the exposure tozopiclone.
Adjust dose.oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tozopiclone. Adjust dose.oStudy
▶Cobicistatis predicted to increase the exposure tozopiclone.
Adjust dose.oTheoretical
▶Crizotinibis predicted to increase the exposure tozopiclone.
Adjust dose.oStudy
▶Enzalutamideis predicted to decrease the exposure to
zopiclone. Adjust dose.oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tozopiclone. Adjust dose.oTheoretical
▶Idelalisibis predicted to increase the exposure tozopiclone.
Adjust dose.oTheoretical
▶Imatinibis predicted to increase the exposure tozopiclone.
Adjust dose.oStudy1010 Voxilaprevir—Zopiclone BNFC 2018 – 2019
Interactions|Appendix 1A1