Antihistamines, non-sedating(continued)
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tomizolastine.rTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure torupatadine. Avoid.oStudy
▶Ceritinibis predicted to increase the exposure tofexofenadine.
oTheoretical
▶Cobicistatis predicted to increase the exposure tomizolastine.
Avoid.rStudy
▶Cobicistatis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Crizotinibis predicted to increase the exposure tomizolastine.
rTheoretical
▶Crizotinibis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Mizolastineis predicted to increase the risk of QT-
prolongation when given withdrugs that prolong the QT
interval. Avoid.rTheoretical
▶Eliglustatis predicted to increase the exposure to
fexofenadine. Adjust dose.oStudy
▶Grapefruit juiceslightly decreases the exposure tobilastine.
Bilastineshould be taken 1 hour before or 2 hours after
grapefruit juice.oStudy
▶Grapefruit juiceincreases the exposure torupatadine. Avoid.
oStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
tomizolastine. Avoid.rStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
torupatadine. Avoid.oStudy
▶Idelalisibis predicted to increase the exposure tomizolastine.
Avoid.rStudy
▶Idelalisibis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Imatinibis predicted to increase the exposure tomizolastine.
rTheoretical
▶Imatinibis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Lapatinibis predicted to increase the exposure to
fexofenadine.oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure tomizolastine. Avoid.rStudy
▶Macrolides(clarithromycin, erythromycin)are predicted to
increase the exposure torupatadine. Avoid.oStudy
▶Macrolides(erythromycin)are predicted to increase the
exposure tomizolastine.rTheoretical
▶Mirabegronis predicted to increase the exposure to
fexofenadine.nTheoretical
▶Monoamine-oxidase A and B inhibitors, irreversibleare
predicted to increase the risk of antimuscarinic side-effects
when given withantihistamines, non-sedating. Avoid.r
Theoretical
▶Netupitantis predicted to increase the exposure tomizolastine.
rTheoretical
▶Netupitantis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Nilotinibis predicted to increase the exposure tomizolastine.
rTheoretical
▶Nilotinibis predicted to increase the exposure torupatadine.
Avoid.oStudy
▶Rifampicinis predicted to decrease the exposure tobilastine.
oTheoretical
▶Rifampicinincreases the clearance offexofenadine.o
Study
▶Velpatasviris predicted to increase the exposure to
fexofenadine.rTheoretical
Antihistamines, sedating→seeTABLE 9p. 849 (QT-interval
prolongation),TABLE 11p. 849 (CNS depressant effects),TABLE 10p. 849
(antimuscarinics)alimemazine.antazoline.buclizine.chlorphenamine.cinnarizine.
clemastine.cyclizine.cyproheptadine.hydroxyzine.ketotifen.
pizotifen.promethazine..ROUTE-SPECIFIC INFORMATIONSince systemic absorption can
follow topical application ofketotifen, the possibility of
interactions should be borne in mind.▶Hydroxyzinepotentially increases the risk of overheating and
dehydration when given withantiepileptics(zonisamide). Avoid
in children.rTheoretical
▶Antihistamines, sedatingare predicted to decrease the effects
ofbetahistine.oTheoretical
▶Cyproheptadinedecreases the effects ofmetyrapone. Avoid.
oStudy
▶Monoamine-oxidase A and B inhibitors, irreversibleare
predicted to increase the risk of antimuscarinic side-effects
when given withantihistamines, sedating. Avoid.r
Theoretical
▶Antihistamines, sedatingare predicted to decrease the efficacy
ofpitolisant.qTheoretical
▶Cyproheptadinepotentially decreases the effects ofSSRIs.
oAnecdotal
Antimalarials→seeTABLE 15p. 850 (myelosuppression),TABLE 9
p. 849 (QT-interval prolongation)
artemether.artenimol.atovaquone.chloroquine.lumefantrine.
mefloquine.piperaquine.primaquine.proguanil.pyrimethamine
.quinine..PHARMACOLOGYPiperaquine has a long half-life; there is a
potential for drug interactions to occur for up to 3 months
after treatment has been stopped.
▶Chloroquineis predicted to decrease the effects ofagalsidase.
Avoid.oTheoretical
▶Antimalarials(chloroquine, primaquine)are predicted to
increase the risk of methaemoglobinaemia when given with
topicalanaesthetics, local(prilocaine). Use with caution or
avoid.rTheoretical
▶Antacidsdecrease the absorption ofchloroquine. Separate
administration by at least 4 hours.oStudy
▶Antacidsare predicted to decrease the absorption ofproguanil.
Separate administration by at least 2 hours.oStudy
▶Antiarrhythmics(dronedarone)are predicted to increase the
concentration ofpiperaquine.rTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toartemether(with lumafantrine). Avoid.rStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the
concentration ofpiperaquine. Avoid.oTheoretical
▶Antiepileptics(carbamazepine, phenobarbital, primidone)
potentially increase the risk of toxicity when given with
quinine.qStudy
▶Pyrimethamineincreases the risk of haematological toxicity
when given withantiepileptics(fosphenytoin, phenytoin).r
Study
▶Pyrimethamineis predicted to increase the risk of
haematological toxicity when given withantiepileptics
(phenobarbital, primidone).rTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole)are predicted to
increase the concentration ofpiperaquine.rTheoretical
▶Antifungals, azoles(fluconazole, itraconazole, posaconazole,
voriconazole)are predicted to increase the exposure to
mefloquine.oTheoretical
▶Antifungals, azoles(ketoconazole)increase the exposure to
mefloquine.oStudy
▶Antimalarials(proguanil)are predicted to increase the risk of
side-effects when given withantimalarials(pyrimethamine).
rTheoretical
▶Aprepitantis predicted to increase the concentration of
piperaquine.rTheoretical
▶Mefloquineis predicted to increase the risk of bradycardia
when given withbeta blockers, non-selective.rTheoretical
▶Mefloquineis predicted to increase the risk of bradycardia
when given withbeta blockers, selective.rTheoretical
▶Mefloquineis predicted to increase the risk of bradycardia
when given withcalcium channel blockers.rTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the concentration ofpiperaquine.rTheoretical
▶Calcium salts(calcium carbonate)decrease the absorption of
chloroquine. Separate administration by at least 4 hours.
oStudy878 Antihistamines, non-sedating—Antimalarials BNFC 2018 – 2019
Interactions|Appendix 1A1