▶Idelalisibis predicted to increase the exposure todabrafenib.
Use with caution or avoid.oStudy→Also seeTABLE 15
p. 850
▶Macrolides(clarithromycin)are predicted to increase the
exposure todabrafenib. Use with caution or avoid.o
Study
▶Dabrafenibdecreases the exposure tomidazolam. Monitor and
adjust dose.oStudy
▶Mitotaneis predicted to decrease the exposure todabrafenib.
Avoid.oTheoretical→Also seeTABLE 15p. 850
▶Rifampicinis predicted to decrease the exposure todabrafenib.
Avoid.oTheoretical
Dacarbazine→see alkylating agents
Daclatasvir
▶Daclatasviris predicted to increase the risk of severe
bradycardia or heart block when given withantiarrhythmics
(amiodarone). Refer to specialist literature.rAnecdotal
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to moderately decrease
the exposure todaclatasvir. Avoid.rStudy
▶Antiepileptics(oxcarbazepine)are predicted to decrease the
exposure todaclatasvir. Avoid.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure todaclatasvir.
Adjustdaclatasvirdose.oStudy
▶Bosentanis predicted to decrease the exposure todaclatasvir.
Adjustdaclatasvirdose.oTheoretical
▶Cobicistatis predicted to moderately increase the exposure to
daclatasvir. Adjustdaclatasvirdose.oStudy
▶Daclatasvirslightly increases the concentration ofdigoxin.
rStudy
▶Efavirenzis predicted to decrease the exposure todaclatasvir.
Adjust dose.rStudy
▶Enzalutamideis predicted to moderately decrease the
exposure todaclatasvir. Avoid.rStudy
▶Etravirineis predicted to decrease the exposure todaclatasvir.
Avoid.oTheoretical
▶HIV-protease inhibitorsare predicted to moderately increase
the exposure todaclatasvir. Adjustdaclatasvirdose.o
Study
▶Idelalisibis predicted to moderately increase the exposure to
daclatasvir. Adjustdaclatasvirdose.oStudy
▶Macrolides(clarithromycin)are predicted to moderately
increase the exposure todaclatasvir. Adjustdaclatasvirdose.
oStudy
▶Mitotaneis predicted to moderately decrease the exposure to
daclatasvir. Avoid.rStudy
▶Nevirapineis predicted to decrease the exposure to
daclatasvir. Avoid.rTheoretical
▶Rifampicinis predicted to moderately decrease the exposure
todaclatasvir. Avoid.rStudy
▶St John’s Wortis predicted to decrease the exposure to
daclatasvir. Avoid.rTheoretical
Dactinomycin→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
dactinomycin. Public Health England advises avoid (refer to
Green Book).rTheoretical
Dairy products
▶Dairy productsare predicted to decrease the absorption of
eltrombopag.Eltrombopagshould be taken 2 hours before or
4 hours afterdairy products.rTheoretical
▶Dairy productsdecrease the exposure totetracyclines
(demeclocycline, oxytetracycline, tetracycline). Avoid.o
Study
Dalteparin→see low molecular-weight heparins
Danaparoid→seeTABLE 3p. 847 (anticoagulant effects)
▶Ranibizumabis predicted to increase the risk of bleeding
events when given withdanaparoid.rTheoretical
Danazol
▶Danazolmoderately increases the concentration of
antiepileptics(carbamazepine). Monitor and adjust dose.r
Study
▶Danazolincreases the concentration ofciclosporin.r
Study
▶Danazolpotentially increases the anticoagulant effect of
coumarins.rAnecdotal
▶Danazolis predicted to increase the risk of rhabdomyolysis
when given withstatins(atorvastatin).rTheoretical
▶Danazolincreases the risk of rhabdomyolysis when given with
statins(simvastatin). Avoid.rAnecdotal
▶Danazolpotentially increases the concentration oftacrolimus.
rAnecdotal
Dantrolene→seeTABLE 1p. 847 (hepatotoxicity)
▶Intravenousdantrolenepotentially increases the risk of acute
hyperkalaemia and cardiovascular collapse when given with
calcium channel blockers(diltiazem, verapamil). Avoid.r
Anecdotal
Dapagliflozin→seeTABLE 14p. 850 (antidiabetic drugs),TABLE 8
p. 848 (hypotension)
Dapoxetine→see SSRIs
Dapsone
▶Aminosalicylic acidis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Dapsoneis predicted to increase the risk of
methaemoglobinaemia when given with topicalanaesthetics,
local(prilocaine). Use with caution or avoid.rTheoretical
▶Antiepileptics(fosphenytoin, phenobarbital, phenytoin,
primidone)are predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Antimalarials(chloroquine, primaquine)are predicted to
increase the risk of methaemoglobinaemia when given with
dapsone.rTheoretical
▶Nitratesare predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Nitrofurantoinis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Paracetamolis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Rifabutindecreases the exposure todapsone.oStudy
▶Rifampicindecreases the exposure todapsone.oStudy
▶Sodium nitroprussideis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Sulfonamidesare predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Dapsoneincreases the exposure totrimethoprimand
trimethoprimincreases the exposure todapsone.rStudy
Daptomycin
▶Aspirin(high-dose) increases the risk of renal impairment
when given withdaptomycin.oTheoretical
▶Ciclosporinis predicted to increase the risk of rhabdomyolysis
when given withdaptomycin.rTheoretical
▶Fibratesare predicted to increase the risk of rhabdomyolysis
when given withdaptomycin.rTheoretical
▶NSAIDsincrease the risk of renal impairment when given with
daptomycin.oTheoretical
▶Statinsare predicted to increase the risk of rhabdomyolysis
when given withdaptomycin.rTheoretical
Daratumumab→see monoclonal antibodies
Darbepoetin alfa→seeTABLE 5p. 847 (thromboembolism),TABLE 16
p. 851 (increased serum potassium)
Darifenacin→seeTABLE 10p. 849 (antimuscarinics)
▶Antiarrhythmics(dronedarone)are predicted to slightly
increase the exposure todarifenacin.oStudy
▶Darifenacinis predicted to increase the concentration of
antiarrhythmics(flecainide).oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
todarifenacin.oTheoreticalBNFC 2018 – 2019 Dabrafenib—Darifenacin 907
Interactions|Appendix 1A1