▶Rifampicinis predicted to decrease the exposure toduloxetine.
oTheoretical
▶SSRIs(fluvoxamine)markedly increase the exposure to
duloxetine. Avoid.rStudy→Also seeTABLE 18p. 851→Also
seeTABLE 13p. 850→Also seeTABLE 4p. 847
▶Teriflunomideis predicted to decrease the exposure to
duloxetine.oTheoretical
Dupilumab→see monoclonal antibodies
Dutasteride
▶Antiarrhythmics(dronedarone)are predicted to moderately
increase the exposure todutasteride.nStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to moderately increase the exposure to
dutasteride.nStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure todutasteride. Monitor
side effects and adjust dose.oTheoretical
▶Aprepitantis predicted to moderately increase the exposure to
dutasteride.nStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
moderately increase the exposure todutasteride.nStudy
▶Cobicistatis predicted to increase the exposure todutasteride.
Monitor side effects and adjust dose.oTheoretical
▶Crizotinibis predicted to moderately increase the exposure to
dutasteride.nStudy
▶HIV-protease inhibitorsare predicted to increase the exposure
todutasteride. Monitor side effects and adjust dose.o
Theoretical
▶Idelalisibis predicted to increase the exposure todutasteride.
Monitor side effects and adjust dose.oTheoretical
▶Imatinibis predicted to moderately increase the exposure to
dutasteride.nStudy
▶Macrolides(clarithromycin)are predicted to increase the
exposure todutasteride. Monitor side effects and adjust dose.
oTheoretical
▶Macrolides(erythromycin)are predicted to moderately increase
the exposure todutasteride.nStudy
▶Netupitantis predicted to moderately increase the exposure to
dutasteride.nStudy
▶Nilotinibis predicted to moderately increase the exposure to
dutasteride.nStudy
Eculizumab→see monoclonal antibodies
Edoxaban→seeTABLE 3p. 847 (anticoagulant effects)
▶Antiarrhythmics(amiodarone)slightly increase the exposure to
edoxaban.rStudy
▶Antiarrhythmics(dronedarone)slightly increase the exposure to
edoxaban. Adjustedoxabandose.rStudy
▶Antiepileptics(carbamazepine)are predicted to decrease the
exposure toedoxaban.oStudy
▶Antifungals, azoles(itraconazole)are predicted to slightly
increase the exposure toedoxaban.rTheoretical
▶Antifungals, azoles(ketoconazole)slightly increase the exposure
toedoxaban. Adjustedoxabandose.rStudy
▶Calcium channel blockers(verapamil)are predicted to slightly
increase the exposure toedoxaban.rTheoretical
▶Ceritinibis predicted to increase the exposure toedoxaban.
oTheoretical
▶Ciclosporinslightly increases the exposure toedoxaban. Adjust
edoxabandose.rStudy
▶Eliglustatis predicted to increase the exposure toedoxaban.
Adjust dose.oStudy
▶HIV-protease inhibitors(lopinavir, ritonavir, saquinavir)are
predicted to slightly increase the exposure toedoxaban.
rTheoretical
▶Lapatinibis predicted to slightly increase the exposure to
edoxaban.rTheoretical
▶Macrolides(azithromycin, clarithromycin)are predicted to
slightly increase the exposure toedoxaban.rTheoretical
▶Macrolides(erythromycin)slightly increase the exposure to
edoxaban. Adjustedoxabandose.rStudy
▶Mirabegronis predicted to increase the exposure toedoxaban.
nTheoretical
▶Ranolazineis predicted to slightly increase the exposure to
edoxaban.rTheoretical
▶Rifampicinis predicted to decrease the exposure toedoxaban.
oStudy
▶St John’sWortis predicted to decrease the exposure to
edoxaban.oStudy
▶Velpatasviris predicted to increase the exposure toedoxaban.
rTheoretical
▶Vemurafenibis predicted to slightly increase the exposure to
edoxaban.rTheoretical
▶Voxilapreviris predicted to increase the concentration of
edoxaban. Avoid.rTheoretical
Efavirenz→seeTABLE 9p. 849 (QT-interval prolongation)
▶Efavirenzis predicted to decrease the exposure to
antiarrhythmics(dronedarone).rTheoretical→Also see
TABLE 9p. 849
▶Antiepileptics(carbamazepine)slightly decrease the exposure
toefavirenzandefavirenzslightly decreases the exposure to
antiepileptics(carbamazepine).rStudy
▶Antiepileptics(fosphenytoin, phenytoin)slightly decrease the
exposure toefavirenzandefavirenzaffects the concentration
ofantiepileptics(fosphenytoin, phenytoin).rTheoretical
▶Antiepileptics(phenobarbital)are predicted to decrease the
exposure toefavirenzandefavirenzaffects the concentration
ofantiepileptics(phenobarbital).rTheoretical
▶Efavirenzis predicted to affect the efficacy ofantiepileptics
(primidone)andantiepileptics(primidone)are predicted to
slightly decrease the exposure toefavirenz.rTheoretical
▶Efavirenzis predicted to decrease the exposure toantifungals,
azoles(isavuconazole). Avoid.rTheoretical
▶Efavirenzslightly decreases the exposure toantifungals, azoles
(itraconazole). Avoid and for 14 days after stoppingefavirenz.
oStudy
▶Efavirenzmoderately decreases the exposure toantifungals,
azoles(ketoconazole).rStudy
▶Efavirenzslightly decreases the exposure toantifungals, azoles
(posaconazole). Avoid.oStudy
▶Efavirenzmoderately decreases the exposure toantifungals,
azoles(voriconazole)andantifungals, azoles(voriconazole)
slightly increase the exposure toefavirenz. Adjust dose.r
Study→Also seeTABLE 9p. 849
▶Efavirenzdecreases the concentration ofantimalarials
(artemether).rStudy→Also seeTABLE 9p. 849
▶Efavirenzmoderately decreases the exposure toantimalarials
(atovaquone). Avoid.oStudy
▶Efavirenzaffects the exposure toantimalarials(proguanil).
Avoid.oStudy
▶Efavirenzis predicted to decrease the exposure toaxitinib.
oTheoretical
▶Efavirenzis predicted to decrease the exposure tobedaquiline.
Avoid.rStudy→Also seeTABLE 9p. 849
▶Efavirenzis predicted to decrease the exposure tobosutinib.
Avoid.rTheoretical→Also seeTABLE 9p. 849
▶Efavirenzis predicted to decrease the exposure tobupropion.
oStudy
▶Efavirenzis predicted to decrease the exposure to
cabozantinib.oTheoretical→Also seeTABLE 9p. 849
▶Efavirenzis predicted to decrease the exposure tocalcium
channel blockers(amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
adjust dose.oTheoretical
▶Efavirenzis predicted to decrease the exposure tocalcium
channel blockers(diltiazem, verapamil).oTheoretical
▶Efavirenzis predicted to decrease the concentration of
caspofungin. Adjust dose.oStudy
▶Efavirenzdecreases the concentration ofciclosporin. Monitor
concentration and adjust dose.oStudy
▶Efavirenzis predicted to decrease the exposure tocobicistat.
Avoid.rTheoretical
▶Efavirenzis predicted to decrease the exposure tocobimetinib.
Avoid.rTheoretical
▶Efavirenzis predicted to decrease the efficacy ofcombined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactionsp. 497.rStudy
▶Efavirenzis predicted to affect the concentration ofcoumarins.
Adjust dose.oTheoreticalBNFC 2018 – 2019 Duloxetine—Efavirenz 913
Interactions|Appendix 1A1