Moxonidine(continued)
▶Tricyclic antidepressantsare predicted to decrease the effects
ofmoxonidine. Avoid.oTheoretical→Also seeTABLE 8
p. 848
Mycophenolate→seeTABLE 15p. 850 (myelosuppression)
▶Mycophenolateis predicted to increase the risk of
haematological toxicity when given withaciclovir.o
Theoretical
▶Antacidsdecrease the exposure tomycophenolate.o
Study
▶Antifungals, azoles(isavuconazole)increase the exposure to
mycophenolate.oStudy
▶Mycophenolateis predicted to increase the risk of
haematological toxicity when given withganciclovir.o
Theoretical→Also seeTABLE 15p. 850
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
mycophenolate. Public Health England advises avoid (refer to
Green Book).rTheoretical
▶Rifampicindecreases the concentration ofmycophenolate.
Monitor and adjust dose.rStudy
▶Mycophenolateis predicted to increase the risk of
haematological toxicity when given withvalaciclovir.o
Theoretical
▶Mycophenolateis predicted to increase the risk of
haematological toxicity when given withvalganciclovir.
oTheoretical→Also seeTABLE 15p. 850
Nabilone→seeTABLE 11p. 849 (CNS depressant effects)
▶Nabiloneis predicted to increase the risk of cardiovascular
side-effects when given withamfetamines.rTheoretical
Nabumetone→see NSAIDs
Nadolol→see beta blockers, non-selective
Nalmefene
GENERAL INFORMATIONDiscontinue treatment 1 week before
anticipated use of opioids; if emergency analgesia is required
during treatment, an increased dose of opioid analgesic might
be necessary (monitor for opioid intoxication).
▶Nalmefeneis predicted to decrease the efficacy ofopioids.
Avoid.rTheoretical
Naloxegol
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tonaloxegol. Adjustnaloxegoldose and monitor side
effects.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to markedly decrease the
exposure tonaloxegol. Avoid.oStudy
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tonaloxegol. Adjust
naloxegoldose and monitor side effects.oStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to markedly increase the exposure tonaloxegol.
Avoid.rStudy
▶Aprepitantis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tonaloxegol. Adjustnaloxegoldose and
monitor side effects.oStudy
▶Cobicistatis predicted to markedly increase the exposure to
naloxegol. Avoid.rStudy
▶Crizotinibis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Enzalutamideis predicted to markedly decrease the exposure
tonaloxegol. Avoid.oStudy
▶Grapefruit juiceis predicted to increase the exposure to
naloxegol. Avoid.oTheoretical
▶HIV-protease inhibitorsare predicted to markedly increase the
exposure tonaloxegol. Avoid.rStudy
▶Idelalisibis predicted to markedly increase the exposure to
naloxegol. Avoid.rStudy
▶Imatinibis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Macrolides(clarithromycin)are predicted to markedly increase
the exposure tonaloxegol. Avoid.rStudy▶Macrolides(erythromycin)are predicted to increase the
exposure tonaloxegol. Adjustnaloxegoldose and monitor side
effects.oStudy
▶Mitotaneis predicted to markedly decrease the exposure to
naloxegol. Avoid.oStudy
▶Netupitantis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Nilotinibis predicted to increase the exposure tonaloxegol.
Adjustnaloxegoldose and monitor side effects.oStudy
▶Rifampicinis predicted to markedly decrease the exposure to
naloxegol. Avoid.oStudy
▶St John’s Wortis predicted to decrease the exposure to
naloxegol. Avoid.oTheoretical
Naltrexone
GENERAL INFORMATIONAvoid concurrent use of opioids.
Nandrolone
▶Nandroloneis predicted to increase the anticoagulant effect of
coumarins. Monitor and adjust dose.rTheoretical
▶Nandroloneis predicted to increase the anticoagulant effect of
phenindione. Monitor and adjust dose.rTheoretical
Naproxen→see NSAIDs
Naratriptan→seeTABLE 13p. 850 (serotonin syndrome)
▶Naratriptanis predicted to increase the risk of
vasoconstriction when given withergotamine. Separate
administration by 24 hours.rTheoretical
Natalizumab→see monoclonal antibodies
Nateglinide→seeTABLE 14p. 850 (antidiabetic drugs)
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to slightly decrease the
exposure tonateglinide.nStudy
▶Enzalutamideis predicted to slightly decrease the exposure to
nateglinide.nStudy
▶Mitotaneis predicted to slightly decrease the exposure to
nateglinide.nStudy
▶Rifampicinis predicted to slightly decrease the exposure to
nateglinide.nStudy
▶Sulfinpyrazoneslightly increases the exposure tonateglinide.
nStudy
Nebivolol→see beta blockers, selective
Necitumumab→see monoclonal antibodies
Nefopam→seeTABLE 10p. 849 (antimuscarinics)
▶Nefopamis predicted to increase the risk of serious elevations
in blood pressure when given withmonoamine-oxidase A and B
inhibitors, irreversible. Avoid.rTheoretical
Nelarabine→seeTABLE 15p. 850 (myelosuppression)
Neomycin→seeTABLE 2p. 847 (nephrotoxicity),TABLE 19p. 851
(ototoxicity),TABLE 20p. 851 (neuromuscular blocking effects)
▶Neomycindecreases the absorption ofdigoxin.oStudy
▶Neomycinmoderately decreases the exposure tosorafenib.
oStudy
Neostigmine→seeTABLE 6p. 848 (bradycardia),TABLE 20p. 851
(neuromuscular blocking effects)
▶Aminoglycosidesare predicted to decrease the effects of
neostigmine.oTheoretical→Also seeTABLE 20p. 851
Nepafenac→see NSAIDs
Netupitant
▶Netupitantis predicted to increase the exposure toaldosterone
antagonists(eplerenone). Adjusteplerenonedose.rStudy
▶Netupitantis predicted to increase the exposure toalpha
blockers(tamsulosin).oTheoretical
▶Netupitantis predicted to increase the exposure toalprazolam.
rStudy
▶Netupitantis predicted to increase the exposure to
antiarrhythmics(propafenone). Monitor and adjust dose.
oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tonetupitant. Avoid.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tonetupitant.o
Study
▶Netupitantis predicted to decrease the exposure toantifungals,
azoles(isavuconazole).oTheoretical
▶Netupitantis predicted to increase the exposure to
antihistamines, non-sedating(mizolastine).rTheoretical960 Moxonidine—Netupitant BNFC 2018 – 2019
Interactions|Appendix 1A1