Paliperidone(continued)
▶Antiepileptics(valproate)slightly increase the exposure to
paliperidone. Adjust dose.oStudy
▶Paliperidoneis predicted to decrease the effects ofdopamine
receptor agonists. Avoid.oTheoretical→Also seeTABLE 8
p. 848→Also seeTABLE 9p. 849
▶Enzalutamideis predicted to decrease the exposure to
paliperidone. Monitor and adjust dose.rStudy
▶Paliperidoneis predicted to decrease the effects oflevodopa.
rTheoretical→Also seeTABLE 8p. 848
▶Mitotaneis predicted to decrease the exposure topaliperidone.
Monitor and adjust dose.rStudy
▶Rifampicinis predicted to decrease the exposure to
paliperidone. Monitor and adjust dose.rStudy
▶St John’s Wortis predicted to decrease the exposure to
paliperidone.rTheoretical
Palonosetron→seeTABLE 13p. 850 (serotonin syndrome),TABLE 9
p. 849 (QT-interval prolongation)
▶Dopamine receptor agonists(apomorphine)are predicted to
increase the risk of severe hypotension when given with
palonosetron.rTheoretical
Pamidronate→see bisphosphonates
Pancreatin
▶Pancreatinis predicted to decrease the effects ofacarbose.
Avoid.oTheoretical
Pancuronium→see neuromuscular blocking drugs, non-depolarising
Panitumumab→see monoclonal antibodies
Panobinostat→seeTABLE 15p. 850 (myelosuppression),TABLE 9
p. 849 (QT-interval prolongation)
FOOD AND LIFESTYLEAvoid pomegranate, pomegranate juice,
and star fruit as they are predicted to increase panobinostat
exposure.
▶Antiarrhythmics(amiodarone, dronedarone)are predicted to
increase the exposure topanobinostat. Adjust dose.o
Theoretical→Also seeTABLE 9p. 849
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
topanobinostat. Avoid.oTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure topanobinostat. Adjust
panobinostatdose; in hepatic impairment avoid.o
Study→Also seeTABLE 9p. 849
▶Antifungals, azoles(posaconazole)are predicted to increase the
exposure topanobinostat. Adjust dose.oTheoretical
▶Panobinostatis predicted to increase the exposure to
atomoxetine. Monitor and adjust dose.rTheoretical
▶Panobinostatis predicted to increase the exposure tobeta
blockers, selective(metoprolol). Monitor and adjust dose.
oTheoretical
▶Panobinostatis predicted to increase the exposure tobeta
blockers, selective(nebivolol). Monitor and adjust dose.n
Theoretical
▶Calcium channel blockers(verapamil)are predicted to increase
the exposure topanobinostat. Adjust dose.oTheoretical
▶Ciclosporinis predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical
▶Cobicistatis predicted to increase the exposure to
panobinostat. Adjustpanobinostatdose; in hepatic
impairment avoid.oStudy
▶Enzalutamideis predicted to decrease the exposure to
panobinostat. Avoid.oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
topanobinostat. Adjustpanobinostatdose; in hepatic
impairment avoid.oStudy→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure to
panobinostat. Adjustpanobinostatdose; in hepatic
impairment avoid.oStudy→Also seeTABLE 15p. 850
▶Lapatinibis predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical→Also see
TABLE 9p. 849
▶Macrolides(azithromycin, erythromycin)are predicted to
increase the exposure topanobinostat. Adjust dose.o
Theoretical→Also seeTABLE 9p. 849▶Macrolides(clarithromycin)are predicted to increase the
exposure topanobinostat. Adjustpanobinostatdose; in
hepatic impairment avoid.oStudy→Also seeTABLE 9
p. 849
▶Mitotaneis predicted to decrease the exposure to
panobinostat. Avoid.oTheoretical→Also seeTABLE 15
p. 850
▶Panobinostatis predicted to increase the exposure to
phenothiazines(perphenazine). Monitor and adjust dose.r
Theoretical
▶Panobinostatis predicted to increase the exposure to
pimozide. Avoid.rTheoretical→Also seeTABLE 9p. 849
▶Ranolazineis predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical→Also see
TABLE 9p. 849
▶Rifampicinis predicted to decrease the exposure to
panobinostat. Avoid.oTheoretical
▶St John’s Wortis predicted to decrease the exposure to
panobinostat. Avoid.oTheoretical
▶Vemurafenibis predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical→Also see
TABLE 9p. 849
Pantoprazole→see proton pump inhibitors
Papaveretum→see opioids
Paracetamol→seeTABLE 1p. 847 (hepatotoxicity)
▶Alcohol (beverage)(in those who drink heavily) causes severe
liver damage when given withparacetamol.rStudy→Also
seeTABLE 1p. 847
▶Paracetamolis predicted to decrease the clearance ofalkylating
agents(busulfan).oTheoretical
▶Paracetamolis predicted to increase the risk of
methaemoglobinaemia when given with topicalanaesthetics,
local(prilocaine). Use with caution or avoid.rTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the exposure toparacetamol.
oStudy→Also seeTABLE 1p. 847
▶Paracetamolincreases the anticoagulant effect ofcoumarins.
oStudy
▶Paracetamolis predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Imatinibincreases the risk of hepatotoxicity when given with
paracetamol.rAnecdotal
▶Paracetamolis predicted to increase the anticoagulant effect
ofphenindione.rTheoretical
▶Pitolisantis predicted to decrease the exposure to
paracetamol.qTheoretical
▶Rifampicindecreases the exposure toparacetamol.o
Study
Paraldehyde→see antiepileptics
Parathyroid hormone
▶Bisphosphonatesare predicted to decrease the effects of
parathyroid hormone. Avoid.oStudy
Parecoxib→see NSAIDs
Paricalcitol→see vitamin D substances
Paritaprevir
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toparitaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure toparitaprevir(with
ritonavir and ombitasvir). Avoid.rTheoretical
▶Antifungals, azoles(posaconazole)are predicted to increase the
exposure toparitaprevir(with ritonavir and ombitasvir) and
paritaprevir(with ritonavir and ombitasvir) is predicted to
increase the exposure toantifungals, azoles(posaconazole).
Avoid.rTheoretical
▶Bosentanis predicted to decrease the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rStudy
▶Cobicistatis predicted to increase the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rTheoretical
▶Paritaprevir(with ritonavir and ombitasvir) increases the risk
of raised liver function tests when given withcombined
hormonal contraceptives. Avoid.rStudy970 Paliperidone—Paritaprevir BNFC 2018 – 2019
Interactions|Appendix 1A1