▶Efavirenzis predicted to decrease the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rStudy
▶Enzalutamideis predicted to decrease the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶HIV-protease inhibitorsare predicted to increase the exposure
toparitaprevir(with ritonavir and ombitasvir). Avoid.r
Theoretical
▶Idelalisibis predicted to increase the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rTheoretical
▶Paritaprevir(with ritonavir and ombitasvir) is predicted to
increase the exposure toloop diuretics(furosemide). Adjust
dose.oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure toparitaprevir(with ritonavir and ombitasvir).
Avoid.rTheoretical
▶Mitotaneis predicted to decrease the exposure toparitaprevir
(with ritonavir and ombitasvir). Avoid.rStudy
▶Nevirapineis predicted to decrease the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶Rifampicinis predicted to decrease the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶St John’s Wortis predicted to decrease the exposure to
paritaprevir(with ritonavir and ombitasvir). Avoid.r
Study
▶Paritaprevir(with ritonavir and ombitasvir) is predicted to
increase the exposure tostatins(fluvastatin). Avoid.o
Theoretical
▶Paritaprevir(with ritonavir and ombitasvir) increases the
exposure tostatins(pravastatin). Adjustpravastatindose.
oStudy
▶Paritaprevir(with ritonavir and ombitasvir) increases the
exposure tostatins(rosuvastatin). Adjustrosuvastatindose,
p. 133.oStudy
Paroxetine→see SSRIs
Pasireotide→seeTABLE 6p. 848 (bradycardia),TABLE 9p. 849 (QT-
interval prolongation)
▶Pasireotideis predicted to decrease the absorption of oral
ciclosporin. Adjust dose.rTheoretical
Patiromer
SEPARATION OF ADMINISTRATIONManufacturer advises take
3 hours before, or after, other drugs.Pazopanib→seeTABLE 15p. 850 (myelosuppression),TABLE 9p. 849
(QT-interval prolongation)
▶Antacidsare predicted to decrease the absorption of
pazopanib.Pazopanibshould be taken 1 hour before or 2 hours
afterantacids.oTheoretical
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure topazopanib.oTheoretical→Also seeTABLE 9
p. 849
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
topazopanib. Avoid.rTheoretical
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure topazopanib.o
Theoretical→Also seeTABLE 9p. 849
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure topazopanib. Avoid or
adjustpazopanibdose.oStudy→Also seeTABLE 9p. 849
▶Aprepitantis predicted to increase the exposure topazopanib.
oTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure topazopanib.oTheoretical
▶Cobicistatis predicted to increase the exposure topazopanib.
Avoid or adjustpazopanibdose.oStudy
▶Pazopanibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Crizotinibis predicted to increase the exposure topazopanib.
oTheoretical→Also seeTABLE 15p. 850→Also seeTABLE 9
p. 849
▶Enzalutamideis predicted to decrease the exposure to
pazopanib. Avoid.rTheoretical
▶Grapefruit juiceis predicted to increase the exposure to
pazopanib. Avoid.rTheoretical
▶H 2 receptor antagonistsare predicted to decrease the exposure
topazopanib.H 2 receptor antagonistsshould be taken 10 hours
before or 2 hours afterpazopanib.oTheoretical
▶HIV-protease inhibitorsare predicted to increase the exposure
topazopanib. Avoid or adjustpazopanibdose.o
Study→Also seeTABLE 9p. 849
▶Idelalisibis predicted to increase the exposure topazopanib.
Avoid or adjustpazopanibdose.oStudy→Also see
TABLE 15p. 850
▶Imatinibis predicted to increase the exposure topazopanib.
oTheoretical→Also seeTABLE 15p. 850
▶Pazopanibis predicted to increase the exposure tolomitapide.
Separate administration by 12 hours.oTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
exposure topazopanib. Avoid or adjustpazopanibdose.
oStudy→Also seeTABLE 9p. 849
▶Macrolides(erythromycin)are predicted to increase the
exposure topazopanib.oTheoretical→Also seeTABLE 9
p. 849
▶Mitotaneis predicted to decrease the exposure topazopanib.
Avoid.rTheoretical→Also seeTABLE 15p. 850
▶Netupitantis predicted to increase the exposure topazopanib.
oTheoretical
▶Nilotinibis predicted to increase the exposure topazopanib.
oTheoretical→Also seeTABLE 15p. 850→Also seeTABLE 9
p. 849
▶Pazopanibis predicted to increase the risk of bleeding events
when given withphenindione.rTheoretical
▶Proton pump inhibitorsare predicted to decrease the exposure
topazopanib. Avoid or administer concurrently without food.
oStudy
▶Rifampicinis predicted to decrease the exposure topazopanib.
Avoid.rTheoretical
Pegaspargase→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
▶Pegaspargaseis predicted to increase the risk of
hepatotoxicity when given withimatinib.rTheoretical→
Also seeTABLE 15p. 850
▶Pegaspargaseaffects the efficacy ofmethotrexate.r
Anecdotal→Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
▶Pegaspargasepotentially increases the risk of neurotoxicity
when given withvinca alkaloids(vincristine).Vincristineshould
be taken 3 to 24 hours beforepegaspargase.rAnecdotal→
Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
Peginterferon alfa→see interferons
Peginterferon beta-1a→seeTABLE 15p. 850 (myelosuppression)
Pembrolizumab→see monoclonal antibodies
Pemetrexed→seeTABLE 15p. 850 (myelosuppression),TABLE 2p. 847
(nephrotoxicity)
▶Antimalarials(pyrimethamine)are predicted to increase the risk
of side-effects when given withpemetrexed.r
Theoretical→Also seeTABLE 15p. 850
▶Aspirin(high-dose) potentially increases the exposure to
pemetrexed. Use with caution or avoid.rTheoretical
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
pemetrexed. Public Health England advises avoid (refer to
Green Book).rTheoretical
▶NSAIDsare predicted to increase the exposure topemetrexed.
Use with caution or avoid.rTheoretical→Also seeTABLE 2
p. 847
Penicillamine→seeTABLE 2p. 847 (nephrotoxicity)
▶Antacidsdecrease the absorption ofpenicillamine. Separate
administration by 2 hours.nStudy
▶Antimalarials(chloroquine)are predicted to increase the risk of
haematological toxicity when given withpenicillamine. Avoid.
rTheoretical
▶Penicillaminepotentially decreases the concentration of
digoxin. Separate administration by 2 hours.rAnecdotal
▶Hydroxychloroquineis predicted to increase the risk of
haematological toxicity when given withpenicillamine. Avoid.
rTheoreticalBNFC 2018 – 2019 Paritaprevir—Penicillamine 971
Interactions|Appendix 1A1