BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 657Acrivastine see AntihistaminesAdalimumabAbatacept: increased risk of side-effects when adalimumabgiven with abatacept. Anakinra: avoid concomitant use of adalimumab with.anakinra. Vaccines: avoid concomitant use of adalimumab withlive .vaccines (see p. 599)AdefovirAntivirals: avoidance of adefovir advised by manufacturerof tenofovirAdenosineNote Possibility of interaction with drugs tending to impairmyocardial conductionAnaesthetics, Local: increased myocardial depressionwhen anti-arrhythmics given with bupivacaine, levobupivacaine,prilocaine or ropivacaine. Anti-arrhythmics: increased myocardial depressionwhen anti-arrhythmics given with other .antiarrhythmics. Antipsychotics: increased risk of ventricular arrhythmiaswhen anti-arrhythmics that prolong the QTinterval given with .antipsychotics that prolong theQT interval. Beta-blockers: increased myocardial depression whenanti-arrhythmics given with .beta-blockers. Dipyridamole: effect of adenosine enhanced andextended by .dipyridamole (important risk of toxicity)Nicotine: effects of adenosine possibly enhanced bynicotineTheophylline: anti-arrhythmic effect of adenosineantagonised by theophyllineAdrenaline (epinephrine) see SympathomimeticsAdrenergic Neurone BlockersAlcohol: enhanced hypotensive effect when adrenergicneurone blockers given with alcoholAlpha-blockers: enhanced hypotensive effect whenadrenergic neurone blockers given with alpha-blockers. Anaesthetics, General: enhanced hypotensive effectwhen adrenergic neurone blockers given with.general anaestheticsAnalgesics: hypotensive effect of adrenergic neuroneblockers antagonised by NSAIDsAngiotensin-II Receptor Antagonists: enhancedhypotensive effect when adrenergic neurone blockersgiven with angiotensin-II receptor antagonistsAntidepressants: enhanced hypotensive effect whenadrenergic neurone blockers given with MAOIs;hypotensive effect of adrenergic neurone blockersantagonised by tricyclicsAntipsychotics: hypotensive effect of adrenergicneurone blockers antagonised by haloperidol; hypotensiveeffect of adrenergic neurone blockers antagonisedby higher doses of chlorpromazine; enhancedhypotensive effect when adrenergic neurone blockersgiven with phenothiazinesAnxiolytics and Hypnotics: enhanced hypotensiveeffect when adrenergic neurone blockers given withanxiolytics and hypnoticsBeta-blockers: enhanced hypotensive effect whenadrenergic neurone blockers given with beta-blockersCalcium-channel Blockers: enhanced hypotensiveeffect when adrenergic neurone blockers given withcalcium-channel blockersClonidine: enhanced hypotensive effect when adrenergicneurone blockers given with clonidineCorticosteroids: hypotensive effect of adrenergicneurone blockers antagonised by corticosteroidsDiazoxide: enhanced hypotensive effect when adrenergicneurone blockers given with diazoxideDiuretics: enhanced hypotensive effect when adrenergicneurone blockers given with diureticsDopaminergics: enhanced hypotensive effect whenadrenergic neurone blockers given with levodopaMethyldopa: enhanced hypotensive effect when adrenergicneurone blockers given with methyldopaAdrenergic Neurone Blockers (continued)Moxisylyte: enhanced hypotensive effect when adrenergicneurone blockers given with moxisylyteMoxonidine: enhanced hypotensive effect when adrenergicneurone blockers given with moxonidineMuscle Relaxants: enhanced hypotensive effect whenadrenergic neurone blockers given with baclofen ortizanidineNitrates: enhanced hypotensive effect when adrenergicneurone blockers given with nitratesOestrogens: hypotensive effect of adrenergic neuroneblockers antagonised by oestrogensPizotifen: hypotensive effect of adrenergic neuroneblockers antagonised by pizotifenProstaglandins: enhanced hypotensive effect whenadrenergic neurone blockers given with alprostadil. Sympathomimetics: hypotensive effect of guanethidineantagonised by .dexamfetamine; hypotensiveeffect of adrenergic neurone blockers antagonised by.ephedrine, .isometheptene, .metaraminol,.methylphenidate, .noradrenaline (norepinephrine),.oxymetazoline, .phenylephrine,.pseudoephedrine and .xylometazolineVasodilator Antihypertensives: enhanced hypotensiveeffect when adrenergic neurone blockers given withhydralazine, minoxidil or sodium nitroprussideAdsorbents see KaolinAgalsidase Alfa and BetaAnti-arrhythmics: effects of agalsidase alfa and betapossibly inhibited by amiodarone (manufacturers ofagalsidase alfa and beta advise avoid concomitantuse)Antibacterials: effects of agalsidase alfa and betapossibly inhibited by gentamicin (manufacturers ofagalsidase alfa and beta advise avoid concomitantuse)Antimalarials: effects of agalsidase alfa and betapossibly inhibited by chloroquine and hydroxychloroquine(manufacturers of agalsidase alfa andbeta advise avoid concomitant use)Agomelatine. Antibacterials: manufacturer of agomelatine advisesavoid concomitant use with .ciprofloxacin. Antidepressants: metabolism of agomelatine inhibitedby .fluvoxamine (increased plasma concentration). Antimalarials: avoidance of antidepressants advised bymanufacturer of .artemether/lumefantrineAtomoxetine: possible increased risk of convulsionswhen antidepressants given with atomoxetineAlcoholACE Inhibitors: enhanced hypotensive effect whenalcohol given with ACE inhibitorsAdrenergic Neurone Blockers: enhanced hypotensiveeffect when alcohol given with adrenergic neuroneblockersAlpha-blockers: increased sedative effect when alcoholgiven with indoramin; enhanced hypotensive effectwhen alcohol given with alpha-blockersAnalgesics: enhanced hypotensive and sedative effectswhen alcohol given with opioid analgesicsAngiotensin-II Receptor Antagonists: enhancedhypotensive effect when alcohol given with angiotensin-IIreceptor antagonists. Antibacterials: disulfiram-like reaction when alcoholgiven with metronidazole; possibility of disulfiramlikereaction when alcohol given with tinidazole;increased risk of convulsions when alcohol given with.cycloserine. Anticoagulants: major changes in consumption ofalcohol may affect anticoagulant control with.coumarins or .phenindione. Antidepressants: some beverages containing alcoholand some dealcoholised beverages contain tyraminewhich interacts with .MAOIs (hypertensive crisis)—ifno tyramine, enhanced hypotensive effect; sedativeeffects possibly increased when alcohol given withSSRIs; increased sedative effect when alcohol givenwith .mirtazapine, .tricyclic-relatedantidepressants or .tricyclicsAppendix 1: Interactions