BNF for Children 2011-2012

662 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsAngiotensin-II Receptor Antagonists (continued)Alpha-blockers: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with alphablockersAnaesthetics, General: enhanced hypotensive effectwhen angiotensin-II receptor antagonists given withgeneral anaestheticsAnalgesics: increased risk of renal impairment whenangiotensin-II receptor antagonists given withNSAIDs, also hypotensive effect antagonisedAntibacterials: plasma concentration of losartan andits active metabolite reduced by rifampicin; possibleincreased risk of hyperkalaemia when angiotensin-IIreceptor antagonists given with trimethoprimAnticoagulants: increased risk of hyperkalaemia whenangiotensin-II receptor antagonists given withheparinsAntidepressants: hypotensive effect of angiotensin-IIreceptor antagonists possibly enhanced by MAOIsAntipsychotics: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with antipsychoticsAnxiolytics and Hypnotics: enhanced hypotensiveeffect when angiotensin-II receptor antagonists givenwith anxiolytics and hypnoticsBeta-blockers: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with betablockersCalcium-channel Blockers: enhanced hypotensiveeffect when angiotensin-II receptor antagonists givenwith calcium-channel blockers. Ciclosporin: increased risk of hyperkalaemia whenangiotensin-II receptor antagonists given with.ciclosporinClonidine: enhanced hypotensive effect when angiotensin-IIreceptor antagonists given with clonidineCorticosteroids: hypotensive effect of angiotensin-IIreceptor antagonists antagonised by corticosteroidsDiazoxide: enhanced hypotensive effect when angiotensin-IIreceptor antagonists given with diazoxide. Diuretics: enhanced hypotensive effect when angiotensin-IIreceptor antagonists given with .diuretics;increased risk of hyperkalaemia when angiotensin-IIreceptor antagonists given with .potassium-sparingdiuretics and aldosterone antagonistsDopaminergics: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with levodopa. Lithium: angiotensin-II receptor antagonists reduceexcretion of .lithium (increased plasma concentration)Methyldopa: enhanced hypotensive effect whenangiotensin-II receptor antagonists given withmethyldopaMoxisylyte: enhanced hypotensive effect when angiotensin-IIreceptor antagonists given with moxisylyteMoxonidine: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with moxonidineMuscle Relaxants: enhanced hypotensive effect whenangiotensin-II receptor antagonists given withbaclofen or tizanidineNitrates: enhanced hypotensive effect when angiotensin-IIreceptor antagonists given with nitratesOestrogens: hypotensive effect of angiotensin-IIreceptor antagonists antagonised by oestrogens. Potassium Salts: increased risk of hyperkalaemiawhen angiotensin-II receptor antagonists given with.potassium saltsProstaglandins: enhanced hypotensive effect whenangiotensin-II receptor antagonists given with alprostadilTacrolimus: increased risk of hyperkalaemia whenangiotensin-II receptor antagonists given with tacrolimusVasodilator Antihypertensives: enhanced hypotensiveeffect when angiotensin-II receptor antagonists givenwith hydralazine, minoxidil or sodium nitroprussideAntacidsNote Antacids should preferably not be taken at the sametime as other drugs since they may impair absorptionACE Inhibitors: antacids possibly reduce absorption ofACE inhibitors; antacids reduce absorption ofcaptopril, enalapril and fosinoprilAnalgesics: alkaline urine due to some antacidsincreases excretion of aspirinAntibacterials: antacids reduce absorption of azithromycin,cefaclor, cefpodoxime, ciprofloxacin, isoniazid,levofloxacin, moxifloxacin, norfloxacin,ofloxacin, rifampicin and tetracyclines; avoid concomitantuse of antacids with methenamine; oralmagnesium salts (as magnesium trisilicate) reduceabsorption of nitrofurantoinAntiepileptics: antacids reduce absorption ofgabapentin and phenytoinAntifungals: antacids reduce absorption ofitraconazole and ketoconazoleAntihistamines: antacids reduce absorption of fexofenadineAntimalarials: antacids reduce absorption of chloroquineand hydroxychloroquine; oral magnesium salts(as magnesium trisilicate) reduce absorption of proguanilAntipsychotics: antacids reduce absorption ofphenothiazines and sulpirideAntivirals: antacids possibly reduce plasma concentrationof atazanavir; antacids reduce absorption oftipranavirBile Acids: antacids possibly reduce absorption of bileacidsBisphosphonates: antacids reduce absorption of bisphosphonatesCardiac Glycosides: antacids possibly reduce absorptionof digoxinCorticosteroids: antacids reduce absorption of deflazacort. Cytotoxics: antacids possibly reduce plasma concentrationof .erlotinib—give antacids at least 4 hoursbefore or 2 hours after erlotinibDeferasirox: antacids containing aluminium possiblyreduce absorption of deferasirox (manufacturer ofdeferasirox advises avoid concomitant use)Dipyridamole: antacids possibly reduce absorption ofdipyridamoleEltrombopag: antacids reduce absorption of eltrombopag(give at least 4 hours apart)Iron: oral magnesium salts (as magnesium trisilicate)reduce absorption of oral ironLipid-regulating Drugs: antacids reduce absorption ofrosuvastatinLithium: sodium bicarbonate increases excretion oflithium (reduced plasma concentration)Mycophenolate: antacids reduce absorption of mycophenolatePenicillamine: antacids reduce absorption of penicillaminePolystyrene Sulphonate Resins: risk of intestinalobstruction when aluminium hydroxide given withpolystyrene sulphonate resins; risk of metabolicalkalosis when oral magnesium salts given withpolystyrene sulphonate resinsThyroid Hormones: antacids possibly reduce absorptionof levothyroxineUlcer-healing Drugs: antacids possibly reduceabsorption of lansoprazole. Ulipristal: avoidance of antacids advised by manufacturerof .ulipristal (plasma concentration of ulipristalpossibly reduced)Antazoline see AntihistaminesAnti-arrhythmics see Adenosine, Amiodarone, Disopyramide,Dronedarone, Flecainide, Lidocaine, andPropafenoneAntibacterials see individual drugsAntibiotics (cytotoxic) see Bleomycin, Doxorubicin,Epirubicin, Idarubicin, Mitomycin, and Mitoxantrone