BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 677Beta-blockers (continued)Ulcer-healing Drugs: plasma concentration of labetalol,metoprolol and propranolol increased by cimetidineVasodilator Antihypertensives: enhanced hypotensiveeffect when beta-blockers given with hydralazine,minoxidil or sodium nitroprussideBetahistineAntihistamines: effect of betahistine theoreticallyantagonised by antihistaminesBetamethasone see CorticosteroidsBetaxolol see Beta-blockersBethanechol see ParasympathomimeticsBexarotene. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis). Lipid-regulating Drugs: plasma concentration of bexaroteneincreased by .gemfibrozil—avoid concomitantuseBezafibrate see FibratesBicalutamideAnticoagulants: bicalutamide possibly enhances anticoagulanteffect of coumarinsBiguanides see AntidiabeticsBile Acid Sequestrants see Colesevelam, Colestipol,and ColestyramineBile AcidsAntacids: absorption of bile acids possibly reduced byantacids. Ciclosporin: ursodeoxycholic acid increases absorptionof .ciclosporinLipid-regulating Drugs: absorption of bile acids possiblyreduced by colestipol and colestyramineBisoprolol see Beta-blockersBisphosphonatesAnalgesics: bioavailability of tiludronic acid increasedby indometacinAntacids: absorption of bisphosphonates reduced byantacidsAntibacterials: increased risk of hypocalcaemia whenbisphosphonates given with aminoglycosidesCalcium Salts: absorption of bisphosphonates reducedby calcium salts. Cytotoxics: sodium clodronate increases plasma concentrationof .estramustineIron: absorption of bisphosphonates reduced by oralironBleomycin. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Cardiac Glycosides: bleomycin possibly reducesabsorption of digoxin tablets. Cytotoxics: increased pulmonary toxicity when bleomycingiven with .cisplatinBortezomibAntifungals: plasma concentration of bortezomibincreased by ketoconazole. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Bosentan. Antibacterials: plasma concentration of bosentanreduced by .rifampicin—avoid concomitant useAnticoagulants: manufacturer of bosentan recommendsmonitoring anticoagulant effect of coumarins. Antidiabetics: increased risk of hepatotoxicity whenbosentan given with .glibenclamide—avoid concomitantuse. Antifungals: plasma concentration of bosentanincreased by ketoconazole; plasma concentration ofbosentan possibly increased by .fluconazole—avoidconcomitant use; plasma concentration of bosentanpossibly increased by itraconazoleAntivirals: plasma concentration of bosentan possiblyincreased by ritonavir. Ciclosporin: plasma concentration of bosentanincreased by .ciclosporin (also plasma concentrationof ciclosporin reduced—avoid concomitant use)Bosentan (continued)Lipid-regulating Drugs: bosentan reduces plasmaconcentration of simvastatin. Oestrogens: bosentan possibly causes contraceptivefailure of hormonal contraceptives containing.oestrogens (alternative contraception recommended). Progestogens: bosentan possibly causes contraceptivefailure of hormonal contraceptives containing.progestogens (alternative contraception recommended)Sildenafil: bosentan reduces plasma concentration ofsildenafilTadalafil: bosentan reduces plasma concentration oftadalafilBrimonidineAntidepressants: manufacturer of brimonidine advisesavoid concomitant use with MAOIs, tricyclic-relatedantidepressants and tricyclicsBrinzolamide see DiureticsBromocriptineAlcohol: tolerance of bromocriptine reduced by alcoholAntibacterials: plasma concentration of bromocriptineincreased by erythromycin (increased risk of toxicity);plasma concentration of bromocriptine possiblyincreased by macrolides (increased risk of toxicity)Antipsychotics: hypoprolactinaemic and antiparkinsonianeffects of bromocriptine antagonised byantipsychoticsDomperidone: hypoprolactinaemic effect of bromocriptinepossibly antagonised by domperidoneHormone Antagonists: plasma concentration ofbromocriptine increased by octreotideMemantine: effects of dopaminergics possiblyenhanced by memantineMethyldopa: antiparkinsonian effect of dopaminergicsantagonised by methyldopaMetoclopramide: hypoprolactinaemic effect ofbromocriptine antagonised by metoclopramide. Sympathomimetics: risk of toxicity when bromocriptinegiven with .isomethepteneBuclizine see AntihistaminesBudesonide see CorticosteroidsBumetanide see DiureticsBupivacaineAnti-arrhythmics: increased myocardial depressionwhen bupivacaine given with anti-arrhythmics. Beta-blockers: increased risk of bupivacaine toxicitywhen given with .propranololBuprenorphine see Opioid AnalgesicsBupropion. Antidepressants: bupropion possibly increases plasmaconcentration of citalopram; manufacturer of bupropionadvises avoid for 2 weeks after stopping.MAOIs; manufacturer of bupropion advises avoidconcomitant use with .moclobemide; bupropionpossibly increases plasma concentration of tricyclics(possible increased risk of convulsions)Antiepileptics: plasma concentration of bupropionreduced by carbamazepine and phenytoin; metabolismof bupropion inhibited by valproateAntivirals: plasma concentration of bupropion reducedby ritonavirAtomoxetine: possible increased risk of convulsionswhen bupropion given with atomoxetineDopaminergics: increased risk of side-effects whenbupropion given with amantadine or levodopa. Hormone Antagonists: bupropion possibly inhibitsmetabolism of .tamoxifen to active metabolite (avoidconcomitant use)Buspirone see Anxiolytics and HypnoticsBusulfanAnalgesics: metabolism of intravenous busulfan possiblyinhibited by paracetamol (manufacturer ofintravenous busulfan advises caution within 72 hoursof paracetamol)Appendix 1: Interactions