BNF for Children 2011-2012

684 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsCilostazol (continued)Ulcer-healing Drugs: plasma concentration of cilostazolincreased by omeprazole (consider reducing doseof cilostazol)Cimetidine see Histamine H 2 -antagonistsCinacalcetAntifungals: metabolism of cinacalcet inhibited byketoconazole (increased plasma concentration). Hormone Antagonists: cinacalcet possibly inhibitsmetabolism of .tamoxifen to active metabolite (avoidconcomitant use)Cinnarizine see AntihistaminesCiprofibrate see FibratesCiprofloxacin see QuinolonesCisatracurium see Muscle RelaxantsCisplatin see Platinum CompoundsCitalopram see Antidepressants, SSRIClarithromycin see MacrolidesClemastine see AntihistaminesClindamycin. Muscle Relaxants: clindamycin enhances effects of.non-depolarising muscle relaxants and.suxamethoniumParasympathomimetics: clindamycin antagoniseseffects of neostigmine and pyridostigmineVaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Clobazam see Anxiolytics and HypnoticsClomethiazole see Anxiolytics and HypnoticsClomipramine see Antidepressants, TricyclicClonazepam see Anxiolytics and HypnoticsClonidineACE Inhibitors: enhanced hypotensive effect whenclonidine given with ACE inhibitors; previous treatmentwith clonidine possibly delays antihypertensiveeffect of captoprilAdrenergic Neurone Blockers: enhanced hypotensiveeffect when clonidine given with adrenergic neuroneblockersAlcohol: enhanced hypotensive effect when clonidinegiven with alcoholAldesleukin: enhanced hypotensive effect when clonidinegiven with aldesleukinAlpha-blockers: enhanced hypotensive effect whenclonidine given with alpha-blockersAnaesthetics, General: enhanced hypotensive effectwhen clonidine given with general anaestheticsAnalgesics: hypotensive effect of clonidine antagonisedby NSAIDsAngiotensin-II Receptor Antagonists: enhancedhypotensive effect when clonidine given with angiotensin-IIreceptor antagonists. Antidepressants: enhanced hypotensive effect whenclonidine given with MAOIs; hypotensive effect ofclonidine possibly antagonised by mirtazapine;hypotensive effect of clonidine antagonised by.tricyclics, also increased risk of hypertension onclonidine withdrawalAntipsychotics: enhanced hypotensive effect whenclonidine given with phenothiazinesAnxiolytics and Hypnotics: enhanced hypotensiveeffect when clonidine given with anxiolytics andhypnotics. Beta-blockers: increased risk of withdrawal hypertensionwhen clonidine given with .beta-blockers(withdraw beta-blockers several days before slowlywithdrawing clonidine)Calcium-channel Blockers: enhanced hypotensiveeffect when clonidine given with calcium-channelblockersCorticosteroids: hypotensive effect of clonidineantagonised by corticosteroidsDiazoxide: enhanced hypotensive effect when clonidinegiven with diazoxideDiuretics: enhanced hypotensive effect when clonidinegiven with diureticsDopaminergics: enhanced hypotensive effect whenclonidine given with levodopaClonidine (continued)Histamine: avoidance of clonidine advised by manufacturerof histamineMethyldopa: enhanced hypotensive effect whenclonidine given with methyldopaMoxisylyte: enhanced hypotensive effect when clonidinegiven with moxisylyteMoxonidine: enhanced hypotensive effect when clonidinegiven with moxonidineMuscle Relaxants: enhanced hypotensive effect whenclonidine given with baclofen or tizanidineNitrates: enhanced hypotensive effect when clonidinegiven with nitratesOestrogens: hypotensive effect of clonidine antagonisedby oestrogensProstaglandins: enhanced hypotensive effect whenclonidine given with alprostadil. Sympathomimetics: possible risk of hypertensionwhen clonidine given with adrenaline(epinephrine) or noradrenaline (norepinephrine);serious adverse events reported with concomitantuse of clonidine and .methylphenidate (causality notestablished)Vasodilator Antihypertensives: enhanced hypotensiveeffect when clonidine given with hydralazine,minoxidil or sodium nitroprussideClopamide see DiureticsClopidogrelAnalgesics: increased risk of bleeding when clopidogrelgiven with NSAIDs or aspirin. Antibacterials: antiplatelet effect of clopidogrel possiblyreduced by .chloramphenicol, .ciprofloxacin and.erythromycin. Anticoagulants: manufacturer of clopidogrel advisesavoid concomitant use with .warfarin; antiplateletaction of clopidogrel enhances anticoagulant effect of.coumarins and .phenindione; increased risk ofbleeding when clopidogrel given with heparins. Antidepressants: antiplatelet effect of clopidogrelpossibly reduced by .fluoxetine, .fluvoxamine and.moclobemide. Antiepileptics: antiplatelet effect of clopidogrel possiblyreduced by .carbamazepine and .oxcarbazepine. Antifungals: antiplatelet effect of clopidogrel possiblyreduced by .fluconazole, .itraconazole,.ketoconazole and .voriconazole. Antivirals: antiplatelet effect of clopidogrel possiblyreduced by .etravirineDipyridamole: increased risk of bleeding when clopidogrelgiven with dipyridamoleIloprost: increased risk of bleeding when clopidogrelgiven with iloprostPrasugrel: possible increased risk of bleeding whenclopidogrel given with prasugrel. Ulcer-healing Drugs: antiplatelet effect of clopidogrelpossibly reduced by .cimetidine, lansoprazole,pantoprazole and rabeprazole; antiplatelet effect ofclopidogrel reduced by .esomeprazole and.omeprazoleClotrimazole see Antifungals, ImidazoleClozapine see AntipsychoticsCo-amoxiclav see PenicillinsCo-beneldopa see LevodopaCo-careldopa see LevodopaCodeine see Opioid AnalgesicsCo-fluampicil see PenicillinsColchicine. Anti-arrhythmics: possible increased risk of colchicinetoxicity when given with .amiodarone. Antibacterials: possible increased risk of colchicinetoxicity when given with .azithromycin,.clarithromycin, .erythromycin and .telithromycin—suspend or reduce dose of colchicine (avoid concomitantuse in hepatic or renal impairment). Antifungals: possible increased risk of colchicinetoxicity when given with .itraconazole and.ketoconazole—suspend or reduce dose of