BNF for Children 2011-2012

688 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsDacarbazine. Aldesleukin: avoidance of dacarbazine advised bymanufacturer of .aldesleukin. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Dairy ProductsAntibacterials: dairy products reduce absorption ofciprofloxacin and norfloxacin; dairy products reduceabsorption of tetracyclines (except doxycycline andminocycline)Eltrombopag: dairy products possibly reduce absorptionof eltrombopag (give at least 4 hours apart)Dalteparin see HeparinsDanazol. Anticoagulants: danazol inhibits metabolism of.coumarins (enhanced anticoagulant effect). Antiepileptics: danazol inhibits metabolism of.carbamazepine (increased risk of toxicity). Ciclosporin: danazol inhibits metabolism of.ciclosporin (increased plasma concentration). Lipid-regulating Drugs: possible increased risk ofmyopathy when danazol given with .simvastatinTacrolimus: danazol possibly increases plasma concentrationof tacrolimusDantrolene see Muscle RelaxantsDapsoneAntibacterials: plasma concentration of dapsonereduced by rifamycins; plasma concentration of bothdrugs may increase when dapsone given withtrimethoprim. Antivirals: increased risk of ventricular arrhythmiaswhen dapsone given with .saquinavir—avoid concomitantuseProbenecid: excretion of dapsone reduced by probenecid(increased risk of side-effects)Vaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Daptomycin. Ciclosporin: increased risk of myopathy when daptomycingiven with .ciclosporin (preferably avoidconcomitant use). Lipid-regulating Drugs: increased risk of myopathywhen daptomycin given with .fibrates or .statins(preferably avoid concomitant use)Vaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Darifenacin see AntimuscarinicsDarunavirAnti-arrhythmics: darunavir possibly increases plasmaconcentration of lidocaine—avoid concomitant use. Antibacterials: darunavir increases plasma concentrationof .rifabutin (reduce dose of rifabutin); plasmaconcentration of darunavir significantly reduced by.rifampicin—avoid concomitant useAnticoagulants: avoidance of darunavir advised bymanufacturer of rivaroxaban. Antidepressants: darunavir possibly reduces plasmaconcentration of paroxetine and sertraline; plasmaconcentration of darunavir reduced by .St John’swort—avoid concomitant useAntiepileptics: plasma concentration of darunavirpossibly reduced by carbamazepine,phenobarbital and phenytoinAntifungals: plasma concentration of both drugsincreased when darunavir given with ketoconazole. Antimalarials: caution with darunavir advised bymanufacturer of artemether/lumefantrine; darunavirpossibly increases plasma concentration of .quinine(increased risk of toxicity). Antivirals: plasma concentration of darunavir reducedby efavirenz and saquinavir; plasma concentration ofboth drugs increased when darunavir given withindinavir; plasma concentration of darunavir reducedby .lopinavir, also plasma concentration of lopinavirincreased (avoid concomitant use); darunavirincreases plasma concentration of .maraviroc (considerreducing dose of maraviroc)Darunavir (continued). Cytotoxics: darunavir possibly increases plasma concentrationof .everolimus—manufacturer of everolimusadvises avoid concomitant use. Lipid-regulating Drugs: darunavir possibly increasesplasma concentration of pravastatin; possibleincreased risk of myopathy when darunavir givenwith .rosuvastatin—manufacturer of rosuvastatinadvises avoid concomitant use. Ranolazine: darunavir possibly increases plasma concentrationof .ranolazine—manufacturer of ranolazineadvises avoid concomitant useDasatinib. Antibacterials: metabolism of dasatinib accelerated by.rifampicin (reduced plasma concentration—avoidconcomitant use)Antifungals: plasma concentration of dasatinib possiblyincreased by ketoconazole. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Lipid-regulating Drugs: dasatinib possibly increasesplasma concentration of simvastatinUlcer-healing Drugs: plasma concentration of dasatinibpossibly reduced by famotidineDeferasiroxAntacids: absorption of deferasirox possibly reducedby antacids containing aluminium (manufacturer ofdeferasirox advises avoid concomitant use)Antibacterials: plasma concentration of deferasiroxreduced by rifampicinAntidiabetics: deferasirox increases plasma concentrationof repaglinideAnxiolytics and Hypnotics: deferasirox possiblyreduces plasma concentration of midazolamDeflazacort see CorticosteroidsDemeclocycline see TetracyclinesDesferrioxamineAntipsychotics: avoidance of desferrioxamine advisedby manufacturer of levomepromazine; manufacturerof desferrioxamine advises avoid concomitant usewith prochlorperazineDesflurane see Anaesthetics, GeneralDesloratadine see AntihistaminesDesmopressinAnalgesics: effects of desmopressin enhanced byindometacinLoperamide: plasma concentration of oral desmopressinincreased by loperamideDesogestrel see ProgestogensDexamethasone see CorticosteroidsDexamfetamine see SympathomimeticsDexibuprofen see NSAIDsDexketoprofen see NSAIDsDextromethorphan see Opioid AnalgesicsDextropropoxyphene see Opioid AnalgesicsDiamorphine see Opioid AnalgesicsDiazepam see Anxiolytics and HypnoticsDiazoxideACE Inhibitors: enhanced hypotensive effect whendiazoxide given with ACE inhibitorsAdrenergic Neurone Blockers: enhanced hypotensiveeffect when diazoxide given with adrenergic neuroneblockersAlcohol: enhanced hypotensive effect when diazoxidegiven with alcoholAldesleukin: enhanced hypotensive effect when diazoxidegiven with aldesleukinAlpha-blockers: enhanced hypotensive effect whendiazoxide given with alpha-blockersAnaesthetics, General: enhanced hypotensive effectwhen diazoxide given with general anaestheticsAnalgesics: hypotensive effect of diazoxide antagonisedby NSAIDsAngiotensin-II Receptor Antagonists: enhancedhypotensive effect when diazoxide given with angiotensin-IIreceptor antagonists