BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 689Diazoxide (continued)Antidepressants: enhanced hypotensive effect whendiazoxide given with MAOIs or tricyclic-relatedantidepressantsAntidiabetics: diazoxide antagonises hypoglycaemiceffect of antidiabeticsAntiepileptics: diazoxide reduces plasma concentrationof phenytoin, also effect of diazoxide may bereducedAntipsychotics: enhanced hypotensive effect whendiazoxide given with phenothiazinesAnxiolytics and Hypnotics: enhanced hypotensiveeffect when diazoxide given with anxiolytics andhypnoticsBeta-blockers: enhanced hypotensive effect whendiazoxide given with beta-blockersCalcium-channel Blockers: enhanced hypotensiveeffect when diazoxide given with calcium-channelblockersClonidine: enhanced hypotensive effect when diazoxidegiven with clonidineCorticosteroids: hypotensive effect of diazoxideantagonised by corticosteroidsDiuretics: enhanced hypotensive and hyperglycaemiceffects when diazoxide given with diureticsDopaminergics: enhanced hypotensive effect whendiazoxide given with levodopaMethyldopa: enhanced hypotensive effect when diazoxidegiven with methyldopaMoxisylyte: enhanced hypotensive effect when diazoxidegiven with moxisylyteMoxonidine: enhanced hypotensive effect when diazoxidegiven with moxonidineMuscle Relaxants: enhanced hypotensive effect whendiazoxide given with baclofen or tizanidineNitrates: enhanced hypotensive effect when diazoxidegiven with nitratesProstaglandins: enhanced hypotensive effect whendiazoxide given with alprostadilVasodilator Antihypertensives: enhanced hypotensiveeffect when diazoxide given with hydralazine,minoxidil or sodium nitroprussideDiclofenac see NSAIDsDicycloverine see AntimuscarinicsDidanosineNote Antacids in tablet formulation may affect absorption ofother drugs. Allopurinol: plasma concentration of didanosineincreased by .allopurinol (risk of toxicity)—avoidconcomitant useAnalgesics: plasma concentration of didanosine possiblyreduced by methadone. Antivirals: plasma concentration of didanosine possiblyincreased by ganciclovir; increased risk of side-effectswhen didanosine given with .ribavirin—avoid concomitantuse; increased risk of side-effects whendidanosine given with .stavudine; plasma concentrationof didanosine increased by .tenofovir(increased risk of toxicity)—avoid concomitant use;plasma concentration of didanosine reduced by.tipranavir. Cytotoxics: increased risk of toxicity when didanosinegiven with .hydroxycarbamide—avoid concomitantuseDienogest see ProgestogensDigoxin see Cardiac GlycosidesDihydrocodeine see Opioid AnalgesicsDiltiazem see Calcium-channel BlockersDimethyl sulfoxide. Analgesics: avoid concomitant use of dimethyl sulfoxidewith .sulindacDinoprostone see ProstaglandinsDiphenoxylate see Opioid AnalgesicsDipipanone see Opioid AnalgesicsDipyridamoleAntacids: absorption of dipyridamole possibly reducedby antacidsDipyridamole (continued). Anti-arrhythmics: dipyridamole enhances and extendsthe effects of .adenosine (important risk of toxicity). Anticoagulants: antiplatelet action of dipyridamoleenhances anticoagulant effect of .coumarins and.phenindione; dipyridamole enhances anticoagulanteffect of heparinsClopidogrel: increased risk of bleeding when dipyridamolegiven with clopidogrelCytotoxics: dipyridamole possibly reduces effects offludarabineDisodium Etidronate see BisphosphonatesDisodium Pamidronate see BisphosphonatesDisopyramideAnaesthetics, Local: increased myocardial depressionwhen anti-arrhythmics given with bupivacaine, levobupivacaine,prilocaine or ropivacaine. Anti-arrhythmics: increased myocardial depressionwhen anti-arrhythmics given with other .antiarrhythmics;increased risk of ventricular arrhythmiaswhen disopyramide given with .amiodarone or.dronedarone—avoid concomitant use. Antibacterials: plasma concentration of disopyramidepossibly increased by .clarithromycin (increased riskof toxicity); plasma concentration of disopyramideincreased by .erythromycin (increased risk of toxicity);increased risk of ventricular arrhythmias whendisopyramide given with .moxifloxacin—avoid concomitantuse; metabolism of disopyramide acceleratedby .rifamycins (reduced plasma concentration). Antidepressants: increased risk of ventricular arrhythmiaswhen disopyramide given with .tricyclicsAntidiabetics: disopyramide possibly enhances hypoglycaemiceffect of gliclazide, insulin and metforminAntiepileptics: metabolism of disopyramide acceleratedby phenobarbital (reduced plasma concentration);plasma concentration of disopyramide reducedby phenytoin. Antifungals: increased risk of ventricular arrhythmiaswhen disopyramide given with .ketoconazole—avoidconcomitant use; avoidance of disopyramide advisedby manufacturer of .itraconazole. Antihistamines: increased risk of ventricular arrhythmiaswhen disopyramide given with .mizolastine—avoid concomitant use. Antimalarials: avoidance of disopyramide advised bymanufacturer of .artemether/lumefantrine (risk ofventricular arrhythmias). Antimuscarinics: increased risk of antimuscarinic sideeffectswhen disopyramide given with antimuscarinics;increased risk of ventricular arrhythmias whendisopyramide given with .tolterodine. Antipsychotics: increased risk of ventricular arrhythmiaswhen anti-arrhythmics that prolong the QTinterval given with .antipsychotics that prolong theQT interval; increased risk of ventricular arrhythmiaswhen disopyramide given with .amisulpride,.droperidol, .pimozide or .zuclopenthixol—avoidconcomitant use; possible increased risk of ventriculararrhythmias when disopyramide given with.haloperidol—avoid concomitant use; increased riskof ventricular arrhythmias when disopyramide givenwith .phenothiazines or .sulpiride. Antivirals: plasma concentration of disopyramidepossibly increased by .ritonavir (increased risk oftoxicity); increased risk of ventricular arrhythmiaswhen disopyramide given with .saquinavir—avoidconcomitant use. Atomoxetine: increased risk of ventricular arrhythmiaswhen disopyramide given with .atomoxetine. Beta-blockers: increased myocardial depression whenanti-arrhythmics given with .beta-blockers; increasedrisk of ventricular arrhythmias when disopyramidegiven with .sotalol—avoid concomitant use. Calcium-channel Blockers: increased risk of myocardialdepression and asystole when disopyramidegiven with .verapamil. Cytotoxics: increased risk of ventricular arrhythmiaswhen disopyramide given with .arsenic trioxideAppendix 1: Interactions