BNF for Children 2011-2012

692 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsDoripenem (continued)Probenecid: excretion of doripenem reduced by probenecid(manufacturers of doripenem advise avoidconcomitant use)Vaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Dorzolamide see DiureticsDosulepin see Antidepressants, TricyclicDoxapram. Anaesthetics, General: increased risk of arrhythmiaswhen doxapram given with .volatile liquid generalanaesthetics (avoid doxapram for at least 10 minutesafter volatile liquid general anaesthetics)Antidepressants: effects of doxapram enhanced byMAOIsSympathomimetics: increased risk of hypertensionwhen doxapram given with sympathomimeticsTheophylline: increased CNS stimulation when doxapramgiven with theophyllineDoxazosin see Alpha-blockersDoxepin see Antidepressants, TricyclicDoxorubicin. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Antivirals: doxorubicin possibly inhibits effects ofstavudineCalcium-channel Blockers: plasma concentration ofdoxorubicin possibly increased by verapamilCardiac Glycosides: doxorubicin possibly reducesabsorption of digoxin tablets. Ciclosporin: increased risk of neurotoxicity whendoxorubicin given with .ciclosporinCytotoxics: plasma concentration of doxorubicin possiblyincreased by sorafenibDoxycycline see TetracyclinesDronedaroneAnaesthetics, 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 dronedarone given with .amiodarone or.disopyramide—avoid concomitant use. Antibacterials: manufacturer of dronedarone advisesavoid concomitant use with .clarithromycin or.telithromycin (risk of ventricular arrhythmias);plasma concentration of dronedarone possiblyincreased by .erythromycin (increased risk ofventricular arrhythmias—avoid concomitant use);plasma concentration of dronedarone reduced by.rifampicin—avoid concomitant use. Antidepressants: plasma concentration of dronedaronepossibly reduced by .St John’s wort—avoidconcomitant use; manufacturer of dronedaroneadvises avoid concomitant use with .tricyclics (risk ofventricular arrhythmias). Antiepileptics: plasma concentration of dronedaronepossibly reduced by .carbamazepine,.phenobarbital and .phenytoin—avoid concomitantuse. Antifungals: plasma concentration of dronedaroneincreased by .ketoconazole—avoid concomitant use;manufacturer of dronedarone advises avoid concomitantuse with .itraconazole, .posaconazole and.voriconazole. Antipsychotics: increased risk of ventricular arrhythmiaswhen anti-arrhythmics that prolong the QTinterval given with .antipsychotics that prolong theQT interval; manufacturer of dronedarone advisesavoid concomitant use with .phenothiazines (risk ofventricular arrhythmias). Antivirals: manufacturer of dronedarone advises avoidconcomitant use with .ritonavir; increased risk ofventricular arrhythmias when dronedarone givenwith .saquinavir—avoid concomitant use. Beta-blockers: increased myocardial depression whenanti-arrhythmics given with .beta-blockers; drone-Dronedarone. Beta-blockers (continued)darone possibly increases plasma concentrationof metoprolol and propranolol; increased risk ofventricular arrhythmias when dronedarone givenwith .sotalol—avoid concomitant use. Calcium-channel Blockers: plasma concentration ofdronedarone increased by .nifedipine; increased riskof bradycardia and myocardial depression whendronedarone given with .diltiazem and .verapamil. Cardiac Glycosides: dronedarone increases plasmaconcentration of .digoxin (halve dose of digoxin). Grapefruit Juice: plasma concentration of dronedaroneincreased by .grapefruit juice—avoid concomitantuse. Lipid-regulating Drugs: increased risk of myopathywhen dronedarone given with .simvastatinSirolimus: manufacturer of dronedarone advisescaution with sirolimusTacrolimus: manufacturer of dronedarone advisescaution with tacrolimusDroperidol see AntipsychoticsDrospirenone see ProgestogensDrotrecogin Alfa. Anticoagulants: manufacturer of drotrecogin alfaadvises avoid concomitant use with high doses of.heparins—consult product literatureDuloxetineAnalgesics: possible increased serotonergic effectswhen duloxetine given with pethidine or tramadol. Antibacterials: metabolism of duloxetine inhibited by.ciprofloxacin—avoid concomitant use. Antidepressants: metabolism of duloxetine inhibitedby .fluvoxamine—avoid concomitant use; possibleincreased serotonergic effects when duloxetine givenwith SSRIs, St John’s wort, amitriptyline, clomipramine,.moclobemide, tryptophan or venlafaxine;duloxetine should not be started until 2 weeks afterstopping .MAOIs, also MAOIs should not be starteduntil at least 5 days after stopping duloxetine; afterstopping SSRI-related antidepressants do not start.moclobemide for at least 1 week. Antimalarials: avoidance of antidepressants advised bymanufacturer of .artemether/lumefantrineAtomoxetine: possible increased risk of convulsionswhen antidepressants given with atomoxetine5HT 1 Agonists: possible increased serotonergic effectswhen duloxetine given with 5HT 1 agonistsDutasterideCalcium-channel Blockers: plasma concentration ofdutasteride increased by diltiazem and verapamilDydrogesterone see ProgestogensEdrophonium see ParasympathomimeticsEfavirenzAnalgesics: efavirenz reduces plasma concentration ofmethadoneAntibacterials: increased risk of rash when efavirenzgiven with clarithromycin; efavirenz reduces plasmaconcentration of rifabutin—increase dose of rifabutin;plasma concentration of efavirenz reduced by rifampicin—increasedose of efavirenz. Anticoagulants: efavirenz possibly affects plasmaconcentration of .warfarin. Antidepressants: plasma concentration of efavirenzreduced by .St John’s wort—avoid concomitant useAntiepileptics: plasma concentration of both drugsreduced when efavirenz given with carbamazepine. Antifungals: efavirenz reduces plasma concentration ofitraconazole and .posaconazole; efavirenz reducesplasma concentration of .voriconazole, also plasmaconcentration of efavirenz increased (increase voriconazoledose and reduce efavirenz dose); efavirenzpossibly reduces plasma concentration of caspofungin—considerincreasing dose of caspofungin. Antipsychotics: efavirenz possibly reduces plasmaconcentration of .aripiprazole—increase dose ofaripiprazole; efavirenz possibly increases plasma