BNF for Children 2011-2012

694 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsErlotinib (continued). Antacids: plasma concentration of erlotinib possiblyreduced by .antacids—give antacids at least 4 hoursbefore or 2 hours after erlotinibAntibacterials: plasma concentration of erlotinibincreased by ciprofloxacin; metabolism of erlotinibaccelerated by rifampicin (reduced plasma concentration). Anticoagulants: increased risk of bleeding whenerlotinib given with .coumarinsAntifungals: metabolism of erlotinib inhibited byketoconazole (increased plasma concentration). Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Cytotoxics: plasma concentration of erlotinib possiblyincreased by capecitabine. Ulcer-healing Drugs: manufacturer of erlotinib advisesavoid concomitant use with .cimetidine,.esomeprazole, .famotidine, .lansoprazole,.nizatidine, .pantoprazole and .rabeprazole; plasmaconcentration of erlotinib reduced by .ranitidine—manufacturer of erlotinib advises give at least 2 hoursbefore or 10 hours after ranitidine; plasma concentrationof erlotinib reduced by .omeprazole—manufacturerof erlotinib advises avoid concomitant useErtapenem. Antiepileptics: carbapenems reduce plasma concentrationof .valproate—avoid concomitant useVaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Erythromycin see MacrolidesEscitalopram see Antidepressants, SSRIEslicarbazepineAnticoagulants: eslicarbazepine reduces plasma concentrationof warfarin. Antidepressants: anticonvulsant effect of antiepilepticspossibly antagonised by MAOIs and .tricyclic-relatedantidepressants (convulsive threshold lowered); anticonvulsanteffect of antiepileptics antagonised by.SSRIs and .tricyclics (convulsive thresholdlowered); avoid concomitant use of antiepilepticswith .St John’s wortAntiepileptics: plasma concentration of both drugsreduced when eslicarbazepine given with carbamazepine;manufacturer of eslicarbazepine advisesavoid concomitant use with oxcarbazepine; plasmaconcentration of eslicarbazepine reduced by phenytoin,also plasma concentration of phenytoinincreased. Antimalarials: possible increased risk of convulsionswhen antiepileptics given with chloroquine andhydroxychloroquine; anticonvulsant effect of antiepilepticsantagonised by .mefloquine. Antipsychotics: anticonvulsant effect of antiepilepticsantagonised by .antipsychotics (convulsive thresholdlowered). Oestrogens: eslicarbazepine accelerates metabolism of.oestrogens (reduced contraceptive effect—seep. 398). Orlistat: possible increased risk of convulsions whenantiepileptics given with .orlistat. Progestogens: eslicarbazepine accelerates metabolismof .progestogens (reduced contraceptive effect—seep. 398)Esmolol see Beta-blockersEsomeprazole see Proton Pump InhibitorsEstradiol see OestrogensEstramustine. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis). Bisphosphonates: plasma concentration of estramustineincreased by .sodium clodronateEstriol see OestrogensEstrone see OestrogensEtanercept. Abatacept: avoid concomitant use of etanercept with.abataceptEtanercept (continued). Anakinra: avoid concomitant use of etanercept with.anakinra. Vaccines: avoid concomitant use of etanercept withlive .vaccines (see p. 599)Ethinylestradiol see OestrogensEthosuximide. Antibacterials: metabolism of ethosuximide inhibitedby .isoniazid (increased plasma concentration andrisk of toxicity). Antidepressants: anticonvulsant effect of antiepilepticspossibly antagonised by MAOIs and .tricyclic-relatedantidepressants (convulsive threshold lowered); anticonvulsanteffect of antiepileptics antagonised by.SSRIs and .tricyclics (convulsive thresholdlowered); avoid concomitant use of antiepilepticswith .St John’s wort. Antiepileptics: plasma concentration of ethosuximidepossibly reduced by carbamazepine and phenobarbital;plasma concentration of ethosuximide possiblyreduced by .phenytoin, also plasma concentration ofphenytoin possibly increased; plasma concentrationof ethosuximide possibly increased by valproate. Antimalarials: possible increased risk of convulsionswhen antiepileptics given with chloroquine andhydroxychloroquine; anticonvulsant effect of antiepilepticsantagonised by .mefloquine. Antipsychotics: anticonvulsant effect of antiepilepticsantagonised by .antipsychotics (convulsive thresholdlowered). Orlistat: possible increased risk of convulsions whenantiepileptics given with .orlistatEtodolac see NSAIDsEtomidate see Anaesthetics, GeneralEtonogestrel see ProgestogensEtoposide. Anticoagulants: etoposide possibly enhances anticoagulanteffect of .coumarinsAntiepileptics: plasma concentration of etoposidepossibly reduced by phenobarbital and phenytoin. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Ciclosporin: plasma concentration of etoposide possiblyincreased by ciclosporin (increased risk oftoxicity)Etoricoxib see NSAIDsEtravirine. Antibacterials: plasma concentration of etravirineincreased by .clarithromycin, also plasma concentrationof clarithromycin reduced; plasma concentrationof both drugs reduced when etravirine givenwith .rifabutin; manufacturer of etravirine advisesavoid concomitant use with rifampicinAntidepressants: manufacturer of etravirine advisesavoid concomitant use with St John’s wortAntiepileptics: manufacturer of etravirine advisesavoid concomitant use with carbamazepine,phenobarbital and phenytoin. Antivirals: plasma concentration of etravirine possiblyreduced by .efavirenz and .nevirapine—avoid concomitantuse; etravirine increases plasma concentrationof .fosamprenavir (consider reducing dose offosamprenavir); etravirine possibly reduces plasmaconcentration of .indinavir—avoid concomitant use;etravirine possibly reduces plasma concentration ofmaraviroc; etravirine possibly increases plasma concentrationof nelfinavir—avoid concomitant use;plasma concentration of etravirine reduced by.tipranavir, also plasma concentration of tipranavirincreased (avoid concomitant use)Cardiac Glycosides: etravirine increases plasma concentrationof digoxin. Clopidogrel: etravirine possibly reduces antiplateleteffect of .clopidogrelLipid-regulating Drugs: etravirine possibly reducesplasma concentration of atorvastatinSildenafil: etravirine reduces plasma concentration ofsildenafil