BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 717Paraldehyde (continued). Disulfiram: risk of toxicity when paraldehyde givenwith .disulfiramParasympathomimeticsAnti-arrhythmics: effects of neostigmine and pyridostigminepossibly antagonised by propafenone. Antibacterials: plasma concentration of galantamineincreased by erythromycin; effects ofneostigmine and pyridostigmine antagonised by.aminoglycosides; effects of neostigmine andpyridostigmine antagonised by clindamycin; effectsof neostigmine and pyridostigmine antagonised by.polymyxinsAntidepressants: plasma concentration of galantamineincreased by paroxetineAntifungals: plasma concentration of galantamineincreased by ketoconazoleAntimalarials: effects of neostigmine and pyridostigminemay be diminished because of potential forchloroquine and hydroxychloroquine to increasesymptoms of myasthenia gravisAntimuscarinics: effects of parasympathomimeticsantagonised by antimuscarinicsBeta-blockers: increased risk of arrhythmias whenpilocarpine given with beta-blockers; effects ofneostigmine and pyridostigmine antagonised bypropranololLithium: effects of neostigmine and pyridostigmineantagonised by lithiumMuscle Relaxants: donepezil possibly enhances effectsof suxamethonium; edrophonium, galantamine, neostigmine,pyridostigmine and rivastigmine enhanceeffects of suxamethonium; donepezil possibly antagoniseseffects of non-depolarising muscle relaxants;edrophonium, neostigmine, pyridostigmine and rivastigmineantagonise effects of non-depolarisingmuscle relaxantsParecoxib see NSAIDsParicalcitol see VitaminsParoxetine see Antidepressants, SSRIPazopanib. Antibacterials: manufacturer of pazopanib advisesavoid concomitant use with .clarithromycin,.rifampicin and .telithromycin. Antifungals: manufacturer of pazopanib advises avoidconcomitant use with .itraconazole,.ketoconazole and .voriconazole. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis). Antivirals: manufacturer of pazopanib advises avoidconcomitant use with .atazanavir, .indinavir,.nelfinavir, .ritonavir and .saquinavirCytotoxics: plasma concentration of pazopanibincreased by lapatinib. Grapefruit Juice: manufacturer of pazopanib advisesavoid concomitant use with .grapefruit juicePegfilgrastim see FilgrastimPeginterferon Alfa see InterferonsPemetrexed. Antimalarials: antifolate effect of pemetrexedincreased by .pyrimethamine. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)PenicillamineAnalgesics: possible increased risk of nephrotoxicitywhen penicillamine given with NSAIDsAntacids: absorption of penicillamine reduced byantacids. Antipsychotics: avoid concomitant use of penicillaminewith .clozapine (increased risk of agranulocytosis)Cardiac Glycosides: penicillamine possibly reducesplasma concentration of digoxinGold: manufacturer of penicillamine advises avoidconcomitant use with sodium aurothiomalate(increased risk of toxicity)Iron: absorption of penicillamine reduced by oral ironPenicillamine (continued)Zinc: penicillamine reduces absorption of zinc, alsoabsorption of penicillamine reduced by zincPenicillinsAllopurinol: increased risk of rash when amoxicillin orampicillin given with allopurinolAntibacterials: absorption of phenoxymethylpenicillinreduced by neomycin; effects of penicillins possiblyantagonised by tetracyclinesAnticoagulants: common experience in anticoagulantclinics is that INR can be altered by a course ofbroad-spectrum penicillins such as ampicillin,although studies have failed to demonstrate aninteraction with coumarins or phenindioneCytotoxics: penicillins reduce excretion of methotrexate(increased risk of toxicity)Muscle Relaxants: piperacillin enhances effects ofnon-depolarising muscle relaxants and suxamethoniumProbenecid: excretion of penicillins reduced by probenecid(increased plasma concentration)Sulfinpyrazone: excretion of penicillins reduced bysulfinpyrazoneVaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Pentamidine Isetionate. Anti-arrhythmics: increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with.amiodarone—avoid concomitant use. Antibacterials: increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with parenteral.erythromycin; increased risk of ventriculararrhythmias when pentamidine isetionate given with.moxifloxacin—avoid concomitant use. Antidepressants: increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with.tricyclicsAntifungals: possible increased risk of nephrotoxicitywhen pentamidine isetionate given with amphotericin. Antipsychotics: increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with.amisulpride or .droperidol—avoid concomitant use;increased risk of ventricular arrhythmias when pentamidineisetionate given with .phenothiazines. Antivirals: increased risk of hypocalcaemia whenparenteral pentamidine isetionate given with.foscarnet; increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with.saquinavir—avoid concomitant use. Ivabradine: increased risk of ventricular arrhythmiaswhen pentamidine isetionate given with .ivabradinePentazocine see Opioid AnalgesicsPentostatin. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis). Cytotoxics: increased toxicity when pentostatin givenwith high-dose .cyclophosphamide—avoid concomitantuse; increased pulmonary toxicity whenpentostatin given with .fludarabine (unacceptablyhigh incidence of fatalities)Pentoxifylline. Analgesics: possible increased risk of bleeding whenpentoxifylline given with NSAIDs; increased risk ofbleeding when pentoxifylline given with .ketorolac(avoid concomitant use)Theophylline: pentoxifylline increases plasma concentrationof theophyllinePergolideAntipsychotics: effects of pergolide antagonised byantipsychoticsMemantine: effects of dopaminergics possiblyenhanced by memantineMethyldopa: antiparkinsonian effect of dopaminergicsantagonised by methyldopaMetoclopramide: antiparkinsonian effect of pergolideantagonised by metoclopramidePericyazine see AntipsychoticsAppendix 1: Interactions