BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 723Prostaglandins (continued)Diuretics: enhanced hypotensive effect when alprostadilgiven with diureticsMethyldopa: enhanced hypotensive effect whenalprostadil given with methyldopaMoxonidine: enhanced hypotensive effect whenalprostadil given with moxonidineNitrates: enhanced hypotensive effect when alprostadilgiven with nitratesOxytocin: prostaglandins potentiate uterotonic effect ofoxytocinVasodilator Antihypertensives: enhanced hypotensiveeffect when alprostadil given with hydralazine,minoxidil or sodium nitroprussideProtein Kinase Inhibitors see Dasatinib, Erlotinib,Everolimus, Gefitinib, Imatinib, Lapatinib, Nilotinib,Pazopanib, Sorafenib, Sunitinib, and TemsirolimusProton Pump InhibitorsAntacids: absorption of lansoprazole possibly reducedby antacidsAntibacterials: plasma concentration of both drugsincreased when omeprazole given with clarithromycin. Anticoagulants: esomeprazole, omeprazole and pantoprazolepossibly enhance anticoagulant effect of.coumarinsAntidepressants: omeprazole increases plasma concentrationof escitalopram; plasma concentration oflansoprazole possibly increased by fluvoxamine;plasma concentration of omeprazole possiblyreduced by St John’s wort. Antiepileptics: esomeprazole enhances effects of.phenytoin; omeprazole possibly enhances effects ofphenytoinAntifungals: proton pump inhibitors reduce absorptionof itraconazole and ketoconazole; avoidance ofproton pump inhibitors advised by manufacturer ofposaconazole (plasma concentration of posaconazolepossibly reduced); plasma concentration of esomeprazolepossibly increased by voriconazole; plasmaconcentration of omeprazole increased by voriconazole(consider reducing dose of omeprazole)Antipsychotics: omeprazole possibly reduces plasmaconcentration of clozapine. Antivirals: proton pump inhibitors reduce plasmaconcentration of .atazanavir—avoid or adjust dose ofboth drugs (consult product literature); omeprazolereduces plasma concentration of .nelfinavir—avoidconcomitant use; proton pump inhibitors possiblyincrease plasma concentration of raltegravir—manufacturerof raltegravir advises avoid concomitantuse; omeprazole increases plasma concentration of.raltegravir—avoid concomitant use; esomeprazole,lansoprazole, pantoprazole and rabeprazole possiblyincrease plasma concentration of .saquinavir—manufacturerof saquinavir advises avoid concomitantuse; omeprazole increases plasma concentration of.saquinavir—manufacturer of saquinavir advisesavoid concomitant use; plasma concentration ofesomeprazole and omeprazole reduced by.tipranavirAnxiolytics and Hypnotics: esomeprazole and omeprazolepossibly inhibit metabolism of diazepam(increased plasma concentration)Cardiac Glycosides: proton pump inhibitors possiblyslightly increase plasma concentration of digoxinCiclosporin: omeprazole possibly affects plasma concentrationof ciclosporinCilostazol: omeprazole increases plasma concentrationof cilostazol (consider reducing dose of cilostazol). Clopidogrel: esomeprazole and omeprazole reduceantiplatelet effect of .clopidogrel; lansoprazole,pantoprazole and rabeprazole possibly reduce antiplateleteffect of clopidogrel. Cytotoxics: omeprazole possibly reduces excretion ofmethotrexate (increased risk of toxicity); avoidanceof esomeprazole, lansoprazole, pantoprazole andrabeprazole advised by manufacturer of .erlotinib;omeprazole reduces plasma concentration ofProton Pump Inhibitors. Cytotoxics (continued).erlotinib—manufacturer of erlotinib advises avoidconcomitant use; proton pump inhibitors possiblyreduce absorption of lapatinibTacrolimus: omeprazole possibly increases plasmaconcentration of tacrolimusUlcer-healing Drugs: absorption of lansoprazole possiblyreduced by sucralfate. Ulipristal: avoidance of proton pump inhibitors advisedby manufacturer of .ulipristal (plasma concentrationof ulipristal possibly reduced)Pseudoephedrine see SympathomimeticsPyrazinamideProbenecid: pyrazinamide antagonises effects of probenecidSulfinpyrazone: pyrazinamide antagonises effects ofsulfinpyrazoneVaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Pyridostigmine see ParasympathomimeticsPyridoxine see VitaminsPyrimethamine. Antibacterials: increased antifolate effect when pyrimethaminegiven with .sulfonamides or.trimethoprim. Antiepileptics: pyrimethamine antagonises anticonvulsanteffect of .phenytoin, also increased antifolateeffect. Antimalarials: avoidance of antimalarials advised bymanufacturer of .artemether/lumefantrine;increased antifolate effect when pyrimethamine givenwith proguanilAntivirals: increased antifolate effect when pyrimethaminegiven with zidovudine. Cytotoxics: pyrimethamine increases antifolate effect of.methotrexate and .pemetrexedHistamine: avoidance of antimalarials advised bymanufacturer of histamineVaccines: antimalarials inactivate oral typhoidvaccine—see p. 620Quetiapine see AntipsychoticsQuinagolideMemantine: effects of dopaminergics possiblyenhanced by memantineMethyldopa: antiparkinsonian effect of dopaminergicsantagonised by methyldopaQuinapril see ACE InhibitorsQuinine. Anti-arrhythmics: increased risk of ventricular arrhythmiaswhen quinine given with .amiodarone—avoidconcomitant use; quinine increases plasma concentrationof .flecainide. Antibacterials: increased risk of ventricular arrhythmiaswhen quinine given with .moxifloxacin—avoidconcomitant use; plasma concentration of quininereduced by .rifampicinAnticoagulants: plasma concentration of both drugsincreased when quinine given with warfarin. Antimalarials: avoidance of antimalarials advised bymanufacturer of .artemether/lumefantrine;increased risk of ventricular arrhythmias whenquinine given with .artemether/lumefantrine;increased risk of convulsions when quinine givenwith .mefloquine (but should not prevent the use ofintravenous quinine in severe cases). Antipsychotics: increased risk of ventricular arrhythmiaswhen quinine given with .droperidol or.pimozide—avoid concomitant use; possibleincreased risk of ventricular arrhythmias whenquinine given with .haloperidol—avoid concomitantuse. Antivirals: plasma concentration of quinine possiblyincreased by .atazanavir, .darunavir, .fosamprenavir,.indinavir, .nelfinavir and .tipranavir (increased riskof toxicity); plasma concentration of quinineincreased by .ritonavir (increased risk of toxicity);increased risk of ventricular arrhythmias whenAppendix 1: Interactions