BNF for Children 2011-2012

728 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsRitonavir (continued). Corticosteroids: ritonavir possibly increases plasmaconcentration of corticosteroids, dexamethasone andprednisolone; ritonavir increases plasma concentrationof inhaled and intranasal budesonide and.fluticasone. Cytotoxics: ritonavir possibly increases plasma concentrationof .everolimus and .vinflunine—manufacturerof everolimus and vinflunine advises avoidconcomitant use; avoidance of ritonavir advised bymanufacturer of .lapatinib, .nilotinib and.pazopanib; ritonavir possibly increases plasmaconcentration of .docetaxel (increased risk of toxicity);ritonavir increases plasma concentration ofpaclitaxel; ritonavir possibly increases plasma concentrationof vinblastine. Diuretics: ritonavir increases plasma concentration of.eplerenone—avoid concomitant use. Ergot Alkaloids: increased risk of ergotism whenritonavir given with .ergotamine and methysergide—avoid concomitant use. 5HT 1 Agonists: ritonavir increases plasma concentrationof .eletriptan (risk of toxicity)—avoid concomitantuse. Ivabradine: ritonavir possibly increases plasma concentrationof .ivabradine—avoid concomitant use. Lipid-regulating Drugs: possible increased risk ofmyopathy when ritonavir given with atorvastatin;possible increased risk of myopathy when ritonavirgiven with .rosuvastatin—manufacturer of rosuvastatinadvises avoid concomitant use; increased risk ofmyopathy when ritonavir given with .simvastatin(avoid concomitant use). Oestrogens: ritonavir accelerates metabolism of.oestrogens (reduced contraceptive effect—seep. 398). Ranolazine: ritonavir possibly increases plasma concentrationof .ranolazine—manufacturer of ranolazineadvises avoid concomitant use. Sildenafil: ritonavir significantly increases plasmaconcentration of .sildenafil—avoid concomitant useSympathomimetics: ritonavir possibly increasesplasma concentration of dexamfetamine. Tacrolimus: ritonavir possibly increases plasma concentrationof .tacrolimus. Tadalafil: ritonavir increases plasma concentration of.tadalafil—manufacturer of tadalafil advises avoidconcomitant use. Theophylline: ritonavir accelerates metabolism of.theophylline (reduced plasma concentration). Ulipristal: avoidance of ritonavir advised by manufacturerof .ulipristal (contraceptive effect of ulipristalpossibly reduced). Vardenafil: ritonavir increases plasma concentration of.vardenafil—avoid concomitant useRivaroxaban. Analgesics: increased risk of haemorrhage when anticoagulantsgiven with intravenous .diclofenac (avoidconcomitant use, including low-dose heparins);increased risk of haemorrhage when anticoagulantsgiven with .ketorolac (avoid concomitant use,including low-dose heparins)Antibacterials: plasma concentration of rivaroxabanreduced by rifampicin. Antifungals: plasma concentration of rivaroxabanincreased by .ketoconazole—avoid concomitant use;manufacturer of rivaroxaban advises avoid concomitantuse with itraconazole, posaconazole andvoriconazole. Antivirals: manufacturer of rivaroxaban advises avoidconcomitant use with atazanavir, darunavir, fosamprenavir,indinavir, lopinavir, nelfinavir,saquinavir and tipranavir; plasma concentration ofrivaroxaban increased by .ritonavir—manufacturerof rivaroxaban advises avoid concomitant useRivastigmine see ParasympathomimeticsRizatriptan see 5HT 1 AgonistsRocuronium see Muscle RelaxantsRoflumilastAntibacterials: plasma concentration of roflumilastreduced by rifampicin—consider increasing dose ofroflumilastAntidepressants: metabolism of roflumilast inhibitedby fluvoxamineTheophylline: manufacturer of roflumilast advisesavoid concomitant use with theophyllineUlcer-healing Drugs: metabolism of roflumilast inhibitedby cimetidineRopiniroleAntibacterials: metabolism of ropinirole inhibited byciprofloxacin (increased plasma concentration)Antipsychotics: manufacturer of ropinirole advisesavoid concomitant use of antipsychotics (antagonismof effect)Memantine: effects of dopaminergics possiblyenhanced by memantineMethyldopa: antiparkinsonian effect of dopaminergicsantagonised by methyldopaMetoclopramide: manufacturer of ropinirole advisesavoid concomitant use of metoclopramide (antagonismof effect)Oestrogens: plasma concentration of ropiniroleincreased by oestrogensRopivacaineAnti-arrhythmics: increased myocardial depressionwhen ropivacaine given with anti-arrhythmicsAntidepressants: metabolism of ropivacaine inhibitedby fluvoxamine—avoid prolonged administration ofropivacaineRosuvastatin see StatinsRotigotineAntipsychotics: manufacturer of rotigotine advisesavoid concomitant use of antipsychotics (antagonismof effect)Memantine: effects of dopaminergics possiblyenhanced by memantineMethyldopa: antiparkinsonian effect of dopaminergicsantagonised by methyldopaMetoclopramide: manufacturer of rotigotine advisesavoid concomitant use of metoclopramide (antagonismof effect)Rufinamide. 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 drugspossibly reduced when rufinamide given with carbamazepine;plasma concentration of rufinamide possiblyreduced by phenobarbital; plasmaconcentration of rufinamide possibly reduced byphenytoin, also plasma concentration of phenytoinpossibly increased; plasma concentration of rufinamidepossibly increased by valproate (reduce dose ofrufinamide). 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: rufinamide accelerates metabolism of.oestrogens (reduced contraceptive effect—seep. 398). Orlistat: possible increased risk of convulsions whenantiepileptics given with .orlistat. Progestogens: rufinamide accelerates metabolism of.progestogens (reduced contraceptive effect—seep. 398)Rupatadine see Antihistamines