BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 731SirolimusAnti-arrhythmics: caution with sirolimus advised bymanufacturer of dronedarone. Antibacterials: plasma concentration of sirolimusincreased by .clarithromycin and .telithromycin—avoid concomitant use; plasma concentration of bothdrugs increased when sirolimus given with.erythromycin; plasma concentration of sirolimusreduced by .rifabutin and .rifampicin—avoid concomitantuse. Antifungals: plasma concentration of sirolimusincreased by .itraconazole, .ketoconazole and.voriconazole—avoid concomitant use; plasma concentrationof sirolimus increased by micafungin and.miconazole; plasma concentration of sirolimuspossibly increased by posaconazole. Antivirals: plasma concentration of sirolimus possiblyincreased by .atazanavir and lopinavir. Calcium-channel Blockers: plasma concentration ofsirolimus increased by .diltiazem; plasma concentrationof both drugs increased when sirolimus givenwith .verapamilCiclosporin: plasma concentration of sirolimusincreased by ciclosporin. Grapefruit Juice: plasma concentration of sirolimusincreased by .grapefruit juice—avoid concomitantuseSitagliptin see AntidiabeticsSitaxentan. Anticoagulants: sitaxentan enhances anticoagulanteffect of .coumarins. Ciclosporin: plasma concentration of sitaxentanincreased by .ciclosporin—avoid concomitant useOestrogens: sitaxentan increases plasma concentrationof oestrogensProgestogens: sitaxentan increases plasma concentrationof progestogensSodium Aurothiomalate. ACE Inhibitors: flushing and hypotension reportedwhen sodium aurothiomalate given with .ACE inhibitorsPenicillamine: avoidance of sodium aurothiomalateadvised by manufacturer of penicillamine (increasedrisk of toxicity)Sodium BenzoateAntiepileptics: effects of sodium benzoate possiblyreduced by valproateAntipsychotics: effects of sodium benzoate possiblyreduced by haloperidolCorticosteroids: effects of sodium benzoate possiblyreduced by corticosteroidsProbenecid: excretion of conjugate formed by sodiumbenzoate possibly reduced by probenecidSodium Bicarbonate see AntacidsSodium CitrateAntibacterials: avoid concomitant use of sodiumcitrate with methenamineSodium Clodronate see BisphosphonatesSodium Nitroprusside see Vasodilator AntihypertensivesSodium Oxybate. Analgesics: effects of sodium oxybate enhanced by.opioid analgesics (avoid concomitant use)Antidepressants: increased risk of side-effects whensodium oxybate given with tricyclicsAntiepileptics: manufacturer of sodium oxybateadvises avoid concomitant use with phenobarbitalAntipsychotics: effects of sodium oxybate possiblyenhanced by antipsychotics. Anxiolytics and Hypnotics: effects of sodium oxybateenhanced by .benzodiazepines (avoid concomitantuse)Sodium PhenylbutyrateAntiepileptics: effects of sodium phenylbutyrate possiblyreduced by valproateAntipsychotics: effects of sodium phenylbutyratepossibly reduced by haloperidolSodium Phenylbutyrate (continued)Corticosteroids: effects of sodium phenylbutyratepossibly reduced by corticosteroidsProbenecid: excretion of conjugate formed by sodiumphenylbutyrate possibly reduced by probenecidSodium Valproate see ValproateSolifenacin see AntimuscarinicsSomatropinCorticosteroids: growth-promoting effect of somatropinmay be inhibited by corticosteroidsOestrogens: increased doses of somatropin may beneeded when given with oestrogens (when used asoral replacement therapy)SorafenibAntibacterials: bioavailability of sorafenib reduced byneomycin; plasma concentration of sorafenibreduced by rifampicin. Anticoagulants: sorafenib possibly enhances anticoagulanteffect of .coumarins. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Cytotoxics: sorafenib possibly increases plasma concentrationof doxorubicin and irinotecan; sorafenibincreases plasma concentration of docetaxelSotalol see Beta-blockersSpironolactone see DiureticsStatinsAntacids: absorption of rosuvastatin reduced byantacids. Anti-arrhythmics: increased risk of myopathy whensimvastatin given with .amiodarone or .dronedarone. Antibacterials: plasma concentration ofatorvastatin and pravastatin increased by.clarithromycin; increased risk of myopathy whensimvastatin given with .clarithromycin,.erythromycin or .telithromycin (avoid concomitantuse); plasma concentration of rosuvastatin reducedby erythromycin; possible increased risk of myopathywhen atorvastatin given with erythromycin or fusidicacid; plasma concentration of pravastatin increasedby erythromycin; plasma concentration ofatorvastatin and simvastatin possibly reduced byrifampicin; metabolism of fluvastatin accelerated byrifampicin (reduced effect); increased risk of myopathywhen statins given with .daptomycin (preferablyavoid concomitant use); increased risk ofmyopathy when simvastatin given with .fusidic acid;increased risk of myopathy when atorvastatin givenwith .telithromycin (avoid concomitant use); possibleincreased risk of myopathy when pravastatin givenwith telithromycin. Anticoagulants: atorvastatin may transiently reduceanticoagulant effect of warfarin; rosuvastatin possiblyenhances anticoagulant effect of .coumarins and.phenindione; fluvastatin and simvastatin enhanceanticoagulant effect of .coumarinsAntidepressants: plasma concentration of simvastatinreduced by St John’s wortAntidiabetics: fluvastatin possibly increases plasmaconcentration of glibenclamide. Antiepileptics: plasma concentration of simvastatinreduced by .carbamazepine—consider increasingdose of simvastatin; combination of fluvastatin withphenytoin may increase plasma concentration ofeither drug (or both). Antifungals: increased risk of myopathy when simvastatingiven with .itraconazole, .ketoconazole or.posaconazole (avoid concomitant use); possibleincreased risk of myopathy when simvastatin givenwith .fluconazole or .miconazole—avoid concomitantuse; plasma concentration of fluvastatinincreased by fluconazole; increased risk of myopathywhen atorvastatin given with .itraconazole or.posaconazole (avoid concomitant use); possibleincreased risk of myopathy when simvastatin givenwith voriconazole; possible increased risk of myopathywhen atorvastatin given with imidazoles ortriazolesAppendix 1: Interactions