BNF for Children 2011-2012

732 Appendix 1: Interactions BNFC 2011–2012Appendix 1: InteractionsStatins (continued). Antivirals: possible increased risk of myopathy whenatorvastatin given with atazanavir, fosamprenavir,indinavir, lopinavir, nelfinavir, ritonavir or saquinavir;possible increased risk of myopathy when rosuvastatingiven with .atazanavir, .darunavir,.fosamprenavir, .indinavir, .lopinavir, .nelfinavir,.ritonavir and .saquinavir—manufacturer of rosuvastatinadvises avoid concomitant use; increasedrisk of myopathy when simvastatin given with.atazanavir, .indinavir, .nelfinavir, .ritonavir or.saquinavir (avoid concomitant use); plasma concentrationof pravastatin possibly increased bydarunavir; plasma concentration of atorvastatin,pravastatin and simvastatin reduced by efavirenz;plasma concentration of atorvastatin possiblyreduced by etravirine; possible increased risk ofmyopathy when simvastatin given with.fosamprenavir or .lopinavir—avoid concomitantuse; plasma concentration of rosuvastatin possiblyincreased by .tipranavir—manufacturer of rosuvastatinadvises avoid concomitant use; plasma concentrationof simvastatin possibly increased by.tipranavir—avoid concomitant use; plasma concentrationof atorvastatin possibly increased by.tipranavir (consider reducing dose of atorvastatin)Bosentan: plasma concentration of simvastatinreduced by bosentan. Calcium-channel Blockers: possible increased risk ofmyopathy when simvastatin given with amlodipine;plasma concentration of atorvastatin and simvastatinincreased by diltiazem—possible increased risk ofmyopathy; increased risk of myopathy when simvastatingiven with .verapamilCardiac Glycosides: atorvastatin possibly increasesplasma concentration of digoxin. Ciclosporin: increased risk of myopathy when statinsgiven with .ciclosporin; increased risk of myopathywhen rosuvastatin given with .ciclosporin (avoidconcomitant use). Colchicine: possible increased risk of myopathy whenstatins given with .colchicineCytotoxics: plasma concentration of simvastatin possiblyincreased by dasatinib; plasma concentration ofsimvastatin increased by imatinib. Eltrombopag: plasma concentration of rosuvastatinincreased by .eltrombopag (consider reducing doseof rosuvastatin). Grapefruit Juice: plasma concentration of atorvastatinpossibly increased by grapefruit juice; plasma concentrationof simvastatin increased by .grapefruitjuice—avoid concomitant use. Hormone Antagonists: possible increased risk ofmyopathy when simvastatin given with .danazol. Lipid-regulating Drugs: increased risk of myopathywhen statins given with .gemfibrozil (preferablyavoid concomitant use); increased risk of myopathywhen statins given with .fibrates; increased risk ofmyopathy when statins given with .nicotinic acid(applies to lipid regulating doses of nicotinic acid)Oestrogens: atorvastatin and rosuvastatin increaseplasma concentration of ethinylestradiolProgestogens: atorvastatin increases plasma concentrationof norethisterone; rosuvastatin increasesplasma concentration of active metabolite of norgestimate;rosuvastatin increases plasma concentrationof norgestrelRanolazine: plasma concentration of simvastatinincreased by ranolazine (consider reducing dose ofsimvastatin)Retinoids: plasma concentration of simvastatinreduced by alitretinoinStavudine. Antivirals: increased risk of side-effects when stavudinegiven with .didanosine; increased risk of toxicitywhen stavudine given with .ribavirin; effects ofstavudine possibly inhibited by .zidovudine (manufacturersadvise avoid concomitant use)Stavudine (continued). Cytotoxics: effects of stavudine possibly inhibited bydoxorubicin; increased risk of toxicity when stavudinegiven with .hydroxycarbamide—avoid concomitantuseStiripentol. 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: stiripentol increases plasma concentrationof .carbamazepine, .phenobarbital and.phenytoin. 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)Anxiolytics and Hypnotics: stiripentol increasesplasma concentration of clobazam. Orlistat: possible increased risk of convulsions whenantiepileptics given with .orlistatStreptomycin see AminoglycosidesStrontium RanelateAntibacterials: strontium ranelate reduces absorptionof quinolones and tetracyclines (manufacturer ofstrontium ranelate advises avoid concomitant use)SucralfateAntibacterials: sucralfate reduces absorption of ciprofloxacin,levofloxacin, moxifloxacin, norfloxacin,ofloxacin and tetracyclines. Anticoagulants: sucralfate possibly reduces absorptionof .coumarins (reduced anticoagulant effect). Antiepileptics: sucralfate reduces absorption of.phenytoinAntifungals: sucralfate reduces absorption of ketoconazoleAntipsychotics: sucralfate reduces absorption of sulpirideCardiac Glycosides: sucralfate possibly reducesabsorption of cardiac glycosidesTheophylline: sucralfate possibly reduces absorption oftheophylline (give at least 2 hours apart)Thyroid Hormones: sucralfate reduces absorption oflevothyroxineUlcer-healing Drugs: sucralfate possibly reducesabsorption of lansoprazoleSugammadexAntibacterials: response to sugammadex possiblyreduced by fusidic acidProgestogens: sugammadex possibly reduces plasmaconcentration of progestogens—manufacturer ofsugammadex advises additional contraceptive precautionsSulfadiazine see SulfonamidesSulfadoxine see SulfonamidesSulfamethoxazole see SulfonamidesSulfasalazine see AminosalicylatesSulfinpyrazoneAnalgesics: effects of sulfinpyrazone antagonised byaspirinAntibacterials: sulfinpyrazone reduces excretion ofnitrofurantoin (increased risk of toxicity); sulfinpyrazonereduces excretion of penicillins; effects ofsulfinpyrazone antagonised by pyrazinamide. Anticoagulants: sulfinpyrazone enhances anticoagulanteffect of .coumarins. Antidiabetics: sulfinpyrazone enhances effects of.sulfonylureas. Antiepileptics: sulfinpyrazone increases plasma concentrationof .phenytoinCalcium-channel Blockers: sulfinpyrazone reducesplasma concentration of verapamil