is predicted to increase the exposure to sunitinib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to sunitinib.oTheoretical
▶ Cobicistat is predicted to slightly increase the exposure to
sunitinib. Avoid or adjust sunitinib dose, p. 999.oStudy
▶ Sunitinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
is predicted to increase the exposure to sunitinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
▶ Elbasvir is predicted to increase the concentration of sunitinib.
Use with caution and adjust dose.oTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
sunitinib. Avoid or adjust sunitinib dose, p. 999.oStudy
▶ Grapefruit juice is predicted to increase the exposure to
▶ Grazoprevir is predicted to increase the concentration of
exposure to sunitinib. Avoid or adjust sunitinib dose, p. 999.
Study → Also see TABLE 9 p. 1377
▶ Idelalisib is predicted to slightly increase the exposure to
sunitinib dose, p. 999.o ▶ Imatinib
is predicted to increase the exposure to sunitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Macrolides (clarithromycin) are predicted to slightly increase
sunitinib. Avoid or adjust sunitinib dose, p. 999.
Study → Also see TABLE 9 p. 1377
▶ Macrolides (erythromycin) are predicted to increase the
exposure to sunitinib.oTheoretical → Also see TABLE 9
BNF 78 Sulfasalazine — Sunitinib 1537
▶ Mitotane is predicted to decrease the exposure to sunitinib.
Avoid or adjust sunitinib dose, p. 999.oStudy → Also see
is predicted to increase the exposure to sunitinib.
is predicted to increase the exposure to sunitinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
▶ Sunitinib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to sunitinib.
Avoid or adjust sunitinib dose, p. 999.oStudy
Suxamethonium → see TABLE 20 p. 1379 (neuromuscular blocking
▶ Alkylating agents (cyclophosphamide) increase the risk of
prolonged neuromuscular blockade when given with
▶ Antiarrhythmics (lidocaine) are predicted to increase the effects
▶ Anticholinesterases, centrally acting increase the effects of
▶ Antiepileptics (carbamazepine) increase the risk of prolonged
neuromuscular blockade when given with
▶ Antiepileptics (fosphenytoin, phenytoin) increase the effects of
increases the effects of suxamethonium.r
▶ Corticosteroids are predicted to decrease the effects of
▶ Suxamethonium is predicted to increase the risk of
cardiovascular side-effects when given with
▶ Irinotecan is predicted to increase the risk of prolonged
neuromuscular blockade when given with
▶ Intravenous magnesium is predicted to increase the effects of
increases the effects of suxamethonium.
(piperacillin) increase the effects of suxamethonium.
▶ SSRIs potentially increase the risk of prolonged
neuromuscular blockade when given with suxamethonium.
dobutamine . dopamine. ▶ Sympathomimetics, inotropic are predicted to decrease the
effects of apraclonidine. Avoid.rTheoretical
▶ Beta blockers, non-selective increase the risk of hypertension
and bradycardia when given with dobutamine.r
▶ Beta blockers, selective increase the risk of hypertension and
bradycardia when given with dobutamine.oTheoretical
▶ Entacapone is predicted to increase the risk of cardiovascular
side-effects when given with sympathomimetics, inotropic.
▶ Ergometrine potentially increases the risk of peripheral
vasoconstriction when given with
is predicted to increase the effects of dopamine.
▶ Sympathomimetics, inotropic are predicted to increase the risk
of elevated blood pressure when given with
▶ Monoamine-oxidase A and B inhibitors, irreversible are
predicted to increase the risk of a hypertensive crisis when
given with sympathomimetics, inotropic. Avoid and for 14 days
after stopping the MAOI.rTheoretical
▶ Monoamine-oxidase B inhibitors are predicted to increase the
risk of a hypertensive crisis when given with
sympathomimetics, inotropic. Avoid.rAnecdotal
▶ Opicapone is predicted to increase the risk of cardiovascular
▶ Tolcapone is predicted to increase the risk of cardiovascular
side-effects when given with sympathomimetics, inotropic.
Sympathomimetics, vasoconstrictor
ROUTE-SPECIFIC INFORMATION Since systemic absorption can
follow topical application, the possibility of interactions
▶ Ephedrine increases the risk of side-effects when given with
aminophylline. Avoid in children.oStudy
▶ Sympathomimetics, vasoconstrictor are predicted to decrease
the effects of apraclonidine. Avoid.rTheoretical
▶ Atropine increases the risk of severe hypertension when given
▶ Beta blockers, non-selective are predicted to increase the risk
of hypertension and bradycardia when given with
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).rStudy
▶ Beta blockers, selective are predicted to increase the risk of
hypertension and bradycardia when given with
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).rStudy
▶ Isometheptene potentially increases the risk of side-effects
when given with dopamine receptor agonists (bromocriptine).
▶ Entacapone is predicted to increase the risk of cardiovascular
side-effects when given with sympathomimetics, vasoconstrictor
(adrenaline/epinephrine, noradrenaline/norepinephrine)
▶ Ergometrine is predicted to increase the risk of peripheral
vasoconstriction when given with
noradrenaline/norepinephrine.rAnecdotal
increases the effects of metaraminol.r
increases the effects of phenylephrine.r
▶ Guanethidine is predicted to increase the effects of
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).oStudy
▶ Pseudoephedrine increases the risk of elevated blood pressure
when given with linezolid. Avoid.rStudy
▶ Sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
ephedrine, isometheptene, noradrenaline/norepinephrine,
phenylephrine) are predicted to increase the risk of elevated
blood pressure when given with
▶ Mianserin decreases the effects of ephedrine.rAnecdotal
▶ Moclobemide is predicted to increase the risk of a hypertensive
crisis when given with sympathomimetics, vasoconstrictor
(ephedrine, isometheptene, phenylephrine, pseudoephedrine).
▶ Monoamine-oxidase A and B inhibitors, irreversible are
predicted to increase the risk of a hypertensive crisis when
given with sympathomimetics, vasoconstrictor. Avoid and for
14 days after stopping the MAOI.rStudy
▶ Monoamine-oxidase B inhibitors are predicted to increase the
risk of a hypertensive crisis when given with
sympathomimetics, vasoconstrictor. Avoid.rAnecdotal
▶ Opicapone is predicted to increase the risk of cardiovascular
side-effects when given with sympathomimetics, vasoconstrictor
(adrenaline/epinephrine, noradrenaline/norepinephrine)
▶ Ephedrine increases the risk of side-effects when given with
theophylline. Avoid in children.oStudy
▶ Tolcapone is predicted to increase the effects of
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).oTheoretical
▶ Tricyclic antidepressants are predicted to decrease the effects
1538 Sunitinib — Sympathomimetics, vasoconstrictor BNF 78
▶ Tricyclic antidepressants increase the effects of
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine, phenylephrine)
Tacalcitol → see vitamin D substances
Tacrolimus → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 16 p. 1379
▶ Pomelo and pomegranate juices might greatly increase the
▶ Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.
▶ Alcohol (beverage) increases the risk of facial flushing and skin
irritation when given with topical tacrolimus.oStudy
▶ Antiarrhythmics (amiodarone) are predicted to increase the
concentration of tacrolimus.rAnecdotal
▶ Antiarrhythmics (dronedarone) are predicted to increase the
concentration of tacrolimus.rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) decrease the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the concentration of tacrolimus. Monitor
▶ Antifungals, azoles (miconazole) are predicted to increase the
tacrolimus. Monitor and adjust dose.r
▶ Aprepitant is predicted to increase the concentration of
▶ Bosentan is predicted to decrease the concentration of
tacrolimus and tacrolimus potentially increases the
concentration of bosentan. Avoid.rTheoretical
▶ Brigatinib potentially decreases the concentration of
tacrolimus. Avoid.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of tacrolimus.rStudy
▶ Calcium channel blockers (nicardipine) potentially increase the
concentration of tacrolimus. Monitor concentration and
▶ Ceritinib is predicted to increase the exposure to tacrolimus.
increases the concentration of tacrolimus.
increases the concentration of tacrolimus. Avoid.
Study → Also see TABLE 2 p. 1375 → Also see TABLE 16 p. 1379
▶ Cobicistat is predicted to increase the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶ Crizotinib is predicted to increase the concentration of
▶ Tacrolimus is predicted to increase the exposure to dabigatran.
potentially increases the concentration of tacrolimus.
▶ Doravirine is predicted to decrease the exposure to tacrolimus.
tacrolimus concentration and adjust dose, p. 841.
▶ Efavirenz is predicted to decrease the concentration of
tacrolimus. Monitor and adjust dose.oTheoretical
▶ Enzalutamide decreases the concentration of tacrolimus.
Monitor and adjust dose.rStudy
▶ Glecaprevir (with pibrentasvir) slightly increases the exposure
to tacrolimus. Monitor and adjust dose.nStudy
▶ Grapefruit juice greatly increases the concentration of
increases the exposure to tacrolimus.o ▶ HIV-protease inhibitors are predicted to increase the
tacrolimus. Monitor and adjust dose.r
▶ Idelalisib is predicted to increase the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶ Imatinib is predicted to increase the concentration of
▶ Letermovir moderately increases the exposure to tacrolimus.
Monitor and adjust dose.rStudy
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
tacrolimus. Public Health England advises avoid (refer to
▶ Tacrolimus is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
▶ Lumacaftor is predicted to decrease the exposure to
tacrolimus. Avoid.rTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
tacrolimus. Monitor and adjust dose.r
▶ Macrolides (erythromycin) are predicted to increase the
concentration of tacrolimus.rStudy
▶ Tacrolimus is predicted to affect the efficacy of mifamurtide.
▶ Mitotane decreases the concentration of tacrolimus. Monitor
▶ Monoclonal antibodies (sarilumab) potentially affect the
tacrolimus. Monitor and adjust dose.o ▶ Netupitant is predicted to increase the concentration of
▶ Nevirapine is predicted to decrease the concentration of
tacrolimus. Monitor and adjust dose.oTheoretical
▶ Nilotinib is predicted to increase the concentration of
▶ Palbociclib is predicted to increase the exposure to tacrolimus.
▶ Pibrentasvir (with glecaprevir) slightly increases the exposure
to tacrolimus. Monitor and adjust dose.nStudy
▶ Pitolisant is predicted to decrease the exposure to tacrolimus.
▶ Ranolazine increases the concentration of tacrolimus. Adjust
▶ Ribociclib is predicted to increase the exposure to tacrolimus.
Use with caution and adjust dose.oTheoretical
▶ Rifampicin decreases the concentration of tacrolimus. Monitor
▶ Rucaparib is predicted to increase the exposure to tacrolimus.
Monitor and adjust dose.oStudy
▶ Sirolimus is predicted to decrease the concentration of
and tacrolimus increases the exposure to sirolimus.
▶ St John’s Wort decreases the concentration of tacrolimus.
increases the exposure to tofacitinib. Avoid.r
▶ Tacrolimus potentially increases the risk of serotonin
syndrome when given with venlafaxine.rAnecdotal
Tadalafil → see phosphodiesterase type-5 inhibitors
Tamoxifen → see TABLE 5 p. 1375 (thromboembolism)
▶ Bupropion is predicted to decrease the efficacy of tamoxifen.
▶ Cinacalcet is predicted to decrease the efficacy of tamoxifen.
increases the anticoagulant effect of coumarins.
markedly decreases the exposure to tamoxifen.
is predicted to increase the exposure to tamoxifen.
▶ SSRIs (fluoxetine, paroxetine) are predicted to decrease the
efficacy of tamoxifen. Avoid.rStudy
▶ Terbinafine is predicted to decrease the efficacy of tamoxifen.
Tamsulosin → see alpha blockers
Taxanes → see TABLE 15 p. 1378 (myelosuppression), TABLE 12 p. 1378
cabazitaxel . docetaxel . paclitaxel.
BNF 78 Sympathomimetics, vasoconstrictor —Taxanes 1539
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to cabazitaxel.oTheoretical
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to paclitaxel.rTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to docetaxel.rTheoretical → Also see TABLE 12 p. 1378
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to taxanes (cabazitaxel, paclitaxel). Avoid.rStudy → Also
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
cabazitaxel.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to docetaxel.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Antifungals, azoles (miconazole) are predicted to increase the
docetaxel. Use with caution and adjust dose.
is predicted to increase the exposure to cabazitaxel.
▶ Bosentan is predicted to decrease the exposure to cabazitaxel.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
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