is predicted to decrease the exposure to reboxetine.
▶ Rifampicin is predicted to decrease the exposure to
▶ Rifampicin is predicted to decrease the exposure to
▶ Rifampicin markedly decreases the exposure to rilpivirine.
▶ Rifampicin is predicted to decrease the exposure to
risperidone. Adjust dose.oStudy
▶ Rifampicin is predicted to moderately decrease the exposure
to rivaroxaban. Avoid unless patient can be monitored for
▶ Rifampicin is predicted to decrease the exposure to roflumilast.
▶ Rifampicin is predicted to markedly decrease the exposure to
▶ Rifampicin is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oStudy
▶ Rifampicin is predicted to moderately decrease the exposure
▶ Rifampicin moderately decreases the exposure to the active
metabolite of selexipag. Adjust dose.oStudy
▶ Rifampicin is predicted to decrease the concentration of
▶ Rifampicin is predicted to decrease the exposure to sofosbuvir.
is predicted to decrease the exposure to solifenacin.
is predicted to decrease the exposure to sorafenib.
▶ Rifampicin markedly decreases the exposure to statins
(atorvastatin). Atorvastatin should be taken at the same time
▶ Rifampicin moderately decreases the exposure to statins
(fluvastatin). Monitor and adjust dose.oStudy
▶ Rifampicin very markedly decreases the exposure to statins
▶ Rifampicin is predicted to decrease the exposure to
▶ Rifampicin is predicted to decrease the exposure to sunitinib.
Avoid or adjust sunitinib dose, p. 999.oStudy
▶ Rifampicin decreases the concentration of tacrolimus. Monitor
markedly decreases the exposure to tamoxifen.
▶ Rifampicin is predicted to decrease the exposure to taxanes
(cabazitaxel, paclitaxel). Avoid.rStudy
▶ Rifampicin is predicted to decrease the exposure to taxanes
▶ Rifampicin is predicted to decrease the concentration of
▶ Rifampicin is predicted to decrease the exposure to tenofovir
alafenamide. Avoid.oTheoretical
decreases the exposure to terbinafine. Adjust dose.
▶ Teriflunomide is predicted to increase the exposure to
▶ Rifampicin decreases the exposure to tetracyclines
(doxycycline). Monitor and adjust dose.oStudy
▶ Rifampicin is predicted to decrease the exposure to tezacaftor.
▶ Rifampicin is predicted to decrease the exposure to
theophylline. Adjust dose.oStudy
▶ Rifampicin is predicted to markedly decrease the exposure to
is predicted to decrease the exposure to tivozanib.
▶ Rifampicin moderately decreases the exposure to tizanidine.
▶ Rifampicin is predicted to decrease the exposure to tofacitinib.
▶ Rifampicin is predicted to decrease the exposure to tolvaptan.
Use with caution or avoid depending on indication.
BNF 78 Rifampicin — Rifampicin 1525
▶ Rifampicin is predicted to decrease the exposure to toremifene.
▶ Rifampicin is predicted to decrease the exposure to
trabectedin. Avoid.rTheoretical
decreases the exposure to trimethoprim.o ▶ Rifampicin decreases the efficacy of ulipristal. For FSRH
Contraceptives, interactions p. 794.r
▶ Rifampicin is predicted to decrease the exposure to
▶ Rifampicin is predicted to moderately decrease the exposure
▶ Rifampicin is predicted to decrease the exposure to
vemurafenib. Avoid.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to venetoclax.
▶ Rifampicin is predicted to decrease the exposure to vinca
alkaloids (vinblastine, vincristine, vindesine).rTheoretical
▶ Rifampicin is predicted to decrease the exposure to vinca
alkaloids (vinflunine). Avoid.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to vinca
(vinorelbine). Use with caution or avoid.r
▶ Rifampicin is predicted to decrease the exposure to
vismodegib. Avoid.oTheoretical
▶ Rifampicin potentially increases the risk of nephrotoxicity
when given with volatile halogenated anaesthetics
(methoxyflurane). Avoid.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to
vortioxetine. Monitor and adjust dose.oStudy
▶ Rifampicin is predicted to decrease the concentration of
moderately decreases the exposure to zolpidem.
▶ Rifampicin is predicted to decrease the exposure to zopiclone.
very markedly increases the exposure to rifaximin.
▶ Antacids are predicted to decrease the exposure to rilpivirine.
Antacids should be taken 2 hours before or 4 hours after
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) markedly decrease the exposure to
▶ Antiepileptics (oxcarbazepine) are predicted to decrease the
concentration of rilpivirine. Avoid.rTheoretical
▶ Bosentan is predicted to decrease the exposure to rilpivirine.
▶ Calcium salts (calcium carbonate) are predicted to slightly
decrease the exposure to rilpivirine. Calcium carbonate should
be taken 2 hours before or 4 hours after
▶ Corticosteroids (dexamethasone) are predicted to decrease the
concentration of rilpivirine. Avoid multiple-dose
▶ Efavirenz is predicted to decrease the exposure to rilpivirine.
▶ Enzalutamide markedly decreases the exposure to rilpivirine.
▶ Etravirine is predicted to decrease the exposure to rilpivirine.
▶ H2 receptor antagonists are predicted to decrease the exposure
to rilpivirine. H2 receptor antagonists should be taken 12 hours
before or 4 hours after rilpivirine.rStudy
▶ Mitotane markedly decreases the exposure to rilpivirine.
▶ Nevirapine is predicted to decrease the exposure to rilpivirine.
▶ Proton pump inhibitors are predicted to decrease the exposure
▶ Rifabutin slightly decreases the exposure to rilpivirine. Adjust
▶ Rifampicin markedly decreases the exposure to rilpivirine.
▶ St John’s Wort is predicted to decrease the exposure to
rilpivirine. Avoid.rTheoretical
FOOD AND LIFESTYLE Charcoal-grilled foods are predicted to
decrease the exposure to riluzole.
is predicted to increase the exposure to riluzole.
▶ Quinolones (ciprofloxacin) are predicted to increase the
exposure to riluzole.oTheoretical
▶ SSRIs (fluvoxamine) are predicted to increase the exposure to
Riociguat → see TABLE 8 p. 1376 (hypotension)
▶ Antacids slightly decrease the exposure to riociguat. Antacids
should be taken 2 hours before or 1 hour after riociguat.n
▶ Antifungals, azoles (itraconazole) are predicted to increase the
exposure to riociguat. Avoid.oStudy
▶ Antifungals, azoles (ketoconazole) moderately increase the
exposure to riociguat. Avoid.oStudy
is predicted to increase the exposure to riociguat.
▶ HIV-protease inhibitors (ritonavir) are predicted to increase the
exposure to riociguat. Avoid.oTheoretical
▶ Riociguat is predicted to increase the risk of hypotension
phosphodiesterase type-5 inhibitors. Avoid.
Theoretical → Also see TABLE 8 p. 1376
Risedronate → see bisphosphonates
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to risperidone. Adjust dose.oStudy → Also see TABLE 11
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Bupropion is predicted to increase the exposure to risperidone.
▶ Cinacalcet is predicted to increase the exposure to risperidone.
▶ Cobicistat is predicted to increase the exposure to risperidone.
▶ Risperidone is predicted to decrease the effects of dopamine
receptor agonists. Avoid.oTheoretical → Also see TABLE 8
p. 1376 → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to decrease the exposure to
risperidone. Adjust dose.oStudy
▶ HIV-protease inhibitors are predicted to increase the exposure
to risperidone. Adjust dose.oStudy → Also see TABLE 9
▶ Idelalisib is predicted to increase the exposure to risperidone.
▶ Risperidone is predicted to decrease the effects of levodopa.
Avoid or adjust dose.rAnecdotal → Also see TABLE 8 p. 1376
▶ Risperidone potentially increases the risk of neurotoxicity
when given with lithium.rAnecdotal → Also see TABLE 9
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to risperidone. Adjust dose.oStudy → Also see
▶ Risperidone increases the risk of dyskinesias when given with
▶ Mitotane is predicted to decrease the exposure to risperidone.
▶ Rifampicin is predicted to decrease the exposure to
risperidone. Adjust dose.oStudy
▶ SSRIs (fluoxetine, paroxetine) are predicted to increase the
exposure to risperidone. Adjust dose.oStudy
▶ Terbinafine is predicted to increase the exposure to
risperidone. Adjust dose.oStudy
Ritonavir → see HIV-protease inhibitors
1526 Rifampicin — Ritonavir BNF 78
Rituximab → see monoclonal antibodies
Rivaroxaban → see TABLE 3 p. 1375 (anticoagulant effects)
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to rivaroxaban. Avoid.oTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to moderately decrease
the exposure to rivaroxaban. Avoid unless patient can be
monitored for signs of thrombosis.rStudy
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
moderately increase the exposure to
▶ Cobicistat is predicted to increase the exposure to rivaroxaban.
▶ Enzalutamide is predicted to moderately decrease the
exposure to rivaroxaban. Avoid unless patient can be
monitored for signs of thrombosis.rStudy
▶ HIV-protease inhibitors (ritonavir) moderately increase the
exposure to rivaroxaban. Avoid.rStudy
▶ Mitotane is predicted to moderately decrease the exposure to
rivaroxaban. Avoid unless patient can be monitored for signs
▶ Rifampicin is predicted to moderately decrease the exposure
to rivaroxaban. Avoid unless patient can be monitored for
Rivastigmine → see anticholinesterases, centrally acting
Rizatriptan → see TABLE 13 p. 1378 (serotonin syndrome)
▶ Beta blockers, non-selective (propranolol) slightly to moderately
increase the exposure to rizatriptan. Adjust rizatriptan dose
and separate administration by at least 2 hours.oStudy
▶ Rizatriptan is predicted to increase the risk of vasoconstriction
when given with ergotamine. Ergotamine should be taken at
least 24 hours before or 6 hours after
▶ Moclobemide moderately increases the exposure to rizatriptan.
Avoid.oStudy → Also see TABLE 13 p. 1378
▶ Monoamine-oxidase A and B inhibitors, irreversible are
predicted to increase the exposure to rizatriptan. Avoid and
for 14 days after stopping the MAOI.rTheoretical → Also
Rocuronium → see neuromuscular blocking drugs, non-depolarising
▶ Aminophylline is predicted to slightly increase the exposure to
roflumilast. Avoid.oTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Combined hormonal contraceptives are predicted to increase
the exposure to roflumilast.oTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
▶ H2 receptor antagonists (cimetidine) slightly increase the
exposure to roflumilast.oStudy
is predicted to increase the exposure to roflumilast.
▶ Mitotane is predicted to decrease the exposure to roflumilast.
▶ Quinolones (ciprofloxacin) are predicted to increase the
exposure to roflumilast.oTheoretical
▶ Rifampicin is predicted to decrease the exposure to roflumilast.
▶ SSRIs (fluvoxamine) are predicted to increase the exposure to
▶ Theophylline is predicted to slightly increase the exposure to
roflumilast. Avoid.oTheoretical
▶ Rolapitant is predicted to increase the exposure to alkylating
agents (bendamustine). Avoid or monitor.oStudy
▶ Rolapitant is predicted to increase the exposure to
anthracyclines (doxorubicin, mitoxantrone). Avoid or monitor.
▶ Rolapitant is predicted to increase the exposure to
antiarrhythmics (propafenone).rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to markedly decrease the
exposure to rolapitant. Avoid.rStudy
▶ Rolapitant is predicted to moderately increase the exposure to
beta blockers, selective (metoprolol).rStudy
▶ Bosentan is predicted to decrease the exposure to rolapitant.
is predicted to increase the exposure to colchicine.
is predicted to increase the exposure to dabigatran.
▶ Enzalutamide is predicted to markedly decrease the exposure
▶ Rolapitant is predicted to increase the exposure to irinotecan.
▶ Rolapitant is predicted to increase the exposure to
methotrexate. Avoid or monitor.oStudy
▶ Mitotane is predicted to markedly decrease the exposure to
▶ Nevirapine is predicted to decrease the exposure to rolapitant.
is predicted to increase the exposure to pimozide.
▶ Rifabutin is predicted to decrease the exposure to rolapitant.
▶ Rifampicin is predicted to markedly decrease the exposure to
▶ St John’s Wort is predicted to decrease the exposure to
▶ Rolapitant is predicted to increase the exposure to statins
(rosuvastatin). Monitor and adjust dose.rStudy
▶ Rolapitant increases the exposure to sulfasalazine.rStudy
is predicted to increase the exposure to tamoxifen.
▶ Rolapitant is predicted to increase the exposure to topotecan.
Ropinirole → see dopamine receptor agonists
Ropivacaine → see anaesthetics, local
Rotavirus vaccine → see live vaccines
Rotigotine → see dopamine receptor agonists
▶ Rucaparib is predicted to increase the exposure to
aminophylline. Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to antiepileptics
(phenytoin). Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to ciclosporin.
Monitor and adjust dose.oStudy
▶ Rucaparib slightly increases the exposure to coumarins
(warfarin). Monitor and adjust dose.rStudy
▶ Rucaparib is predicted to increase the exposure to ergotamine.
Monitor and adjust dose.oStudy
▶ Rucaparib slightly increases the exposure to midazolam.
Monitor and adjust dose.rStudy
▶ Rucaparib is predicted to increase the exposure to opioids
(alfentanil, fentanyl). Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to pimozide.
Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to sirolimus.
Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to tacrolimus.
Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to
theophylline. Monitor and adjust dose.oStudy
▶ Rucaparib is predicted to increase the exposure to tizanidine.
Monitor and adjust dose.oStudy
Rufinamide → see antiepileptics
Rupatadine → see antihistamines, non-sedating
Ruxolitinib → see TABLE 15 p. 1378 (myelosuppression)
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to ruxolitinib.oTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to ruxolitinib. Monitor and adjust dose.oStudy
BNF 78 Rituximab — Ruxolitinib 1527
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
ruxolitinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to ruxolitinib. Adjust dose
and monitor side effects.oStudy
is predicted to increase the exposure to ruxolitinib.
▶ Bosentan is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ruxolitinib.oTheoretical
▶ Cobicistat is predicted to increase the exposure to ruxolitinib.
Adjust dose and monitor side effects.oStudy
▶ Ruxolitinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
is predicted to increase the exposure to ruxolitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Efavirenz is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
ruxolitinib. Monitor and adjust dose.oStudy
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
Adjust dose and monitor side effects.oStudy → Also see
is predicted to increase the exposure to ruxolitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Macrolides (clarithromycin) are predicted to increase the
ruxolitinib. Adjust dose and monitor side effects.
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ruxolitinib.oTheoretical
▶ Mitotane is predicted to decrease the exposure to ruxolitinib.
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