is predicted to decrease the exposure to quetiapine.
▶ Netupitant is predicted to increase the exposure to quetiapine.
is predicted to decrease the exposure to quetiapine.
▶ Nilotinib is predicted to increase the exposure to quetiapine.
▶ Ribociclib (high-dose) is predicted to increase the exposure to
quetiapine. Avoid.oTheoretical
is predicted to decrease the exposure to quetiapine.
▶ St John’s Wort is predicted to decrease the exposure to
Quinagolide → see dopamine receptor agonists
Quinapril → see ACE inhibitors
Quinolones → see TABLE 9 p. 1377 (QT-interval prolongation)
ciprofloxacin . levofloxacin . moxifloxacin . ofloxacin.
▶ Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.
▶ Interactions do not generally apply to topical use of
moxifloxacin unless specified.
▶ Ciprofloxacin is predicted to increase the exposure to
▶ Ciprofloxacin is predicted to increase the exposure to
aminophylline. Adjust dose.oTheoretical
▶ Ciprofloxacin is predicted to increase the exposure to
▶ Antacids decrease the absorption of quinolones. Quinolones
should be taken 2 hours before or 4 hours after
▶ Ciprofloxacin slightly increases the exposure to antiarrhythmics
▶ Ciprofloxacin affects the concentration of antiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
▶ Calcium salts (calcium carbonate) decrease the absorption of
. Separate administration by 2 hours.o ▶ Ciprofloxacin increases the concentration of clozapine.
Monitor side effects and adjust dose.rStudy
increase the anticoagulant effect of coumarins.
▶ Didanosine (buffered) is predicted to greatly decrease the
exposure to oral quinolones. Didanosine should be taken
2 hours after quinolones.oStudy
▶ Ciprofloxacin is predicted to increase the exposure to dopamine
receptor agonists (ropinirole). Adjust dose.oStudy
▶ Ciprofloxacin is predicted to increase the exposure to
duloxetine. Avoid.oTheoretical
▶ Ciprofloxacin is predicted to increase the exposure to
. Avoid or adjust dose—consult product literature.
Monitor side effects and adjust dose.oStudy
▶ Ciprofloxacin is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose, p. 983.rTheoretical
1518 Proton pump inhibitors — Quinolones BNF 78
▶ Iron (oral) decreases the exposure to quinolones. Separate
administration by at least 2 hours.oStudy
▶ Lanthanum moderately decreases the exposure to quinolones.
Quinolones should be taken 2 hours before or 4 hours after
▶ Leflunomide is predicted to increase the exposure to
▶ Ciprofloxacin is predicted to increase the exposure to loxapine.
▶ Ciprofloxacin is predicted to increase the exposure to
▶ Ciprofloxacin potentially increases the risk of toxicity when
given with methotrexate.rAnecdotal
▶ Ciprofloxacin slightly increases the exposure to monoamineoxidase B inhibitors (rasagiline).oStudy
▶ NSAIDs potentially increase the risk of seizures when given
▶ Ciprofloxacin is predicted to increase the exposure to
olanzapine. Adjust dose.oAnecdotal
▶ Ciprofloxacin very slightly increases the exposure to
▶ Ciprofloxacin is predicted to increase the exposure to
pirfenidone. Use with caution and adjust dose.oStudy
▶ Ciprofloxacin is predicted to increase the exposure to
. Adjust pomalidomide dose, p. 961.o ▶ Ciprofloxacin
is predicted to increase the exposure to riluzole.
▶ Ciprofloxacin is predicted to increase the exposure to
▶ Sucralfate decreases the exposure to quinolones. Separate
administration by 2 hours.oStudy
▶ Teriflunomide is predicted to increase the exposure to
▶ Ciprofloxacin is predicted to increase the exposure to
theophylline. Monitor and adjust dose.oTheoretical
increases the exposure to tizanidine. Avoid.
▶ Ciprofloxacin is predicted to increase the exposure to
. Use with caution and adjust tolvaptan dose, p. 669.
▶ Zinc is predicted to decrease the exposure to quinolones.
Separate administration by 2 hours.oStudy
▶ Ciprofloxacin is predicted to increase the exposure to
. Adjust zolmitriptan dose, p. 482.o
Rabeprazole → see proton pump inhibitors
Rabies immunoglobulin → see immunoglobulins
▶ Antimalarials (chloroquine) decrease the efficacy of rabies
▶ Hydroxychloroquine is predicted to decrease efficacy rabies
Raloxifene → see TABLE 5 p. 1375 (thromboembolism)
▶ Combined hormonal contraceptives potentially oppose the
effects of raloxifene. Avoid.rTheoretical
▶ Hormone replacement therapy potentially opposes the effects
of raloxifene. Avoid.rTheoretical
slightly decrease the exposure to raltegravir. Avoid.
▶ Antiepileptics (carbamazepine) are predicted to affect the
exposure to raltegravir.oTheoretical
▶ Antiepileptics (fosphenytoin, phenobarbital, phenytoin,
primidone) are predicted to affect the exposure to raltegravir.
Use with caution or avoid.oTheoretical
▶ Calcium salts (calcium carbonate) greatly decrease the exposure
to raltegravir (high-dose). Avoid.rStudy
▶ Encorafenib is predicted to increase the exposure to
▶ HIV-protease inhibitors (atazanavir) increase the exposure to
raltegravir (high-dose). Avoid.oStudy
▶ HIV-protease inhibitors (darunavir) increase the risk of rash
when given with raltegravir.oStudy
▶ HIV-protease inhibitors (fosamprenavir) (boosted with ritonavir)
decrease the exposure to raltegravir and raltegravir decreases
the exposure to HIV-protease inhibitors (fosamprenavir)
(boosted with ritonavir). Avoid.rStudy
▶ HIV-protease inhibitors (tipranavir boosted with ritonavir) are
predicted to decrease the exposure to raltegravir (high-dose).
▶ Rifampicin slightly decreases the exposure to raltegravir.
Raltitrexed → see TABLE 15 p. 1378 (myelosuppression)
are predicted to alter the effects of raltitrexed. Avoid.
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
raltitrexed. Public Health England advises avoid (refer to
Ramucirumab → see monoclonal antibodies
▶ Ranibizumab is predicted to increase the risk of bleeding
events when given with argatroban.rTheoretical
▶ Ranibizumab is predicted to increase the risk of bleeding
events when given with bivalirudin.oTheoretical
▶ Ranibizumab increases the risk of bleeding events when given
▶ Ranibizumab is predicted to increase the risk of bleeding
events when given with danaparoid.rTheoretical
▶ Ranibizumab increases the risk of bleeding events when given
with heparin (unfractionated).rTheoretical
▶ Ranibizumab increases the risk of bleeding events when given
with low molecular-weight heparins.rTheoretical
▶ Ranibizumab is predicted to increase the risk of bleeding
events when given with phenindione.rTheoretical
Ranitidine → see H2 receptor antagonists
Ranolazine → see TABLE 9 p. 1377 (QT-interval prolongation)
▶ Ranolazine is predicted to increase the exposure to afatinib.
Separate administration by 12 hours.oStudy
is predicted to increase the exposure to aliskiren.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to ranolazine.rStudy → Also see TABLE 9 p. 1377
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to ranolazine.
▶ Ranolazine is predicted to increase the exposure to beta
blockers, non-selective (nadolol).oStudy
▶ Ranolazine is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ranolazine.rStudy
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 9 p. 1377
▶ Ciclosporin is predicted to increase the concentration of
ranolazine and ranolazine is predicted to increase the
concentration of ciclosporin.oTheoretical
▶ Cobicistat is predicted to increase the exposure to ranolazine.
▶ Ranolazine is predicted to increase the exposure to colchicine.
Avoid or adjust colchicine dose, p. 1120.rTheoretical
is predicted to increase the exposure to ranolazine.
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to dabigatran.
increases the concentration of digoxin.o
BNF 78 Quinolones — Ranolazine 1519
▶ Ranolazine is predicted to increase the exposure to dopamine
receptor agonists (pramipexole). Adjust dose.oStudy
▶ Ranolazine is predicted to slightly increase the exposure to
▶ Enzalutamide is predicted to decrease the exposure to
is predicted to increase the exposure to erlotinib.
▶ Ranolazine is predicted to increase the exposure to
▶ Grapefruit juice is predicted to increase the concentration of
ranolazine. Avoid.rTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
to ranolazine. Avoid.rStudy → Also see TABLE 9 p. 1377
▶ Idelalisib is predicted to increase the exposure to ranolazine.
is predicted to increase the exposure to ranolazine.
▶ Ranolazine is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to ranolazine. Avoid.rStudy → Also see TABLE 9
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ranolazine.rStudy → Also see TABLE 9 p. 1377
▶ Mitotane is predicted to decrease the exposure to ranolazine.
is predicted to increase the exposure to ranolazine.
is predicted to increase the exposure to ranolazine.
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to nintedanib.
▶ Ranolazine is predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical → Also see
▶ Ranolazine is predicted to increase the exposure to
▶ Rifampicin is predicted to decrease the exposure to ranolazine.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Ranolazine is predicted to increase the exposure to statins
▶ Ranolazine slightly increases the exposure to statins
(simvastatin). Adjust simvastatin dose, p. 205.oStudy
▶ Ranolazine increases the concentration of tacrolimus. Adjust
▶ Ranolazine is predicted to increase the exposure to ticagrelor.
Use with caution or avoid.rStudy
is predicted to increase the exposure to topotecan.
▶ Ranolazine is predicted to increase the concentration of
▶ Ranolazine is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
Rasagiline → see monoamine-oxidase B inhibitors
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Antifungals, azoles (miconazole) are predicted to increase the
reboxetine. Use with caution and adjust dose.
▶ Cobicistat is predicted to increase the exposure to reboxetine.
▶ Enzalutamide is predicted to decrease the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
▶ Idelalisib is predicted to increase the exposure to reboxetine.
▶ Reboxetine is predicted to increase the risk of a hypertensive
crisis when given with linezolid. Avoid.rTheoretical
▶ Reboxetine is predicted to increase the risk of hypokalaemia
when given with loop diuretics.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to reboxetine. Avoid.oStudy
is predicted to decrease the exposure to reboxetine.
▶ Reboxetine is predicted to increase the risk of a hypertensive
crisis when given with moclobemide. Avoid.rTheoretical
▶ Reboxetine is predicted to increase the risk of a hypertensive
crisis when given with monoamine-oxidase A and B inhibitors,
irreversible. Avoid.rTheoretical
▶ Reboxetine is predicted to increase the risk of a hypertensive
crisis when given with monoamine-oxidase B inhibitors
(rasagiline, selegiline). Avoid.rTheoretical
is predicted to decrease the exposure to reboxetine.
▶ Reboxetine is predicted to increase the risk of hypokalaemia
when given with thiazide diuretics.oAnecdotal
Regorafenib → see TABLE 15 p. 1378 (myelosuppression), TABLE 4
p. 1375 (antiplatelet effects)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Cobicistat is predicted to increase the exposure to regorafenib.
▶ Regorafenib is predicted to increase the risk of bleeding events
when given with coumarins.rStudy
▶ Enzalutamide is predicted to decrease the exposure to
▶ Grapefruit juice is predicted to increase the exposure to
regorafenib. Avoid.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
▶ Idelalisib is predicted to increase the exposure to regorafenib.
Avoid.oStudy → Also see TABLE 15 p. 1378
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to regorafenib. Avoid.oStudy
▶ Regorafenib is predicted to increase the exposure to
methotrexate.oTheoretical → Also see TABLE 15 p. 1378
▶ Mitotane is predicted to decrease the exposure to regorafenib.
Avoid.oStudy → Also see TABLE 15 p. 1378
▶ Regorafenib is predicted to increase the exposure to NSAIDs
(mefenamic acid). Avoid.oTheoretical → Also see TABLE 4
▶ Regorafenib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to
▶ Regorafenib is predicted to increase the exposure to statins
(atorvastatin, fluvastatin, rosuvastatin).oStudy
▶ Regorafenib is predicted to increase the exposure to
sulfasalazine.oStudy → Also see TABLE 15 p. 1378
is predicted to increase the exposure to topotecan.
Study → Also see TABLE 15 p. 1378
Repaglinide → see TABLE 14 p. 1378 (antidiabetic drugs)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
repaglinide. Monitor blood glucose and adjust dose.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
moderately increases the exposure to repaglinide.
increases the exposure to repaglinide. Avoid.
1520 Ranolazine — Repaglinide BNF 78
is predicted to increase the exposure to repaglinide.
▶ Enzalutamide is predicted to decrease the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
is predicted to increase the exposure to repaglinide.
▶ Iron chelators (deferasirox) moderately increase the exposure
▶ Leflunomide is predicted to increase the exposure to
▶ Letermovir is predicted to increase the concentration of
repaglinide. Avoid.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to repaglinide.oStudy
▶ Mitotane is predicted to decrease the exposure to repaglinide.
Monitor blood glucose and adjust dose.oStudy
▶ Opicapone is predicted to increase the exposure to repaglinide.
▶ Pitolisant is predicted to decrease the exposure to repaglinide.
▶ Rifampicin is predicted to decrease the exposure to
. Monitor blood glucose and adjust dose.o ▶ Teriflunomide is predicted to increase the exposure to
▶ Trimethoprim slightly increases the exposure to repaglinide.
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