is predicted to increase the exposure to ribociclib.
Study → Also see TABLE 9 p. 1377
▶ Rifampicin is predicted to moderately decrease the exposure
is predicted to increase the exposure to ruxolitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Nilotinib is predicted to increase the exposure to saxagliptin.
▶ Nilotinib increases the concentration of sirolimus. Monitor and
▶ Nilotinib is predicted to increase the exposure to SSRIs
(dapoxetine). Adjust dapoxetine dose with moderate inhibitors
of CYP3A4, p. 821.oTheoretical
▶ St John’s Wort is predicted to decrease the exposure to
▶ Nilotinib is predicted to increase the exposure to statins
(atorvastatin). Monitor and adjust dose.rStudy
▶ Nilotinib is predicted to increase the exposure to statins
(simvastatin). Use with caution and adjust simvastatin dose,
is predicted to increase the exposure to sunitinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
▶ Nilotinib is predicted to increase the concentration of
▶ Nilotinib is predicted to increase the exposure to taxanes
(cabazitaxel).oTheoretical → Also see TABLE 15 p. 1378
▶ Nilotinib is predicted to increase the concentration of
temsirolimus.oTheoretical → Also see TABLE 15 p. 1378
▶ Nilotinib is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Nilotinib given with a potent CYP2C19 inhibitor is predicted to
increase the exposure to tofacitinib. Adjust tofacitinib dose,
▶ Nilotinib is predicted to increase the exposure to tolterodine.
nTheoretical → Also see TABLE 9 p. 1377
BNF 78 Nilotinib — Nilotinib 1503
▶ Nilotinib is predicted to increase the exposure to tolvaptan.
Manufacturer advises caution or adjust tolvaptan dose with
moderate inhibitors of CYP3A4, p. 669.oStudy
is predicted to increase the exposure to trazodone.
▶ Nilotinib is predicted to increase the exposure to ulipristal.
Avoid if used for uterine fibroids.oStudy
▶ Nilotinib is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Nilotinib is predicted to increase the exposure to vinca
alkaloids.rTheoretical → Also see TABLE 15 p. 1378 → Also see
▶ Nilotinib is predicted to increase the exposure to zopiclone.
Nimodipine → see calcium channel blockers
▶ Antiarrhythmics (amiodarone, dronedarone) are predicted to
increase the exposure to nintedanib.oStudy
▶ Antiepileptics (carbamazepine) are predicted to decrease the
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
increase the exposure to nintedanib.oStudy
▶ Calcium channel blockers (verapamil) are predicted to increase
the exposure to nintedanib.oStudy
is predicted to increase the exposure to nintedanib.
▶ HIV-protease inhibitors (lopinavir, ritonavir, saquinavir) are
predicted to increase the exposure to
is predicted to increase the exposure to nintedanib.
▶ Macrolides are predicted to increase the exposure to
is predicted to increase the exposure to nintedanib.
is predicted to decrease the exposure to nintedanib.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Vemurafenib is predicted to increase the exposure to
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to nitisinone. Adjust dose.oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Cobicistat is predicted to increase the exposure to nitisinone.
▶ Enzalutamide is predicted to decrease the exposure to
nitisinone. Adjust dose.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
to nitisinone. Adjust dose.oTheoretical
▶ Idelalisib is predicted to increase the exposure to nitisinone.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to nitisinone. Adjust dose.oTheoretical
▶ Mitotane is predicted to decrease the exposure to nitisinone.
▶ Rifampicin is predicted to decrease the exposure to nitisinone.
Nitrates → see TABLE 7 p. 1376 (first-dose hypotension), TABLE 8 p. 1376
glyceryl trinitrate .isosorbide dinitrate .isosorbide mononitrate.
PHARMACOLOGY Drugs with antimuscarinic effects can cause
dry mouth, which can reduce the effectiveness of sublingual
▶ Nitrates are predicted to increase the risk of
methaemoglobinaemia when given with topical anaesthetics,
local (prilocaine). Avoid.rTheoretical
▶ Nitrates are predicted to increase the risk of
methaemoglobinaemia when given with
▶ Nitrates potentially increase the risk of hypotension when
phosphodiesterase type-5 inhibitors
Nitrazepam → see TABLE 11 p. 1377 (CNS depressant effects)
increases the clearance of nitrazepam.o
Nitrofurantoin → see TABLE 12 p. 1378 (peripheral neuropathy)
▶ Nitrofurantoin is predicted to increase the risk of
methaemoglobinaemia when given with topical anaesthetics,
local (prilocaine). Use with caution or avoid.rTheoretical
▶ Antacids (magnesium trisilicate) decrease the absorption of
▶ Nitrofurantoin is predicted to increase the risk of
methaemoglobinaemia when given with
Nitrous oxide → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377
▶ Nitrous oxide potentially increases the risk of methotrexate
toxicity when given with methotrexate. Avoid.rStudy
Nivolumab → see monoclonal antibodies
Nizatidine → see H2 receptor antagonists
Noradrenaline/norepinephrine → see sympathomimetics,
▶ Antiepileptics (carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate) are predicted to decrease
the efficacy of norethisterone. For FSRH guidance, see
Contraceptives, interactions p. 794.rAnecdotal
▶ Aprepitant is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Bosentan is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Efavirenz is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Fosaprepitant is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Griseofulvin potentially decreases the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the
efficacy of norethisterone. For FSRH guidance, see
Contraceptives, interactions p. 794.rAnecdotal
▶ Modafinil is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Nevirapine is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Rifabutin is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Rifampicin is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ St John’s Wort is predicted to decrease the efficacy of
norethisterone. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactions p. 794.rAnecdotal
▶ Sugammadex is predicted to decrease the exposure to
. Use additional contraceptive precautions.
▶ Ulipristal is predicted to decrease the efficacy of
norethisterone. Avoid.rTheoretical
Normal immunoglobulin → see immunoglobulins
Nortriptyline → see tricyclic antidepressants
NSAIDs → see TABLE 18 p. 1379 (hyponatraemia), TABLE 2 p. 1375
(nephrotoxicity), TABLE 16 p. 1379 (increased serum potassium), TABLE 4
p. 1375 (antiplatelet effects)
1504 Nilotinib — NSAIDs BNF 78
▶ Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.
▶ Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.
▶ Celecoxib is predicted to increase the exposure to
antiarrhythmics (flecainide, propafenone). Monitor and adjust
▶ Antifungals, azoles (fluconazole) moderately increase the
parecoxib. Monitor and adjust dose.oStudy
▶ Antifungals, azoles (voriconazole) slightly increase the exposure
to diclofenac. Monitor and adjust dose.oStudy
▶ Antifungals, azoles (voriconazole) moderately increase the
exposure to ibuprofen. Adjust dose.oStudy
▶ NSAIDs are predicted to increase the risk of gastrointestinal
irritation when given with bisphosphonates (alendronic acid,
▶ NSAIDs are predicted to increase the risk of renal impairment
when given with bisphosphonates (sodium clodronate).r
▶ Ceritinib is predicted to increase the exposure to NSAIDs
(celecoxib, diclofenac). Adjust dose.oTheoretical
increases the concentration of
TABLE 2 p. 1375 → Also see TABLE 16
▶ Etoricoxib slightly increases the exposure to combined
hormonal contraceptives.oStudy
▶ NSAIDs increase the risk of gastrointestinal bleeding when
given with corticosteroids.rStudy
▶ NSAIDs increase the risk of renal impairment when given with
increases the concentration of digoxin.r
▶ Erlotinib is predicted to increase the risk of gastrointestinal
perforation when given with NSAIDs.rTheoretical
▶ Etoricoxib slightly increases the exposure to hormone
▶ NSAIDs are predicted to increase the risk of gastrointestinal
bleeding when given with iron chelators (deferasirox).r
▶ Leflunomide is predicted to increase the exposure to NSAIDs
(indometacin, ketoprofen).oTheoretical
▶ NSAIDs increase the concentration of lithium. Monitor and
▶ NSAIDs are predicted to increase the risk of toxicity when
given with methotrexate.rStudy → Also see TABLE 2 p. 1375
▶ NSAIDs (high-dose) are predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
▶ Nicorandil is predicted to increase the risk of gastrointestinal
perforation when given with NSAIDs.rTheoretical
▶ NSAIDs are predicted to increase the exposure to pemetrexed.
Use with caution or avoid.rTheoretical → Also see TABLE 2
▶ NSAIDs potentially increase the risk of seizures when given
▶ Regorafenib is predicted to increase the exposure to
mefenamic acid. Avoid.oTheoretical → Also see TABLE 4
▶ Rifampicin moderately decreases the exposure to NSAIDs
(celecoxib, diclofenac, etoricoxib).oStudy
▶ Teriflunomide is predicted to increase the exposure to NSAIDs
(indometacin, ketoprofen).oTheoretical
▶ NSAIDs increase the risk of acute renal failure when given with
thiazide diuretics.rTheoretical → Also see TABLE 18 p. 1379
▶ Zidovudine increases the risk of haematological toxicity when
given with NSAIDs.rStudy → Also see TABLE 2 p. 1375
▶ Obeticholic acid decreases the anticoagulant effect of
▶ Obeticholic acid is predicted to increase the exposure to
▶ Obeticholic acid is predicted to increase the exposure to
Obinutuzumab → see monoclonal antibodies
Ocrelizumab → see monoclonal antibodies
▶ Octreotide decreases the absorption of oral ciclosporin. Adjust
ciclosporin dose, p. 838.rAnecdotal
▶ Octreotide (short-acting) decreases the exposure to telotristat
ethyl. Telotristat ethyl should be taken at least 30 minutes
Olanzapine → see TABLE 8 p. 1376 (hypotension), TABLE 15 p. 1378
(myelosuppression), TABLE 11 p. 1377 (CNS depressant effects)
FOOD AND LIFESTYLE Dose adjustment might be necessary if
smoking started or stopped during treatment.
▶ Antiepileptics (carbamazepine) potentially decrease the
olanzapine. Monitor and adjust dose.o ▶ Antiepileptics (phenytoin) are predicted to decrease the
olanzapine. Monitor and adjust dose.o ▶ Olanzapine is predicted to decrease the effects of dopamine
receptor agonists. Avoid.oTheoretical → Also see TABLE 8
▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the
olanzapine. Monitor and adjust dose.o ▶ Leflunomide is predicted to decrease the exposure to
olanzapine. Monitor and adjust dose.oStudy → Also see
▶ Olanzapine decreases the effects of levodopa. Avoid or monitor
worsening parkinsonian symptoms.rAnecdotal → Also see
▶ Mexiletine is predicted to increase the exposure to olanzapine.
▶ Quinolones (ciprofloxacin) are predicted to increase the
exposure to olanzapine. Adjust dose.oAnecdotal
▶ Rifampicin is predicted to decrease the exposure to olanzapine.
Monitor and adjust dose.oStudy
▶ SSRIs (fluvoxamine) moderately increase the exposure to
olanzapine. Adjust dose.rAnecdotal
▶ Teriflunomide is predicted to decrease the exposure to
olanzapine. Monitor and adjust dose.oStudy
Olaparib → see TABLE 15 p. 1378 (myelosuppression)
FOOD AND LIFESTYLE Bitter (Seville) orange is predicted to
increase the exposure to olaparib.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to olaparib. Avoid moderate inhibitors of CYP3A4 or
adjust olaparib dose, p. 1005.oTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to olaparib. Avoid.oTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to olaparib. Avoid
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