is predicted to increase the exposure to adefovir.
▶ Teriflunomide is predicted to decrease the exposure to
▶ Teriflunomide decreases the exposure to aminophylline. Adjust
▶ Teriflunomide is predicted to decrease the exposure to
anaesthetics, local (ropivacaine).oTheoretical
▶ Teriflunomide is predicted to increase the exposure to
anthracyclines (daunorubicin, doxorubicin, mitoxantrone).
▶ Teriflunomide is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).oStudy
potentially increases the exposure to baricitinib.
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to moderately increase the
clearance of caffeine citrate. Monitor and adjust dose.
▶ Teriflunomide is predicted to increase the exposure to
cephalosporins (cefaclor).oStudy
▶ Teriflunomide is predicted to decrease the exposure to
affects the anticoagulant effect of coumarins.
▶ Teriflunomide is predicted to decrease the exposure to
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to H2
receptor antagonists (cimetidine, famotidine).oStudy
▶ Teriflunomide is predicted to increase the concentration of
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
teriflunomide. Public Health England advises avoid (refer to
▶ Teriflunomide is predicted to increase the exposure to loop
▶ Teriflunomide is predicted to decrease the exposure to
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the clearance of
mexiletine. Monitor and adjust dose.oStudy
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to NSAIDs
(indometacin, ketoprofen).oTheoretical
▶ Teriflunomide is predicted to decrease the exposure to
olanzapine. Monitor and adjust dose.oStudy
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
penicillins (benzylpenicillin).oStudy
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to decrease the exposure to
▶ Teriflunomide is predicted to increase the exposure to
quinolones (ciprofloxacin).oTheoretical
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
selexipag. Adjust dose.oTheoretical
▶ Teriflunomide is predicted to increase the exposure to statins
(atorvastatin, fluvastatin, pravastatin, simvastatin)
.o ▶ Teriflunomide moderately increases the exposure to statins
(rosuvastatin). Adjust rosuvastatin dose, p. 204.oStudy
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
sulfonylureas (glibenclamide).oStudy
▶ Teriflunomide is predicted to increase the concentration of
taxanes (paclitaxel).rAnecdotal
▶ Teriflunomide is predicted to increase the exposure to
tenofovir alafenamide.oTheoretical
▶ Teriflunomide is predicted to increase the exposure to
tenofovir disoproxil.oTheoretical
▶ Teriflunomide is predicted to decrease the exposure to
theophylline. Adjust dose.oStudy
▶ Teriflunomide moderately decreases the exposure to
▶ Teriflunomide is predicted to increase the exposure to
▶ Teriflunomide is predicted to increase the exposure to
Tetanus immunoglobulin → see immunoglobulins
Tetrabenazine → see TABLE 9 p. 1377 (QT-interval prolongation)
▶ Tetrabenazine is predicted to decrease the effects of levodopa.
Use with caution or avoid.oTheoretical
▶ Tetrabenazine is predicted to increase the risk of CNS toxicity
when given with monoamine-oxidase A and B inhibitors,
. Avoid and for 14 days after stopping the MAOI.
Tetracaine → see anaesthetics, local
Tetracycline → see tetracyclines
Tetracyclines → see TABLE 1 p. 1375 (hepatotoxicity)
ROUTE-SPECIFIC INFORMATION Interactions do not generally
apply to topical use of oxytetracycline unless specified.
▶ ACE inhibitors (quinapril) (tablet) decrease the absorption of
oral tetracycline. Avoid.oStudy
▶ Antacids decrease the absorption of tetracyclines. Separate
administration by 2 to 3 hours.oStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) decrease the exposure to doxycycline.
Monitor and adjust dose.oStudy → Also see TABLE 1
1542 Terbinafine —Tetracyclines BNF 78
▶ Tetracycline decreases the concentration of antimalarials
▶ Calcium salts (calcium carbonate) are predicted to decrease the
absorption of tetracyclines. Separate administration by 2 to
▶ Tetracyclines increase the risk of bleeding events when given
▶ Dairy products decrease the exposure to tetracyclines
(demeclocycline, oxytetracycline, tetracycline)
. Avoid.o ▶ Enzalutamide decreases the exposure to doxycycline. Monitor
▶ Iron (oral) decreases the absorption of tetracyclines.
should be taken 2 to 3 hours after iron (oral).
is predicted to decrease the absorption of tetracyclines.
▶ Lanthanum is predicted to decrease the absorption of
. Separate administration by 2 hours.o ▶ Mitotane decreases the exposure to doxycycline. Monitor and
▶ Retinoids (acitretin, alitretinoin, isotretinoin, tretinoin) increase
the risk of benign intracranial hypertension when given with
tetracyclines. Avoid.rAnecdotal
▶ Rifampicin decreases the exposure to doxycycline. Monitor and
▶ Oral zinc is predicted to decrease the absorption of
. Separate administration by 2 to 3 hours.
FOOD AND LIFESTYLE Avoid bitter (Seville) oranges as they are
predicted to increase the exposure to tezacaftor.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to tezacaftor. Adjust tezacaftor with ivacaftor p. 295
dose with moderate inhibitors of CYP3A4.rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to tezacaftor. Avoid.rTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to tezacaftor. Adjust
tezacaftor with ivacaftor p. 295 dose with moderate inhibitors
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to tezacaftor. Adjust
tezacaftor with ivacaftor p. 295 dose with potent inhibitors of
▶ Aprepitant is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to tezacaftor. Adjust tezacaftor with
p. 295 dose with moderate inhibitors of CYP3A4.
▶ Cobicistat is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with potent
▶ Crizotinib is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Enzalutamide is predicted to decrease the exposure to
tezacaftor. Avoid.rTheoretical
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
to tezacaftor. Adjust tezacaftor with ivacaftor p. 295 dose with
potent inhibitors of CYP3A4.rStudy
▶ Idelalisib is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with potent
▶ Imatinib is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to tezacaftor. Adjust tezacaftor with ivacaftor p. 295
dose with potent inhibitors of CYP3A4.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to tezacaftor. Adjust tezacaftor with ivacaftor p. 295
dose with moderate inhibitors of CYP3A4.rStudy
▶ Mitotane is predicted to decrease the exposure to tezacaftor.
▶ Netupitant is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Nilotinib is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with moderate
▶ Rifabutin is predicted to decrease the exposure to tezacaftor.
▶ Rifampicin is predicted to decrease the exposure to tezacaftor.
▶ St John’s Wort is predicted to decrease the exposure to
tezacaftor. Avoid.rTheoretical
Thalidomide → see TABLE 6 p. 1376 (bradycardia), TABLE 15 p. 1378
(myelosuppression), TABLE 12 p. 1378 (peripheral neuropathy), TABLE 5
p. 1375 (thromboembolism), TABLE 11 p. 1377 (CNS depressant effects)
▶ Combined hormonal contraceptives are predicted to increase
the risk of venous thromboembolism when given with
▶ Hormone replacement therapy is predicted to increase the risk
of venous thromboembolism when given with
Theophylline → see TABLE 17 p. 1379 (reduced serum potassium)
FOOD AND LIFESTYLE Smoking can increase theophylline
clearance and increased doses of theophylline are therefore
required; dose adjustments are likely to be necessary if
smoking started or stopped during treatment.
▶ Aciclovir is predicted to increase the exposure to theophylline.
Monitor and adjust dose.rTheoretical
▶ Theophylline decreases the efficacy of antiarrhythmics
(adenosine). Separate administration by 24 hours.nStudy
▶ Antiepileptics (carbamazepine) potentially increase the
clearance of theophylline and theophylline decreases the
antiepileptics (carbamazepine). Adjust dose.
▶ Antiepileptics (fosphenytoin, phenytoin) are predicted to
theophylline. Adjust dose.o ▶ Antiepileptics (phenobarbital, primidone) are predicted to
theophylline. Adjust dose.o ▶ Antiepileptics (stiripentol) are predicted to increase the
exposure to theophylline. Avoid.oTheoretical
▶ Beta blockers, non-selective are predicted to increase the risk
of bronchospasm when given with
▶ Beta blockers, selective are predicted to increase the risk of
decreases the clearance of theophylline.
▶ Combined hormonal contraceptives are predicted to increase
theophylline. Monitor and adjust dose.
▶ Theophylline increases the risk of agitation when given with
given with theophylline. Avoid.rTheoretical
▶ H2 receptor antagonists (cimetidine) increase the concentration
of theophylline. Adjust dose.rStudy
▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the
exposure to theophylline. Adjust dose.oStudy
▶ Interferons slightly increase the exposure to theophylline.
▶ Iron chelators (deferasirox) increase the exposure to
BNF 78 Tetracyclines —Theophylline 1543
is predicted to affect the clearance of theophylline.
▶ Leflunomide is predicted to decrease the exposure to
theophylline. Adjust dose.oStudy
▶ Theophylline is predicted to decrease the concentration of
theophylline. Adjust dose.o ▶ Macrolides (erythromycin) decrease the clearance of
theophylline and theophylline potentially decreases the
macrolides (erythromycin). Adjust dose.r
decreases the clearance of theophylline.
▶ Mexiletine is predicted to increase the exposure to
theophylline. Monitor and adjust dose.oTheoretical
▶ Monoclonal antibodies (blinatumomab) are predicted to
transiently increase the exposure to theophylline. Monitor and
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