is predicted to increase the exposure to ruxolitinib.
▶ Nevirapine is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oTheoretical
is predicted to increase the exposure to ruxolitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Ruxolitinib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oStudy
▶ St John’s Wort is predicted to decrease the exposure to
ruxolitinib. Monitor and adjust dose.oTheoretical
Sacubitril → see TABLE 8 p. 1376 (hypotension)
is predicted to increase the exposure to statins.
Safinamide → see monoamine-oxidase B inhibitors
Salbutamol → see beta2 agonists
Salmeterol → see beta2 agonists
Sapropterin → see TABLE 8 p. 1376 (hypotension)
▶ Methotrexate is predicted to decrease the efficacy of
▶ Phosphodiesterase type-5 inhibitors are predicted to increase
the risk of hypotension when given with
Theoretical → Also see TABLE 8 p. 1376
sapropterin.o ▶ Trimethoprim is predicted to decrease the efficacy of
Saquinavir → see HIV-protease inhibitors
Sarilumab → see monoclonal antibodies
Saxagliptin → see TABLE 14 p. 1378 (antidiabetic drugs)
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to saxagliptin.nStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to moderately decrease
the exposure to saxagliptin.oStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to saxagliptin.n
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
saxagliptin.o ▶ Aprepitant is predicted to increase the exposure to saxagliptin.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to saxagliptin.nStudy
is predicted to increase the exposure to saxagliptin.
▶ Crizotinib is predicted to increase the exposure to saxagliptin.
▶ Enzalutamide is predicted to moderately decrease the
exposure to saxagliptin.oStudy
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
is predicted to increase the exposure to saxagliptin.
▶ Imatinib is predicted to increase the exposure to saxagliptin.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to saxagliptin.oStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to saxagliptin.nStudy
▶ Mitotane is predicted to moderately decrease the exposure to
▶ Netupitant is predicted to increase the exposure to saxagliptin.
▶ Nilotinib is predicted to increase the exposure to saxagliptin.
▶ Rifampicin is predicted to moderately decrease the exposure
Secukinumab → see monoclonal antibodies
Selegiline → see monoamine-oxidase B inhibitors
ROUTE-SPECIFIC INFORMATION Interactions do not generally
apply to topical use unless specified.
▶ Oral selenium is predicted to decrease the absorption of
eltrombopag. Eltrombopag should be taken 2 hours before or
4 hours after selenium.rTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenytoin) are
predicted to decrease the exposure to the active metabolite of
▶ Antiepileptics (valproate) are predicted to increase the exposure
▶ Antifungals, azoles (fluconazole) are predicted to increase the
exposure to selexipag.qTheoretical
▶ Clopidogrel is predicted to increase the exposure to selexipag.
▶ Fibrates (gemfibrozil) increase the exposure to selexipag.
▶ Iron chelators (deferasirox) are predicted to increase the
exposure to selexipag. Adjust dose.oStudy
▶ Leflunomide is predicted to increase the exposure to selexipag.
▶ Rifampicin moderately decreases the exposure to the active
metabolite of selexipag. Adjust dose.oStudy
▶ Teriflunomide is predicted to increase the exposure to
selexipag. Adjust dose.oTheoretical
Semaglutide → see TABLE 14 p. 1378 (antidiabetic drugs)
Sevoflurane → see volatile halogenated anaesthetics
Sildenafil → see phosphodiesterase type-5 inhibitors
Siltuximab → see monoclonal antibodies
PHARMACOLOGY Silver might inactivate enzymatic debriding
agents—concurrent use might not be appropriate.
1528 Ruxolitinib — Simvastatin BNF 78
▶ Antiarrhythmics (amiodarone) are predicted to increase the
concentration of sirolimus.rAnecdotal
▶ Antiarrhythmics (dronedarone) increase the concentration of
sirolimus. Monitor and adjust dose.oStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the
concentration of sirolimus. Avoid.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
increase the concentration of sirolimus. Monitor and adjust
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the concentration of
▶ Antifungals, azoles (miconazole) are predicted to increase the
sirolimus. Monitor and adjust dose.o ▶ Apalutamide is predicted to decrease the exposure to
sirolimus. Avoid or monitor.oStudy
▶ Aprepitant increases the concentration of sirolimus. Monitor
▶ Bosentan is predicted to decrease the concentration of
sirolimus and sirolimus potentially increases the
concentration of bosentan. Avoid.rTheoretical
▶ Brigatinib potentially decreases the concentration of
▶ Calcium channel blockers (diltiazem, verapamil) increase the
sirolimus. Monitor and adjust dose.o ▶ Ceritinib is predicted to increase the exposure to sirolimus.
▶ Sirolimus is predicted to affect the efficacy of chenodeoxycholic
acid. Monitor and adjust dose.oTheoretical
▶ Ciclosporin moderately increases the exposure to sirolimus.
Separate administration by 4 hours.rStudy
▶ Cobicistat is predicted to increase the concentration of
▶ Crizotinib increases the concentration of sirolimus. Monitor
▶ Doravirine is predicted to decrease the exposure to sirolimus.
sirolimus concentration and adjust dose, p. 840.
▶ Efavirenz is predicted to decrease the concentration of
sirolimus. Monitor and adjust dose.oTheoretical
▶ Eliglustat is predicted to increase the exposure to sirolimus.
▶ Enzalutamide is predicted to decrease the concentration of
▶ Grapefruit juice increases the concentration of sirolimus.
▶ HIV-protease inhibitors are predicted to increase the
concentration of sirolimus. Avoid.rStudy
▶ Idelalisib is predicted to increase the concentration of
▶ Imatinib increases the concentration of sirolimus. Monitor and
is predicted to increase the exposure to sirolimus.
▶ Letermovir moderately increases the exposure to sirolimus.
Monitor and adjust dose.rStudy
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
sirolimus. Public Health England advises avoid (refer to Green
▶ Lumacaftor is predicted to decrease the exposure to sirolimus.
▶ Macrolides (clarithromycin) are predicted to increase the
concentration of sirolimus. Avoid.rStudy
▶ Macrolides (erythromycin) increase the concentration of
sirolimus. Monitor and adjust dose.oStudy
▶ Sirolimus is predicted to decrease the efficacy of mifamurtide.
▶ Mirabegron is predicted to increase the exposure to sirolimus.
▶ Mitotane is predicted to decrease the concentration of
▶ Monoclonal antibodies (sarilumab) potentially affect the
sirolimus. Monitor and adjust dose.o ▶ Netupitant increases the concentration of sirolimus. Monitor
▶ Nevirapine is predicted to decrease the concentration of
sirolimus. Monitor and adjust dose.oTheoretical
▶ Nilotinib increases the concentration of sirolimus. Monitor and
▶ Palbociclib is predicted to increase the exposure to sirolimus.
▶ Pibrentasvir (with glecaprevir) is predicted to increase the
▶ Pitolisant is predicted to decrease the exposure to sirolimus.
▶ Ribociclib is predicted to increase the exposure to sirolimus.
Use with caution and adjust dose.oTheoretical
▶ Rifampicin is predicted to decrease the concentration of
▶ Rucaparib is predicted to increase the exposure to sirolimus.
Monitor and adjust dose.oStudy
▶ St John’s Wort is predicted to decrease the concentration of
sirolimus. Monitor and adjust dose.rTheoretical
▶ Sirolimus is predicted to decrease the concentration of
and tacrolimus increases the exposure to sirolimus.
is predicted to increase the exposure to sirolimus.
▶ Venetoclax is predicted to increase the exposure to sirolimus.
Sitagliptin → see TABLE 14 p. 1378 (antidiabetic drugs)
▶ ACE inhibitors are predicted to increase the risk of
hypersensitivity when given with sodium aurothiomalate.
previous adverse reactions to gold). Avoid.rStudy
ROUTE-SPECIFIC INFORMATION Interactions do not generally
apply to topical use unless specified.
▶ Oral sodium bicarbonate decreases the absorption of
antifungals, azoles (ketoconazole).oStudy
decreases the concentration of lithium.
▶ Sodium bicarbonate is predicted to decrease the efficacy of
methenamine. Avoid.oTheoretical
▶ Sodium citrate is predicted to decrease the efficacy of
methenamine. Avoid.oTheoretical
▶ Sodium citrate is predicted to increase the risk of side-effects
when given with sucralfate. Avoid.oTheoretical
Sodium clodronate → see bisphosphonates
Sodium feredetate → see iron (oral)
Sodium nitroprusside → see TABLE 8 p. 1376 (hypotension)
▶ Sodium nitroprusside is predicted to increase the risk of
methaemoglobinaemia when given with topical anaesthetics,
local (prilocaine). Use with caution or avoid.rTheoretical
▶ Sodium nitroprusside is predicted to increase the risk of
methaemoglobinaemia when given with
Sodium oxybate → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377
▶ Antiepileptics (valproate) increase the exposure to sodium
oxybate. Adjust sodium oxybate dose, p. 491.oStudy
▶ Antiepileptics (valproate) potentially decrease the effects of
sodium phenylbutyrate.oAnecdotal
▶ Corticosteroids potentially decrease the effects of sodium
▶ Haloperidol potentially decreases the effects of sodium
Sodium picosulfate → see TABLE 18 p. 1379 (hyponatraemia)
BNF 78 Sirolimus — Sodium picosulfate 1529
▶ Sodium stibogluconate increases the risk of cardiovascular
side-effects when given with amphotericin. Separate
administration by 14 days.rStudy
▶ Sofosbuvir is predicted to increase the risk of severe
bradycardia or heart block when given with antiarrhythmics
(amiodarone). Refer to specialist literature.rAnecdotal
▶ Antiepileptics (carbamazepine) are predicted to decrease the
exposure to sofosbuvir. Avoid.rStudy
▶ Antiepileptics (fosphenytoin, oxcarbazepine, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to sofosbuvir. Avoid.rTheoretical
▶ H2 receptor antagonists potentially decrease the exposure to
sofosbuvir. Adjust dose, see ledipasvir with sofosbuvir p. 628,
sofosbuvir with velpatasvir p. 629, and sofosbuvir with
velpatasvir and voxilaprevir p. 630.oStudy
▶ HIV-protease inhibitors (tipranavir) are predicted to decrease the
exposure to sofosbuvir. Avoid.rTheoretical
▶ Modafinil is predicted to decrease the exposure to sofosbuvir.
▶ Proton pump inhibitors potentially decrease the exposure to
sofosbuvir. Adjust dose, see ledipasvir with sofosbuvir p. 628,
sofosbuvir with velpatasvir p. 629, and sofosbuvir with
velpatasvir and voxilaprevir p. 630.oStudy
▶ Rifabutin is predicted to decrease the exposure to sofosbuvir.
▶ Rifampicin is predicted to decrease the exposure to sofosbuvir.
▶ St John’s Wort is predicted to decrease the exposure to
Solifenacin → see TABLE 10 p. 1377 (antimuscarinics)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to solifenacin. Adjust
solifenacin p. 779 or tamsulosin with solifenacin p. 786 dose;
avoid in hepatic and renal impairment.rStudy
▶ Cobicistat is predicted to increase the exposure to solifenacin.
Adjust solifenacin p. 779 or tamsulosin with solifenacin p. 786
dose; avoid in hepatic and renal impairment.rStudy
▶ Enzalutamide is predicted to decrease the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
to solifenacin. Adjust solifenacin p. 779 or tamsulosin with
p. 786 dose; avoid in hepatic and renal impairment.
▶ Idelalisib is predicted to increase the exposure to solifenacin.
Adjust solifenacin p. 779 or tamsulosin with solifenacin p. 786
dose; avoid in hepatic and renal impairment.rStudy
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to solifenacin. Adjust solifenacin p. 779 or tamsulosin
with solifenacin p. 786 dose; avoid in hepatic and renal
is predicted to decrease the exposure to solifenacin.
is predicted to decrease the exposure to solifenacin.
▶ Corticosteroids are predicted to decrease the effects of
Sorafenib → see TABLE 15 p. 1378 (myelosuppression), TABLE 9 p. 1377
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
increases the anticoagulant effect of coumarins.
▶ Enzalutamide is predicted to decrease the exposure to
is predicted to decrease the exposure to sorafenib.
Theoretical → Also see TABLE 15 p. 1378
moderately decreases the exposure to sorafenib.
▶ Sorafenib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
is predicted to decrease the exposure to sorafenib.
Sotalol → see beta blockers, non-selective
Spironolactone → see aldosterone antagonists
SSRIs → see TABLE 18 p. 1379 (hyponatraemia), TABLE 13 p. 1378
(serotonin syndrome), TABLE 9 p. 1377 (QT-interval prolongation),
TABLE 4 p. 1375 (antiplatelet effects)
▶ Fluvoxamine moderately increases the exposure to alprazolam.
▶ SSRIs (fluoxetine, paroxetine) are predicted to increase the
No comments:
Post a Comment
اكتب تعليق حول الموضوع