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pomalidomide. Adjust pomalidomide dose, p. 961.

Theoretical

▶ SSRIs (fluvoxamine) moderately increase the exposure to

pomalidomide. Adjust pomalidomide dose, p. 961.oStudy

Ponatinib

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to ponatinib. Avoid.oTheoretical

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to slightly increase the exposure to ponatinib.

Monitor and adjust ponatinib dose, p. 994.oStudy

▶ Cobicistat is predicted to slightly increase the exposure to

ponatinib

Study

. Monitor and adjust ponatinib dose, p. 994.o ▶ Ponatinib is predicted to increase the risk of bleeding events

when given with coumarins.rTheoretical

▶ Enzalutamide is predicted to decrease the exposure to

ponatinib. Avoid.oTheoretical

▶ Grapefruit juice is predicted to increase the exposure to

ponatinib.oTheoretical

▶ HIV-protease inhibitors are predicted to slightly increase the

exposure to ponatinib. Monitor and adjust ponatinib dose,

p. 994.oStudy

▶ Idelalisib is predicted to slightly increase the exposure to

ponatinib

Study

. Monitor and adjust ponatinib dose, p. 994.o ▶ Macrolides (clarithromycin) are predicted to slightly increase

the exposure to ponatinib. Monitor and adjust ponatinib dose,

p. 994.oStudy

▶ Mitotane is predicted to decrease the exposure to ponatinib.

Avoid.oTheoretical

▶ Ponatinib is predicted to increase the risk of bleeding events

when given with phenindione.rTheoretical

▶ Rifampicin is predicted to decrease the exposure to ponatinib.

Avoid.oTheoretical

▶ St John’s Wort is predicted to decrease the exposure to

ponatinib. Avoid.rTheoretical

1516 Pitolisant — Ponatinib BNF 78

Interactions | Appendix 1

A1

Posaconazole → see antifungals, azoles

Potassium aminobenzoate → see TABLE 16 p. 1379 (increased serum

potassium)

▶ Potassium aminobenzoate increases the concentration of

methotrexate.oTheoretical

▶ Potassium aminobenzoate is predicted to affect the efficacy of

sulfonamides. Avoid.rTheoretical

Potassium canrenoate → see TABLE 16 p. 1379 (increased serum

potassium)

Potassium chloride → see TABLE 16 p. 1379 (increased serum

potassium)

Potassium citrate

▶ Potassium citrate is predicted to decrease the efficacy of

methenamine. Avoid.oTheoretical

▶ Potassium citrate increases the risk of side-effects when given

with sucralfate. Avoid.oTheoretical

Potassium-sparing diuretics → see TABLE 18 p. 1379

(hyponatraemia), TABLE 16 p. 1379 (increased serum potassium)

amiloride .triamterene. ▶ Triamterene

o

potentially increases the clearance of lithium.

Study

Pramipexole → see dopamine receptor agonists

Prasugrel → see TABLE 4 p. 1375 (antiplatelet effects)

Pravastatin → see statins

Praziquantel

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to markedly decrease the

exposure to praziquantel. Avoid.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to moderately increase the exposure to

praziquantel.nStudy

▶ Antimalarials (chloroquine) moderately decrease the exposure

to

Study

praziquantel. Use with caution and adjust dose.o ▶ Cobicistat is predicted to moderately increase the exposure to

praziquantel.nStudy

▶ Corticosteroids (dexamethasone) decrease the exposure to

praziquantel.oStudy

▶ Enzalutamide is predicted to markedly decrease the exposure

to praziquantel. Avoid.oStudy

▶ Grapefruit juice is predicted to increase the exposure to

praziquantel.oStudy

▶ H2 receptor antagonists (cimetidine) moderately increase the

exposure to praziquantel.oStudy

▶ HIV-protease inhibitors are predicted to moderately increase

the exposure to praziquantel.nStudy

▶ Idelalisib is predicted to moderately increase the exposure to

praziquantel.nStudy

▶ Macrolides (clarithromycin) are predicted to moderately

increase the exposure to praziquantel.nStudy

▶ Mitotane is predicted to markedly decrease the exposure to

praziquantel. Avoid.oStudy

▶ Rifampicin is predicted to markedly decrease the exposure to

praziquantel. Avoid.oStudy

Prazosin → see alpha blockers

Prednisolone → see corticosteroids

Pregabalin → see antiepileptics

Prilocaine → see anaesthetics, local

Primaquine → see antimalarials

Primidone → see antiepileptics

Procarbazine → see TABLE 15 p. 1378 (myelosuppression), TABLE 13

p. 1378 (serotonin syndrome)

FOOD AND LIFESTYLE Procarbazine is a mild monoamineoxidase inhibitor and might rarely interact with tyramine-rich

foods (such as mature cheese, salami, pickled herring, Bovril ®,

Oxo ®, Marmite ® or any similar meat or yeast extract or

fermented soya bean extract, and some beers, lagers or

wines).

▶ Alcohol (beverage) potentially causes a disulfiram-like

reaction when given with procarbazine.oAnecdotal

▶ Antiepileptics (carbamazepine, phenobarbital, phenytoin,

primidone) are predicted to increase the risk of

hypersensitivity reactions when given with

r

procarbazine.

Anecdotal

▶ Antiepileptics (fosphenytoin) are predicted to increase the risk

of hypersensitivity when given with

Anecdotal

procarbazine.r

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

procarbazine. Public Health England advises avoid (refer to

Green Book).rTheoretical

Prochlorperazine → see phenothiazines

Procyclidine → see TABLE 10 p. 1377 (antimuscarinics)

▶ SSRIs (paroxetine) slightly increase the exposure to

procyclidine. Monitor and adjust dose.oStudy

Proguanil → see antimalarials

Promazine → see phenothiazines

Promethazine → see antihistamines, sedating

Propafenone → see antiarrhythmics

Propantheline → see TABLE 10 p. 1377 (antimuscarinics)

Propiverine → see TABLE 10 p. 1377 (antimuscarinics)

▶ Propiverine is predicted to increase the exposure to

lomitapide

Theoretical

. Separate administration by 12 hours.o

Propofol → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS

depressant effects)

▶ Antiepileptics (valproate) potentially increase the

concentration of propofol. Adjust dose.rTheoretical

Propranolol → see beta blockers, non-selective

Propylthiouracil → see TABLE 15 p. 1378 (myelosuppression)

▶ Propylthiouracil is predicted to decrease the effects of

metyrapone. Avoid.oTheoretical

Proton pump inhibitors

esomeprazole . lansoprazole . omeprazole . pantoprazole . rabeprazole. ▶ Antifungals, azoles (voriconazole) increase the exposure to

proton pump inhibitors (esomeprazole, omeprazole). Adjust

dose.oStudy

▶ Proton pump inhibitors decrease the absorption of antifungals,

azoles (itraconazole). Administer itraconazole capsules with an

acidic beverage.oStudy

▶ Proton pump inhibitors decrease the absorption of antifungals,

azoles (ketoconazole). Administer ketoconazole with an acidic

beverage.oStudy

▶ Proton pump inhibitors decrease the absorption of antifungals,

azoles (posaconazole) (oral suspension). Avoid.oStudy

▶ Apalutamide markedly decreases the exposure to omeprazole.

Avoid or monitor.oStudy

▶ Apalutamide is predicted to decrease the exposure to proton

pump inhibitors (lansoprazole, rabeprazole). Avoid or monitor.

nStudy

▶ Proton pump inhibitors are predicted to decrease the

absorption of bosutinib.oStudy

▶ Proton pump inhibitors are predicted to decrease the

absorption of ceritinib.oTheoretical

▶ Esomeprazole is predicted to increase the exposure to

cilostazol.oTheoretical

▶ Omeprazole is predicted to increase the exposure to cilostazol.

Adjust cilostazol dose, p. 232.oStudy

▶ Proton pump inhibitors (esomeprazole, omeprazole) potentially

increase the exposure to

Theoretical

clobazam. Adjust dose.o ▶ Proton pump inhibitors (esomeprazole, omeprazole) are

predicted to decrease the ef

o

ficacy of clopidogrel. Avoid.

Study

▶ Proton pump inhibitors are predicted to slightly to moderately

decrease the exposure to dasatinib. Avoid.rStudy

▶ Proton pump inhibitors are predicted to decrease the

absorption of

o

dipyridamole (immediate release tablets).

Theoretical

▶ Proton pump inhibitors are predicted to slightly decrease the

exposure to erlotinib. Avoid.oStudy

▶ Proton pump inhibitors are predicted to decrease the exposure

to gefitinib.rTheoretical

▶ HIV-protease inhibitors (tipranavir) decrease the exposure to

proton pump inhibitors. Avoid.rStudy

▶ Proton pump inhibitors decrease the exposure to HIV-protease

inhibitors (atazanavir). Avoid or adjust dose.rStudy

BNF 78 Posaconazole — Proton pump inhibitors 1517

Interactions | Appendix 1

A1

Proton pump inhibitors (continued)

▶ Proton pump inhibitors increase the exposure to HIV-protease

inhibitors (saquinavir). Avoid.rStudy

▶ Proton pump inhibitors are predicted to decrease the exposure

to

o

ledipasvir. Adjust dose, see ledipasvir with sofosbuvir p. 628.

Theoretical

▶ Proton pump inhibitors decrease the clearance of methotrexate

(high-dose). Use with caution or avoid.rStudy

▶ Proton pump inhibitors are predicted to decrease the exposure

to

o

pazopanib. Avoid or administer concurrently without food.

Study

▶ Proton pump inhibitors are predicted to decrease the exposure

to rilpivirine. Avoid.rStudy

▶ 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

▶ Esomeprazole is predicted to slightly to moderately increase

the exposure to SSRIs (citalopram, escitalopram). Monitor and

adjust dose.rTheoretical

▶ Omeprazole slightly to moderately increases the exposure to

rSSRIs (citalopram, escitalopram). Monitor and adjust dose.

Study

▶ Proton pump inhibitors are predicted to decrease the

concentration of velpatasvir. Adjust dose, see sofosbuvir with

velpatasvir p. 629.oStudy

▶ Proton pump inhibitors are predicted to decrease the exposure

to voxilaprevir. Adjust dose, see sofosbuvir with velpatasvir and

voxilaprevir p. 630.oStudy

Proxymetacaine → see anaesthetics, local

Pseudoephedrine → see sympathomimetics, vasoconstrictor

Pyrazinamide

▶ Allopurinol is predicted to increase the risk of hyperuricaemia

when given with pyrazinamide.oTheoretical

Pyridostigmine → see TABLE 6 p. 1376 (bradycardia)

▶ Aminoglycosides are predicted to decrease the effects of

pyridostigmine.oTheoretical

Pyrimethamine → see antimalarials

Quetiapine → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS

depressant effects)

▶ Antiarrhythmics (dronedarone) are predicted to increase the

exposure to quetiapine. Avoid.oStudy

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to quetiapine.oStudy → Also see TABLE 11 p. 1377

▶ Antiepileptics (valproate) potentially increase the risk of

neutropenia when given with quetiapine.oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

o

quetiapine. Avoid.

Study

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to

r

quetiapine. Avoid.

Study

▶ Apalutamide is predicted to decrease the exposure to

quetiapine. Avoid or monitor.oStudy

▶ Aprepitant is predicted to increase the exposure to quetiapine.

Avoid.oStudy

▶ Bosentan

o

is predicted to decrease the exposure to quetiapine.

Study

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to quetiapine. Avoid.oStudy →

Also see TABLE 8 p. 1376

▶ Cobicistat is predicted to increase the exposure to quetiapine.

Avoid.rStudy

▶ Crizotinib is predicted to increase the exposure to quetiapine.

Avoid.oStudy

▶ Quetiapine is predicted to decrease the effects of dopamine

receptor agonists. Avoid.oTheoretical → Also see TABLE 8

p. 1376

▶ Efavirenz

o

is predicted to decrease the exposure to quetiapine.

Study

▶ Enzalutamide is predicted to decrease the exposure to

quetiapine.oStudy

▶ Grapefruit juice is predicted to increase the exposure to

quetiapine. Avoid.rTheoretical

▶ HIV-protease inhibitors are predicted to increase the exposure

to quetiapine. Avoid.rStudy

▶ Idelalisib is predicted to increase the exposure to quetiapine.

Avoid.rStudy

▶ Imatinib is predicted to increase the exposure to quetiapine.

Avoid.oStudy

▶ Quetiapine

Anecdotal →

decreases the effects of

Also see TABLE 8 p. 1376

levodopa.r

▶ Quetiapine potentially increases the risk of neurotoxicity

when given with lithium.rAnecdotal

▶ Macrolides (clarithromycin) are predicted to increase the

exposure to quetiapine. Avoid.rStudy

▶ Macrolides (erythromycin) are predicted to increase the

exposure to quetiapine. Avoid.oStudy

▶ Mitotane

o

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