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valganciclovir.

Theoretical → Also see TABLE 15 p. 1378

Nabilone → see TABLE 11 p. 1377 (CNS depressant effects)

▶ Nabilone is predicted to increase the risk of cardiovascular

side-effects when given with amfetamines.rTheoretical

Nabumetone → see NSAIDs

Nadolol → see beta blockers, non-selective

Nalmefene

GENERAL INFORMATION Discontinue treatment 1 week before

anticipated use of opioids; if emergency analgesia is required

during treatment, an increased dose of opioid analgesic might

be necessary (monitor for opioid intoxication).

▶ Nalmefene is predicted to decrease the efficacy of opioids.

Avoid.rTheoretical

Naloxegol

▶ Antiarrhythmics (dronedarone) are predicted to increase the

exposure to naloxegol. Adjust naloxegol dose and monitor side

effects, p. 65.oStudy

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to markedly decrease the

exposure to naloxegol. Avoid.oStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to naloxegol. Adjust

naloxegol dose and monitor side effects, p. 65.oStudy

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

predicted to markedly increase the exposure to naloxegol.

Avoid.rStudy

▶ Apalutamide is predicted to decrease the exposure to

naloxegol. Avoid or monitor.oStudy

▶ Aprepitant is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to naloxegol. Adjust naloxegol dose and

monitor side effects, p. 65.oStudy

▶ Cobicistat is predicted to markedly increase the exposure to

naloxegol. Avoid.rStudy

▶ Crizotinib is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Enzalutamide is predicted to markedly decrease the exposure

to naloxegol. Avoid.oStudy

▶ Grapefruit juice is predicted to increase the exposure to

naloxegol. Avoid.oTheoretical

▶ HIV-protease inhibitors are predicted to markedly increase the

exposure to naloxegol. Avoid.rStudy

▶ Idelalisib is predicted to markedly increase the exposure to

naloxegol. Avoid.rStudy

▶ Imatinib is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Macrolides (clarithromycin) are predicted to markedly increase

the exposure to naloxegol. Avoid.rStudy

▶ Macrolides (erythromycin) are predicted to increase the

exposure to naloxegol. Adjust naloxegol dose and monitor side

effects, p. 65.oStudy

▶ Mitotane is predicted to markedly decrease the exposure to

naloxegol. Avoid.oStudy

▶ Netupitant is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Nilotinib is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Rifampicin is predicted to markedly decrease the exposure to

naloxegol. Avoid.oStudy

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

naloxegol. Avoid.oTheoretical

Naltrexone

GENERAL INFORMATION Avoid concurrent use of opioids.

Nandrolone

▶ Nandrolone is predicted to increase the anticoagulant effect of

coumarins. Monitor and adjust dose.rTheoretical

1498 Monoclonal antibodies — Nandrolone BNF 78

Interactions | Appendix 1

A1

▶ Nandrolone is predicted to increase the anticoagulant effect of

phenindione. Monitor and adjust dose.rTheoretical

Naproxen → see NSAIDs

Naratriptan → see TABLE 13 p. 1378 (serotonin syndrome)

▶ Naratriptan is predicted to increase the risk of

vasoconstriction when given with ergotamine. Separate

administration by 24 hours.rTheoretical

Natalizumab → see monoclonal antibodies

Nateglinide → see TABLE 14 p. 1378 (antidiabetic drugs)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to slightly decrease the

exposure to nateglinide.nStudy

▶ Enzalutamide is predicted to slightly decrease the exposure to

nateglinide.nStudy

▶ Leflunomide is predicted to increase the exposure to

nateglinide.oTheoretical

▶ Mitotane is predicted to slightly decrease the exposure to

nateglinide.nStudy

▶ Rifampicin is predicted to slightly decrease the exposure to

nateglinide.nStudy

▶ Teriflunomide is predicted to increase the exposure to

nateglinide.oTheoretical

Nebivolol → see beta blockers, selective

Necitumumab → see monoclonal antibodies

Nefopam → see TABLE 10 p. 1377 (antimuscarinics)

▶ Nefopam is predicted to increase the risk of serious elevations

in blood pressure when given with monoamine-oxidase A and B

inhibitors, irreversible. Avoid.rTheoretical

Nelarabine → see TABLE 15 p. 1378 (myelosuppression)

Neomycin → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 19 p. 1379

(ototoxicity), TABLE 20 p. 1379 (neuromuscular blocking effects)

ROUTE-SPECIFIC INFORMATION Since systemic absorption can

follow topical application, the possibility of interactions

should be borne in mind.

▶ Neomycin decreases the absorption of digoxin.oStudy

▶ Neomycin

o

moderately decreases the exposure to sorafenib.

Study

Neostigmine → see TABLE 6 p. 1376 (bradycardia)

▶ Aminoglycosides are predicted to decrease the effects of

neostigmine.oTheoretical

Nepafenac → see NSAIDs

Netupitant

▶ Netupitant is predicted to increase the exposure to

abemaciclib.oStudy

▶ Netupitant is predicted to increase the exposure to aldosterone

antagonists

Study

(eplerenone). Adjust eplerenone dose, p. 193.r

▶ Netupitant very slightly increases the exposure to alkylating

agents (cyclophosphamide).oStudy

▶ Netupitant is predicted to increase the exposure to alkylating

agents (ifosfamide).oStudy

▶ Netupitant is predicted to increase the exposure to alpha

blockers (tamsulosin).oTheoretical

▶ Netupitant

r

is predicted to increase the exposure to alprazolam.

Study

▶ Netupitant is predicted to increase the exposure to

antiarrhythmics

o

(propafenone). Monitor and adjust dose.

Study

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to netupitant. Avoid.rStudy

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

predicted to increase the exposure to

Study

netupitant.o ▶ Netupitant is predicted to decrease the exposure to antifungals,

azoles (isavuconazole).oTheoretical

▶ Netupitant is predicted to increase the exposure to

antihistamines, non-sedating (mizolastine).rTheoretical

▶ Netupitant is predicted to increase the exposure to

antihistamines, non-sedating (rupatadine). Avoid.oStudy

▶ Netupitant is predicted to increase the concentration of

antimalarials (piperaquine).rTheoretical

▶ Netupitant

o

is predicted to increase the exposure to axitinib.

Theoretical

▶ Netupitant is predicted to increase the exposure to

bedaquiline. Avoid prolonged use.nTheoretical

▶ Netupitant is predicted to increase the exposure to beta2

agonists (salmeterol).oStudy

▶ Bosentan

o

is predicted to decrease the exposure to netupitant.

Theoretical

▶ Netupitant is predicted to increase the exposure to bosutinib.

Avoid or adjust dose.rTheoretical

▶ Netupitant is predicted to increase the exposure to buspirone.

Use with caution and adjust dose.oStudy

▶ Netupitant is predicted to increase the exposure to

cabozantinib.oTheoretical

▶ Netupitant is predicted to increase the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine,

lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and

adjust dose.oStudy

▶ Netupitant is predicted to increase the exposure to cariprazine.

Avoid.rStudy

▶ Netupitant

o

is predicted to increase the exposure to ceritinib.

Theoretical

▶ Netupitant is predicted to increase the concentration of

ciclosporin.rStudy

▶ Cobicistat

o

is predicted to increase the exposure to netupitant.

Study

▶ Netupitant is predicted to increase the exposure to

cobimetinib.rTheoretical

▶ Netupitant is predicted to increase the exposure to colchicine.

Adjust colchicine dose with moderate inhibitors of CYP3A4,

p. 1120.rStudy

▶ Netupitant is predicted to increase the exposure to oral

corticosteroids (budesonide).oStudy

▶ Netupitant is predicted to increase the exposure to

corticosteroids (dexamethasone). Adjust dose.oStudy

▶ Netupitant is predicted to increase the exposure to

corticosteroids (fluticasone).oStudy

▶ Netupitant is predicted to increase the exposure to

corticosteroids

o

(methylprednisolone). Monitor and adjust dose.

Study

▶ Netupitant is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Netupitant

r

is predicted to increase the exposure to dasatinib.

Study

▶ Netupitant increases the risk of QT-prolongation when given

with domperidone. Avoid.rStudy

▶ Netupitant is predicted to increase the exposure to dopamine

receptor agonists (bromocriptine).rTheoretical

▶ Netupitant is predicted to increase the concentration of

dopamine receptor agonists (cabergoline).oAnecdotal

▶ Netupitant is predicted to moderately increase the exposure to

dutasteride.nStudy

▶ Efavirenz

o

is predicted to decrease the exposure to netupitant.

Theoretical

▶ Netupitant

o

is predicted to increase the exposure to eletriptan.

Study

▶ Netupitant is predicted to increase the exposure to eliglustat.

Avoid or adjust dose—consult product literature.rStudy

▶ Netupitant is predicted to moderately increase the exposure to

encorafenib.oStudy

▶ Enzalutamide is predicted to decrease the exposure to

netupitant. Avoid.rStudy

▶ Netupitant is predicted to increase the risk of ergotism when

given with ergometrine.rTheoretical

▶ Netupitant is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Netupitant

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Netupitant

o

slightly increases the exposure to etoposide.

Study

▶ Netupitant is predicted to increase the concentration of

everolimus. Avoid or adjust dose.oStudy

▶ Netupitant is predicted to increase the exposure to

fesoterodine. Adjust fesoterodine dose with moderate

inhibitors of CYP3A4 in hepatic and renal impairment, p. 777.

nStudy

BNF 78 Nandrolone — Netupitant 1499

Interactions | Appendix 1

A1

Netupitant (continued)

▶ Netupitant

o

is predicted to increase the exposure to gefitinib.

Theoretical

▶ Netupitant is predicted to increase the concentration of

guanfacine. Adjust guanfacine dose, p. 352.oTheoretical

▶ HIV-protease inhibitors are predicted to increase the exposure

to netupitant.oStudy

▶ Netupitant is predicted to increase the exposure to ibrutinib.

Adjust ibrutinib dose with moderate inhibitors of CYP3A4,

p. 983.rStudy

▶ Idelalisib

o

is predicted to increase the exposure to netupitant.

Study

▶ Netupitant

o

is predicted to increase the exposure to imatinib.

Theoretical

▶ Netupitant

o

is predicted to increase the exposure to irinotecan.

Study

▶ Netupitant is predicted to increase the exposure to ivabradine.

Adjust ivabradine dose, p. 211.rTheoretical

▶ Netupitant is predicted to increase the exposure to ivacaftor.

Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose

with moderate inhibitors of CYP3A4.rStudy

▶ Netupitant

o

is predicted to increase the exposure to lapatinib.

Study

▶ Netupitant is predicted to increase the exposure to lomitapide.

Avoid.oTheoretical

▶ Netupitant is predicted to increase the exposure to lurasidone.

Adjust lurasidone dose, p. 398.oStudy

▶ Macrolides (clarithromycin) are predicted to increase the

exposure to netupitant.oStudy

▶ Netupitant

o

is predicted to increase the exposure to maraviroc.

Study

▶ Netupitant is predicted to increase the exposure to midazolam.

Monitor side effects and adjust dose.rStudy

▶ Netupitant is predicted to increase the exposure to

midostaurin.oTheoretical

▶ Mitotane is predicted to decrease the exposure to netupitant.

Avoid.rStudy

▶ Netupitant is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Nevirapine

o

is predicted to decrease the exposure to netupitant.

Theoretical

▶ Netupitant

o

is predicted to increase the exposure to nilotinib.

Theoretical

▶ Netupitant is predicted to increase the exposure to olaparib.

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