Theoretical → Also see TABLE 15 p. 1378
Valproate → see antiepileptics
Valsartan → see angiotensin-II receptor antagonists
Vancomycin → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 19 p. 1379
Vandetanib → see TABLE 9 p. 1377 (QT-interval prolongation)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Vandetanib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Vandetanib slightly increases the exposure to digoxin. Monitor
▶ Vandetanib is predicted to increase the exposure to dopamine
receptor agonists (pramipexole). Adjust dose.oStudy
▶ Enzalutamide is predicted to decrease the exposure to
▶ Vandetanib increases the exposure to metformin. Monitor and
▶ Mitotane is predicted to decrease the exposure to vandetanib.
▶ Vandetanib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
BNF 78 Trospium — Vandetanib 1549
▶ Rifampicin is predicted to decrease the exposure to
Vardenafil → see phosphodiesterase type-5 inhibitors
Varicella-zoster immunoglobulin → see immunoglobulins
Varicella-zoster vaccine → see live vaccines
Vedolizumab → see monoclonal antibodies
is predicted to increase the exposure to aliskiren.
▶ Antacids are predicted to decrease the concentration of
. Separate administration by 4 hours.o ▶ Antiarrhythmics (amiodarone) are predicted to increase the
velpatasvir. Avoid or monitor.o ▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to moderately decrease
the exposure to velpatasvir. Avoid.rStudy
▶ Antiepileptics (oxcarbazepine) are predicted to decrease the
exposure to velpatasvir. Avoid.rTheoretical
▶ Velpatasvir is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).rTheoretical
▶ Bosentan is predicted to decrease the exposure to velpatasvir.
▶ Calcium salts (calcium carbonate) are predicted to decrease the
concentration of velpatasvir. Separate administration by
is predicted to increase the exposure to colchicine.
increases the exposure to dabigatran. Avoid.
is predicted to increase the exposure to digoxin.
is predicted to increase the exposure to edoxaban.
▶ Efavirenz is predicted to decrease the exposure to velpatasvir.
▶ Enzalutamide is predicted to moderately decrease the
exposure to velpatasvir. Avoid.rStudy
▶ Velpatasvir is predicted to increase the exposure to
▶ H2 receptor antagonists are predicted to decrease the
concentration of velpatasvir. Adjust dose, see sofosbuvir with
▶ HIV-protease inhibitors (tipranavir) are predicted to increase the
exposure to velpatasvir.rTheoretical
▶ Velpatasvir is predicted to increase the exposure to
▶ Mitotane is predicted to moderately decrease the exposure to
▶ Modafinil is predicted to decrease the exposure to velpatasvir.
▶ Nevirapine is predicted to decrease the exposure to velpatasvir.
▶ Proton pump inhibitors are predicted to decrease the
concentration of velpatasvir. Adjust dose, see sofosbuvir with
▶ Rifampicin is predicted to moderately decrease the exposure
is predicted to increase the exposure to sirolimus.
▶ St John’s Wort is predicted to decrease the exposure to
velpatasvir. Avoid.oTheoretical
▶ Velpatasvir is predicted to increase the exposure to statins
▶ Velpatasvir increases the exposure to statins (rosuvastatin).
rosuvastatin dose and monitor side effects, p. 204.
▶ Velpatasvir is predicted to increase the exposure to statins
. Monitor side effects and adjust dose.r
▶ Velpatasvir is predicted to increase the exposure to
▶ Velpatasvir is predicted to increase the exposure to taxanes
▶ Velpatasvir is predicted to increase the exposure to tenofovir
is predicted to increase the exposure to topotecan.
Vemurafenib → see TABLE 9 p. 1377 (QT-interval prolongation)
▶ Vemurafenib is predicted to increase the exposure to afatinib.
Separate administration by 12 hours.oStudy
▶ Vemurafenib is predicted to increase the exposure to aliskiren.
Use with caution and adjust dose.oTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to vemurafenib. Avoid.rTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
Theoretical → Also see TABLE 9 p. 1377
▶ Vemurafenib is predicted to increase the exposure to beta
blockers, non-selective (nadolol).oStudy
▶ Vemurafenib is predicted to increase the exposure to
bictegravir. Use with caution or avoid.oTheoretical
▶ Cobicistat is predicted to increase the exposure to
▶ Vemurafenib is predicted to increase the exposure to
. Avoid or adjust colchicine dose, p. 1120.r
▶ Vemurafenib increases the exposure to dabigatran. Use with
caution and adjust dose.rTheoretical
▶ Vemurafenib is predicted to slightly increase the exposure to
▶ Enzalutamide is predicted to decrease the exposure to
vemurafenib. Avoid.rTheoretical
is predicted to increase the exposure to erlotinib.
▶ Vemurafenib is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
to vemurafenib.rTheoretical → Also see TABLE 9 p. 1377
is predicted to increase the exposure to vemurafenib.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to vemurafenib.rTheoretical → Also see TABLE 9
▶ Mitotane is predicted to decrease the exposure to vemurafenib.
▶ Vemurafenib is predicted to increase the exposure to
▶ Vemurafenib is predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical → Also see
▶ Vemurafenib is predicted to increase the exposure to
▶ Rifampicin is predicted to decrease the exposure to
vemurafenib. Avoid.rTheoretical
▶ Vemurafenib is predicted to increase the exposure to
ticagrelor. Use with caution or avoid.rStudy
▶ Vemurafenib is predicted to increase the exposure to
▶ Vemurafenib is predicted to increase the concentration of
▶ Vemurafenib is predicted to increase the exposure to
venetoclax. Avoid or monitor for toxicity.rTheoretical
FOOD AND LIFESTYLE Avoid Seville (bitter orange) and star fruit
as they might increase the exposure to venetoclax.
▶ Antiarrhythmics (amiodarone) are predicted to increase the
venetoclax. Avoid or monitor for toxicity.r
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to venetoclax. Avoid or adjust dose—consult product
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
1550 Vandetanib — Venetoclax BNF 78
▶ Antifungals, azoles (fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole) are predicted to
increase the exposure to venetoclax. Avoid or adjust dose—
consult product literature.rStudy
▶ Venetoclax is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).oTheoretical
▶ Aprepitant is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Bosentan is predicted to decrease the exposure to venetoclax.
is predicted to increase the exposure to bosentan.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to venetoclax. Avoid or adjust dose—
consult product literature.rStudy
▶ Ciclosporin is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
▶ Cobicistat is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Venetoclax slightly increases the exposure to coumarins
▶ Crizotinib is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Venetoclax is predicted to increase the exposure to dabigatran.
▶ Venetoclax increases the exposure to digoxin. Avoid or adjust
▶ Efavirenz is predicted to decrease the exposure to venetoclax.
▶ Enzalutamide is predicted to decrease the exposure to
▶ Venetoclax is predicted to increase the exposure to everolimus.
▶ Grapefruit juice is predicted to increase the exposure to
venetoclax. Avoid.rTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
to venetoclax. Avoid or adjust dose—consult product
▶ Idelalisib is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Imatinib is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Lapatinib is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
▶ Venetoclax potentially decreases the efficacy of live vaccines.
▶ Macrolides (clarithromycin, erythromycin) are predicted to
increase the exposure to venetoclax. Avoid or adjust dose—
consult product literature.rStudy
▶ Mitotane is predicted to decrease the exposure to venetoclax.
▶ Netupitant is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Nevirapine is predicted to decrease the exposure to venetoclax.
▶ Nilotinib is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
▶ Ranolazine is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
is predicted to increase the exposure to repaglinide.
▶ Rifampicin is predicted to decrease the exposure to venetoclax.
▶ Venetoclax is predicted to increase the exposure to sirolimus.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Venetoclax is predicted to increase the exposure to statins
▶ Venetoclax is predicted to increase the exposure to statins
(fluvastatin, pravastatin, rosuvastatin, simvastatin)
.o ▶ Venetoclax is predicted to increase the exposure to
▶ Venetoclax is predicted to increase the exposure to
sulfonylureas (glibenclamide).oTheoretical
is predicted to increase the exposure to topotecan.
▶ Vemurafenib is predicted to increase the exposure to
venetoclax. Avoid or monitor for toxicity.rTheoretical
Venlafaxine → see TABLE 13 p. 1378 (serotonin syndrome), TABLE 9
p. 1377 (QT-interval prolongation), TABLE 11 p. 1377 (CNS depressant
effects), TABLE 4 p. 1375 (antiplatelet effects)
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to venlafaxine.
▶ H2 receptor antagonists (cimetidine) slightly increase the
exposure to venlafaxine.nStudy
slightly increases the exposure to haloperidol.
Study → Also see TABLE 9 p. 1377 → Also see TABLE 11 p. 1377
▶ HIV-protease inhibitors are predicted to increase the exposure
to venlafaxine.oStudy → Also see TABLE 9 p. 1377
is predicted to increase the exposure to venlafaxine.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to venlafaxine.oStudy → Also see TABLE 9
▶ Venlafaxine is predicted to increase the exposure to pitolisant.
Use with caution and adjust dose.nTheoretical
▶ Tacrolimus potentially increases the risk of serotonin
syndrome when given with venlafaxine.rAnecdotal
Verapamil → see calcium channel blockers
GENERAL INFORMATION Caution on concurrent use with other
Vigabatrin → see antiepileptics
Vilanterol → see beta2 agonists
Vildagliptin → see TABLE 14 p. 1378 (antidiabetic drugs)
Vinblastine → see vinca alkaloids
Vinca alkaloids → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 15 p. 1378
(myelosuppression), TABLE 19 p. 1379 (ototoxicity), TABLE 12 p. 1378
(peripheral neuropathy), TABLE 5 p. 1375 (thromboembolism), TABLE 9
p. 1377 (QT-interval prolongation)
exposure to vinca alkaloids.rTheoretical → Also see TABLE 9
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to vinflunine. Avoid.rTheoretical → Also see TABLE 12 p. 1378
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to vinorelbine. Use with caution or avoid.rTheoretical →
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
(vinblastine, vincristine, vindesine)
TABLE 1 p. 1375 → Also see TABLE 12
▶ Antifungals, azoles (fluconazole, isavuconazole, itraconazole,
ketoconazole, posaconazole, voriconazole) are predicted to
increase the exposure to vinca alkaloids.rTheoretical →
Also see TABLE 1 p. 1375 → Also see TABLE 9 p. 1377
▶ Antifungals, azoles (miconazole) are predicted to increase the
concentration of vinca alkaloids. Use with caution and adjust
▶ Aprepitant is predicted to increase the exposure to vinca
▶ Asparaginase potentially increases the risk of neurotoxicity
when given with vincristine.Vincristine should be taken
3 to 24 hours before asparaginase.rAnecdotal → Also see
TABLE 1 p. 1375 → Also see TABLE 15 p. 1378
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to vinca alkaloids.rTheoretical
▶ Cobicistat is predicted to increase the exposure to vinca
BNF 78 Venetoclax — Vinca alkaloids 1551
▶ Crisantaspase potentially increases the risk of neurotoxicity
when given with vincristine.Vincristine should be taken
3 to 24 hours before crisantaspase.rAnecdotal → Also see
TABLE 1 p. 1375 → Also see TABLE 15 p. 1378
▶ Crizotinib is predicted to increase the exposure to vinca
alkaloids.rTheoretical → Also see TABLE 15 p. 1378 → Also see
▶ Enzalutamide is predicted to decrease the exposure to vinca
alkaloids (vinblastine, vincristine, vindesine).rTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
vinflunine. Avoid.rTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
vinorelbine. Use with caution or avoid.rTheoretical
▶ Fosaprepitant is predicted to increase the exposure to vinca
▶ HIV-protease inhibitors are predicted to increase the exposure
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