. Avoid.o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to gefitinib.oTheoretical
▶ Grapefruit juice very slightly increases the exposure to
▶ Grapefruit juice increases the exposure to calcium channel
blockers (nifedipine, verapamil). Avoid.nStudy
increases the exposure to felodipine. Avoid.
▶ Grapefruit juice is predicted to increase the exposure to
lercanidipine. Avoid.oTheoretical
▶ Grapefruit juice increases the exposure to nicardipine.n
▶ Grazoprevir is predicted to increase the concentration of
calcium channel blockers.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of guanfacine. Adjust guanfacine
dose, p. 352.oTheoretical → Also see TABLE 8 p. 1376
▶ H2 receptor antagonists (cimetidine) (high-dose) are predicted to
increase the exposure to lercanidipine.oTheoretical
▶ H2 receptor antagonists (cimetidine) moderately increase the
exposure to nifedipine. Monitor and adjust dose.rStudy
▶ H2 receptor antagonists (cimetidine) increase the exposure to
▶ H2 receptor antagonists (cimetidine) slightly increase the
exposure to calcium channel blockers (diltiazem, nimodipine).
Monitor and adjust dose.oStudy
▶ HIV-protease inhibitors are predicted to increase the exposure
to calcium channel blockers (amlodipine, felodipine, lacidipine,
nicardipine, nifedipine, nimodipine)
▶ HIV-protease inhibitors are predicted to increase the exposure
to calcium channel blockers (diltiazem, verapamil).rStudy
▶ HIV-protease inhibitors are predicted to markedly increase the
exposure to lercanidipine. Avoid.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ibrutinib. Adjust ibrutinib dose with
moderate inhibitors of CYP3A4, p. 983.rStudy
▶ Idelalisib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine, nicardipine,
1422 Calcium channel blockers — Calcium channel blockers BNF 78
▶ Idelalisib is predicted to increase the exposure to calcium
channel blockers (diltiazem, verapamil).rStudy
▶ Idelalisib is predicted to markedly increase the exposure to
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to imatinib.oTheoretical
▶ Imatinib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ivabradine. Avoid.oStudy →
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ivacaftor. Adjust ivacaftor p. 293 or
tezacaftor with ivacaftor p. 295 dose with moderate inhibitors
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to lapatinib.oStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the risk of neurotoxicity when given with
▶ Calcium channel blockers (amlodipine, lacidipine) are predicted
to increase the exposure to lomitapide. Separate
administration by 12 hours.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to lomitapide. Avoid.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to lurasidone. Adjust lurasidone dose,
p. 398.oStudy → Also see TABLE 8 p. 1376
▶ Macrolides (clarithromycin) are predicted to markedly increase
the exposure to lercanidipine. Avoid.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to diltiazem.rTheoretical
▶ Macrolides (erythromycin) are predicted to increase the
▶ Macrolides (erythromycin) are predicted to increase the
exposure to calcium channel blockers (amlodipine, felodipine,
lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine).
Monitor and adjust dose.oStudy
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to calcium channel blockers (amlodipine, felodipine,
lacidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Macrolides (clarithromycin) are predicted to increase the
calcium channel blockers (diltiazem, verapamil).
▶ Intravenous magnesium potentially increases the risk of
hypotension when given with calcium channel blockers
(amlodipine, clevidipine, felodipine, lacidipine, lercanidipine,
nicardipine, nifedipine, nimodipine, verapamil) (in pregnant
▶ Mexiletine increases the risk of cardiovascular side-effects
when given with diltiazem. Avoid or monitor.rTheoretical
▶ Mexiletine potentially increases the risk of cardiovascular
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to midazolam. Monitor side effects and
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to midostaurin.oTheoretical
▶ Mitotane is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nimodipine). Monitor and adjust
▶ Monoclonal antibodies (tocilizumab) are predicted to decrease
the exposure to calcium channel blockers. Monitor and adjust
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to naloxegol. Adjust naloxegol dose and
monitor side effects, p. 65.oStudy
▶ Netupitant is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Nevirapine is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Nevirapine is predicted to decrease the exposure to calcium
channel blockers (diltiazem, verapamil).oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to nilotinib.oTheoretical
▶ Nilotinib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
is predicted to increase the exposure to nintedanib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to olaparib. Avoid moderate inhibitors
of CYP3A4 or adjust olaparib dose, p. 1005.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to opioids (alfentanil, buprenorphine,
o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
opioids (methadone, sufentanil).
Theoretical → Also see TABLE 6 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to oxybutynin.nTheoretical
▶ Verapamil is predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to pazopanib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to phosphodiesterase type-5 inhibitors
(avanafil). Adjust avanafil dose, p. 812.oTheoretical →
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to phosphodiesterase type-5 inhibitors
(sildenafil). Monitor or adjust sildenafil dose with moderate
inhibitors of CYP3A4, p. 813.oStudy → Also see TABLE 8
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to phosphodiesterase type-5 inhibitors
(tadalafil).rTheoretical → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to phosphodiesterase type-5 inhibitors
(vardenafil). Adjust dose.rTheoretical → Also see TABLE 8
▶ Verapamil is predicted to increase the exposure to
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to pimozide. Avoid.rTheoretical →
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to quetiapine. Avoid.oStudy →
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ranolazine.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ribociclib.oStudy
▶ Rifampicin is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nimodipine). Monitor and adjust
▶ Rifampicin greatly decreases the exposure to calcium channel
blockers (diltiazem, verapamil).rStudy
▶ Rifampicin moderately decreases the exposure to nifedipine.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ruxolitinib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to saxagliptin.nStudy
▶ Calcium channel blockers (diltiazem, verapamil) increase the
sirolimus. Monitor and adjust dose.o
BNF 78 Calcium channel blockers — Calcium channel blockers 1423
Calcium channel blockers (continued)
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to SSRIs (dapoxetine). Adjust dapoxetine
dose with moderate inhibitors of CYP3A4,
p. 821.o ▶ St John’s Wort is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ St John’s Wort is predicted to decrease the exposure to calcium
channel blockers (diltiazem, verapamil).oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to statins (atorvastatin). Monitor and
▶ Amlodipine slightly increases the exposure to statins
(simvastatin). Adjust simvastatin dose, p. 205.nStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to statins (simvastatin). Use with caution
and adjust simvastatin dose, p. 205.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to sunitinib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of tacrolimus.rStudy
▶ Nicardipine potentially increases the concentration of
. Monitor concentration and adjust dose.r
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
taxanes (cabazitaxel).o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
temsirolimus.o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to tezacaftor. Adjust tezacaftor with
p. 295 dose with moderate inhibitors of CYP3A4.
▶ Calcium channel blockers (diltiazem, verapamil) given with a
potent CYP2C19 inhibitor are predicted to increase the
tofacitinib. Adjust tofacitinib dose, p. 1105.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to tolterodine.nTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to tolvaptan. Manufacturer advises
caution or adjust tolvaptan dose with moderate inhibitors of
is predicted to increase the exposure to topotecan.
▶ Verapamil is predicted to increase the concentration of
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to trazodone.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ulipristal. Avoid if used for uterine
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to venetoclax. Avoid or adjust dose—
consult product literature.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to vinca alkaloids.rTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to zopiclone. Adjust dose.oStudy
Calcium chloride → see calcium salts
Calcium gluconate → see calcium salts
Calcium lactate → see calcium salts
Calcium phosphate → see calcium salts
calcium acetate . calcium carbonate . calcium chloride . calcium
gluconate . calcium lactate . calcium phosphate.
same time as other drugs since they might impair
absorption. Antacids might damage enteric coatings designed
to prevent dissolution in the stomach.
▶ Oral calcium salts decrease the absorption of alkylating agents
▶ Calcium carbonate decreases the absorption of antimalarials
. Separate administration by at least 4 hours.
▶ Calcium carbonate is predicted to decrease the absorption of
antimalarials (proguanil). Separate administration by at least
▶ Oral calcium salts decrease the absorption of bisphosphonates
(alendronic acid). Alendronic acid should be taken at least
30 minutes before calcium salts.oStudy
▶ Oral calcium salts are predicted to decrease the absorption of
oral bisphosphonates (ibandronic acid). Avoid calcium salts for
at least 6 hours before or 1 hour after
▶ Oral calcium salts decrease the absorption of bisphosphonates
. Separate administration by at least 2 hours.
▶ Oral calcium salts decrease the absorption of bisphosphonates
(sodium clodronate). Avoid calcium salts for 2 hours before or
1 hour after sodium clodronate.oStudy
▶ Cephalosporins (ceftriaxone) increase the risk of cardiorespiratory arrest when given with
▶ Intravenous calcium salts increase the concentration of
▶ Oral calcium salts decrease the absorption of dolutegravir.
Dolutegravir should be taken 2 hours before or 6 hours after
▶ Oral calcium salts decrease the absorption of eltrombopag.
Eltrombopag should be taken 2 hours before or 4 hours after
▶ Calcium carbonate decreases the absorption of
hydroxychloroquine. Separate administration by at least
▶ Calcium carbonate decreases the absorption of iron (oral).
Calcium carbonate should be taken 1 hour before or 2 hours
▶ Calcium carbonate is predicted to decrease the exposure to
. Separate administration by 4 hours.o ▶ Calcium carbonate decreases the absorption of quinolones
. Separate administration by 2 hours.o ▶ Calcium carbonate greatly decreases the exposure to
raltegravir (high-dose). Avoid.rStudy
▶ Calcium carbonate is predicted to slightly decrease the
exposure to rilpivirine. Calcium carbonate should be taken
2 hours before or 4 hours after rilpivirine.rTheoretical
▶ Calcium carbonate is predicted to decrease the absorption of
. Separate administration by 2 to 3 hours.
▶ Thiazide diuretics increase the risk of hypercalcaemia when
given with calcium salts.rAnecdotal
▶ Oral calcium salts are predicted to decrease the absorption of
thyroid hormones (levothyroxine). Separate administration by at
▶ Calcium carbonate is predicted to decrease the concentration
velpatasvir. Separate administration by 4 hours.o ▶ Oral
calcium salts decrease the absorption of zinc.o
Canagliflozin → see TABLE 14 p. 1378 (antidiabetic drugs), TABLE 8
▶ Rifampicin moderately decreases the exposure to canagliflozin.
Adjust canagliflozin dose, p. 702.oStudy
Canakinumab → see monoclonal antibodies
Candesartan → see angiotensin-II receptor antagonists
Cangrelor → see TABLE 4 p. 1375 (antiplatelet effects)
Cannabis extract → see TABLE 11 p. 1377 (CNS depressant effects)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
1424 Calcium channel blockers — Cannabis extract BNF 78
to cannabis extract. Avoid.rTheoretical → Also see TABLE 11
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to cannabis extract. Use
with caution and adjust dose.oTheoretical
▶ Cobicistat is predicted to increase the exposure to cannabis
extract. Use with caution and adjust dose.oTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
cannabis extract. Avoid.rTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
cannabis extract. Use with caution and adjust dose.
▶ Idelalisib is predicted to increase the exposure to cannabis
extract. Use with caution and adjust dose.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to cannabis extract. Use with caution and adjust
▶ Mitotane is predicted to decrease the exposure to cannabis
▶ Rifampicin is predicted to decrease the exposure to cannabis
Capecitabine → see TABLE 15 p. 1378 (myelosuppression)
▶ Allopurinol is predicted to decrease the effects of capecitabine.
▶ Capecitabine increases the concentration of antiepileptics
(fosphenytoin, phenytoin).rAnecdotal
▶ Capecitabine increases the effects of coumarins. Monitor INR
▶ Folates are predicted to increase the risk of toxicity when
given with capecitabine.rAnecdotal
▶ H2 receptor antagonists (cimetidine) are predicted to slightly
increase the exposure to capecitabine.rTheoretical
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
capecitabine. Public Health England advises avoid (refer to
▶ Metronidazole is predicted to increase the risk of capecitabine
toxicity when given with capecitabine.rTheoretical
Capreomycin → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 19 p. 1379
Captopril → see ACE inhibitors
Carbamazepine → see antiepileptics
ertapenem .imipenem . meropenem. ▶ Carbapenems decrease the concentration of antiepileptics
▶ Ganciclovir is predicted to increase the risk of seizures when
given with imipenem. Avoid.rAnecdotal
▶ Valganciclovir is predicted to increase the risk of seizures when
given with imipenem. Avoid.rAnecdotal
is predicted to decrease the exposure to carbidopa.
Carbimazole → see TABLE 15 p. 1378 (myelosuppression)
▶ Carbimazole affects the concentration of digoxin. Monitor and
Comments
Post a Comment
اكتب تعليق حول الموضوع