TRIPASS XR تري باس

 

cilostazol. Use with caution and adjust dose.

Theoretical

▶ Cobicistat is predicted to moderately increase the exposure to

cilostazol. Adjust cilostazol dose, p. 232.oStudy

▶ Enzalutamide

o

is predicted to alter the effects of cilostazol.

Theoretical

▶ HIV-protease inhibitors are predicted to moderately increase

the exposure to

o

cilostazol. Adjust cilostazol dose, p. 232.

Study

▶ Idelalisib is predicted to moderately increase the exposure to

cilostazol. Adjust cilostazol dose, p. 232.oStudy

▶ Cilostazol is predicted to increase the exposure to lomitapide.

Separate administration by 12 hours.oTheoretical

▶ Macrolides (clarithromycin) are predicted to moderately

increase the exposure to cilostazol. Adjust cilostazol dose,

p. 232.oStudy

▶ Macrolides (erythromycin) slightly increase the exposure to

cilostazol. Adjust cilostazol dose, p. 232.oStudy

▶ Mitotane

Theoretical

is predicted to alter the effects of cilostazol.o ▶ Moclobemide is predicted to increase the exposure to

cilostazol.oTheoretical

▶ Proton pump inhibitors (esomeprazole) are predicted to increase

the exposure to cilostazol.oTheoretical

1428 Ciclosporin — Cilostazol BNF 78

Interactions | Appendix 1

A1

▶ Proton pump inhibitors (omeprazole) are predicted to increase

the exposure to

o

cilostazol. Adjust cilostazol dose, p. 232.

Study

▶ Rifampicin

o

is predicted to alter the effects of cilostazol.

Theoretical

▶ SSRIs (fluoxetine, fluvoxamine) are predicted to increase the

exposure to

Theoretical →

cilostazol

Also see TABLE 4

. Adjust

p. 1375

cilostazol dose, p. 232.o ▶ St John

o’s Wort is predicted to alter the effects of cilostazol.

Theoretical

Cimetidine → see H2 receptor antagonists

Cinacalcet

FOOD AND LIFESTYLE Dose adjustment might be necessary if

smoking started or stopped during treatment.

▶ Cinacalcet is predicted to increase the exposure to

anticholinesterases, centrally acting (galantamine). Monitor and

adjust dose.oStudy

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to cinacalcet. Monitor and adjust dose.oStudy

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

predicted to moderately increase the exposure to cinacalcet.

Adjust dose.oStudy

▶ Cinacalcet is predicted to moderately increase the exposure to

aripiprazole. Adjust aripiprazole dose, p. 395.oStudy

▶ Cinacalcet is predicted to markedly increase the exposure to

atomoxetine. Adjust dose.rStudy

▶ Cinacalcet is predicted to increase the exposure to beta

blockers, selective (metoprolol, nebivolol).oStudy

▶ Cobicistat is predicted to moderately increase the exposure to

cinacalcet. Adjust dose.oStudy

▶ Cinacalcet is predicted to slightly increase the exposure to

darifenacin.nStudy

▶ Cinacalcet is predicted to increase the exposure to eliglustat.

Avoid or adjust dose—consult product literature.rStudy

▶ Enzalutamide is predicted to decrease the exposure to

cinacalcet. Monitor and adjust dose.oStudy

▶ Cinacalcet increases the risk of hypocalcaemia when given

with etelcalcetide. Avoid.rTheoretical

▶ HIV-protease inhibitors are predicted to moderately increase

the exposure to cinacalcet. Adjust dose.oStudy

▶ Idelalisib is predicted to moderately increase the exposure to

cinacalcet. Adjust dose.oStudy

▶ Macrolides (clarithromycin) are predicted to moderately

increase the exposure to

Study

cinacalcet. Adjust dose.o ▶ Cinacalcet

o

is predicted to increase the exposure to mexiletine.

Study

▶ Mitotane is predicted to decrease the exposure to cinacalcet.

Monitor and adjust dose.oStudy

▶ Cinacalcet is predicted to decrease the efficacy of opioids

(codeine).oTheoretical

▶ Cinacalcet is predicted to decrease the efficacy of opioids

(tramadol).rStudy

▶ Cinacalcet is predicted to moderately increase the exposure to

pitolisant. Use with caution and adjust dose.oStudy

▶ Rifampicin is predicted to decrease the exposure to cinacalcet.

Monitor and adjust dose.oStudy

▶ Cinacalcet is predicted to increase the exposure to risperidone.

Adjust dose.oStudy

▶ SSRIs (fluvoxamine) are predicted to increase the exposure to

cinacalcet. Adjust dose.oTheoretical

▶ Cinacalcet is predicted to increase the exposure to SSRIs

(dapoxetine).oTheoretical

▶ Cinacalcet is predicted to decrease the efficacy of tamoxifen.

Avoid.rStudy

▶ Cinacalcet is predicted to increase the exposure to tricyclic

antidepressants

Study

. Monitor for toxicity and adjust dose.r

▶ Cinacalcet is predicted to increase the exposure to vortioxetine.

Monitor and adjust dose.oStudy

Cinnarizine → see antihistamines, sedating

Ciprofibrate → see fibrates

Ciprofloxacin → see quinolones

Cisatracurium → see neuromuscular blocking drugs, non-depolarising

Cisplatin → see platinum compounds

Citalopram → see SSRIs

Cladribine → see TABLE 15 p. 1378 (myelosuppression)

SEPARATION OF ADMINISTRATION Oral cladribine might affect

the absorption of concurrently administered drugs—consider

separating administration by at least 3 hours.

▶ Antiepileptics (carbamazepine) are predicted to increase the risk

of haematological toxicity when given with oral

o

cladribine.

Theoretical

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

cladribine. Public Health England advises avoid (refer to Green

Book).rTheoretical

Clarithromycin → see macrolides

Clavulanic acid → see TABLE 1 p. 1375 (hepatotoxicity)

Clemastine → see antihistamines, sedating

Clevidipine → see calcium channel blockers

Clindamycin

ROUTE-SPECIFIC INFORMATION Since systemic absorption can

follow topical application, the possibility of interactions

should be borne in mind.

▶ Clindamycin increases the effects of neuromuscular blocking

drugs, non-depolarising.rAnecdotal

▶ Clindamycin

Anecdotal

increases the effects of suxamethonium.r

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

▶ Antiepileptics (stiripentol) increase the concentration of

clobazam.rStudy

▶ Clobazam potentially affects the concentration of antiepileptics

(fosphenytoin, phenytoin).rAnecdotal

▶ Antifungals, azoles (fluconazole, voriconazole) potentially

increase the exposure to

Theoretical

clobazam. Adjust dose.o ▶ Moclobemide potentially increases the exposure to clobazam.

Adjust dose.oTheoretical

▶ Proton pump inhibitors (esomeprazole, omeprazole) potentially

increase the exposure to

Theoretical

clobazam. Adjust dose.o ▶ SSRIs (fluoxetine, fluvoxamine) potentially increase the

exposure to clobazam. Adjust dose.oTheoretical

Clofarabine → see TABLE 15 p. 1378 (myelosuppression)

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

clofarabine. Public Health England advises avoid (refer to

Green Book).rTheoretical

Clofazimine

▶ Clofazimine potentially increases the risk of QT-prolongation

when given with bedaquiline.rStudy

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

▶ Alcohol (beverage) causes serious, potentially fatal, CNS

Study

depression when given with

→ Also see TABLE 11 p. 1377

clomethiazole. Avoid.r

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) decrease the exposure to clomethiazole.

Monitor and adjust dose.oStudy → Also see TABLE 11

p. 1377

▶ Enzalutamide decreases the exposure to clomethiazole.

Monitor and adjust dose.oStudy

▶ Mitotane decreases the exposure to clomethiazole. Monitor

and adjust dose.oStudy

▶ Rifampicin decreases the exposure to clomethiazole. Monitor

and adjust dose.oStudy

Clomipramine → see tricyclic antidepressants

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

▶ Clonazepam potentially affects the concentration of

antiepileptics (fosphenytoin, phenytoin).rAnecdotal

Clonidine → see TABLE 6 p. 1376 (bradycardia), TABLE 8 p. 1376

(hypotension), TABLE 11 p. 1377 (CNS depressant effects)

▶ Tricyclic antidepressants decrease the antihypertensive effects

of clonidine. Monitor and adjust dose.oAnecdotal →

Also see TABLE 8 p. 1376

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

▶ Antifungals, azoles (fluconazole) are predicted to decrease the

efficacy of clopidogrel. Avoid.rTheoretical

BNF 78 Cilostazol — Clopidogrel 1429

Interactions | Appendix 1

A1

Clopidogrel (continued)

▶ Antifungals, azoles (voriconazole) are predicted to decrease the

efficacy of clopidogrel. Avoid.oStudy

▶ Clopidogrel is predicted to increase the exposure to

apalutamide.nStudy

▶ Clopidogrel is predicted to increase the exposure to

dabrafenib.oTheoretical

▶ Clopidogrel is predicted to very markedly increase the

exposure to dasabuvir. Avoid.rStudy

▶ Clopidogrel moderately increases the exposure to

enzalutamide

Study

. Avoid or adjust enzalutamide dose, p. 947.r

▶ Grapefruit juice markedly decreases the exposure to

clopidogrel.rStudy

▶ Moclobemide is predicted to decrease the efficacy of

clopidogrel. Avoid.oStudy

▶ Clopidogrel is predicted to moderately increase the exposure

to montelukast.oStudy

▶ Clopidogrel increases the exposure to pioglitazone. Monitor

blood glucose and adjust dose.rStudy

▶ Proton pump inhibitors (esomeprazole, omeprazole) are

predicted to decrease the ef

o

ficacy of clopidogrel. Avoid.

Study

▶ Clopidogrel

r

increases the exposure to repaglinide. Avoid.

Study

▶ Clopidogrel is predicted to increase the exposure to retinoids

(alitretinoin)

Theoretical

. Adjust alitretinoin dose, p. 1262.o ▶ Clopidogrel is predicted to increase the exposure to selexipag.

Adjust dose.oStudy

▶ SSRIs (fluoxetine, fluvoxamine) are predicted to decrease the

efficacy of clopidogrel. Avoid.rTheoretical → Also see

TABLE 4 p. 1375

▶ Clopidogrel increases the exposure to statins (rosuvastatin).

Adjust rosuvastatin dose, p. 204.oStudy

▶ Clopidogrel is predicted to increase the concentration of

taxanes (paclitaxel).rAnecdotal

Clotrimazole → see antifungals, azoles

Clozapine → see TABLE 8 p. 1376 (hypotension), TABLE 15 p. 1378

(myelosuppression), TABLE 11 p. 1377 (CNS depressant effects), TABLE 10

p. 1377 (antimuscarinics)

▶ Dose adjustment might be necessary if smoking started or

stopped during treatment.

▶ Avoid concomitant use of clozapine with drugs that have a

substantial potential for causing agranulocytosis.

▶ Antiepileptics (carbamazepine) are predicted to increase the risk

of myelosuppression when given with

Anecdotal

clozapine. Avoid.r

▶ Antiepileptics (fosphenytoin, phenobarbital, phenytoin,

primidone) are predicted to decrease the exposure to

clozapine.oAnecdotal → Also see TABLE 11 p. 1377

▶ Combined hormonal contraceptives increase the concentration

of clozapine. Monitor side effects and adjust dose.rStudy

▶ Clozapine is predicted to decrease the effects of dopamine

receptor agonists.oTheoretical → Also see TABLE 8

p. 1376 → Also see TABLE 10 p. 1377

▶ Enzalutamide is predicted to decrease the exposure to

clozapine.oTheoretical

▶ HIV-protease inhibitors (ritonavir) are predicted to affect the

exposure to clozapine. Avoid.rTheoretical

▶ Iron chelators (deferasirox) are predicted to increase the

exposure to clozapine. Avoid.oTheoretical

▶ Leflunomide

o

is predicted to decrease the exposure to clozapine.

Theoretical → Also see TABLE 15 p. 1378

▶ Clozapine

r

is predicted to decrease the effects of levodopa.

Theoretical → Also see TABLE 8 p. 1376

▶ Macrolides (erythromycin) potentially increase the risk of

toxicity when given with clozapine.rAnecdotal

▶ Mexiletine increases the concentration of clozapine. Monitor

side effects and adjust dose.rStudy

▶ Quinolones (ciprofloxacin) increase the concentration of

clozapine. Monitor side effects and adjust dose.rStudy

▶ Rifampicin

Anecdotal

decreases the exposure to clozapine.r

▶ SSRIs (fluvoxamine) increase the concentration of clozapine.

Monitor side effects and adjust dose.rStudy

▶ Teriflunomide is predicted to decrease the exposure to

clozapine.oTheoretical

Cobicistat

▶ Cobicistat is predicted to increase the exposure to abemaciclib.

Avoid or adjust abemaciclib dose, p. 967.rStudy

▶ Cobicistat is predicted to markedly increase the exposure to

aldosterone antagonists (eplerenone). Avoid.rStudy

▶ Cobicistat increases the exposure to almotriptan.nStudy

▶ Cobicistat is predicted to moderately increase the exposure to

alpha blockers (alfuzosin, tamsulosin). Use with caution or

avoid.oStudy

▶ Cobicistat is predicted to increase the exposure to alpha

blockers (doxazosin).oStudy

▶ Cobicistat moderately increases the exposure to alprazolam.

Avoid.oStudy

▶ Cobicistat potentially increases the concentration of

antiarrhythmics (amiodarone, disopyramide, flecainide,

lidocaine).rTheoretical

▶ Cobicistat very markedly increases the exposure to

antiarrhythmics (dronedarone). Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to

Study

antiarrhythmics (propafenone). Monitor and adjust dose.r

▶ Cobicistat is predicted to increase the exposure to

anticholinesterases, centrally acting (galantamine). Monitor and

adjust dose.oStudy

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to cobicistat. Avoid.rTheoretical

▶ Antiepileptics (oxcarbazepine) are predicted to decrease the

concentration of cobicistat.rTheoretical

▶ Cobicistat is predicted to very slightly increase the exposure to

antiepileptics (perampanel).nStudy

▶ Cobicistat is predicted to increase the exposure to antifungals,

azoles (fluconazole, posaconazole).oTheoretical

▶ Cobicistat is predicted to increase the exposure to antifungals,

azoles

Study

(isavuconazole). Avoid or monitor side effects.r

▶ Cobicistat is predicted to increase the exposure to antifungals,

azoles

Theoretical

(itraconazole, ketoconazole). Adjust dose.o ▶ Cobicistat is predicted to affect the exposure to antifungals,

azoles (voriconazole). Avoid.oTheoretical

▶ Cobicistat is predicted to increase the exposure to

antihistamines, non-sedating (mizolastine). Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to

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

▶ Cobicistat is predicted to increase the concentration of

antimalarials (piperaquine).rTheoretical

▶ Cobicistat is predicted to increase the exposure to

apalutamide.nStudy

▶ Cobicistat is predicted to increase the exposure to apixaban.

Avoid.rTheoretical

▶ Cobicistat is predicted to markedly increase the exposure to

aprepitant.oStudy

▶ Cobicistat is predicted to slightly increase the exposure to

aripiprazole. Adjust aripiprazole dose, p. 395.oStudy

▶ Cobicistat is predicted to increase the exposure to axitinib.

Avoid or adjust dose.oStudy

▶ Cobicistat is predicted to increase the exposure to bedaquiline.

Avoid prolonged use.nStudy

▶ Cobicistat is predicted to increase the exposure to beta2

agonists (salmeterol). Avoid.rStudy

▶ Cobicistat

o

slightly increases the exposure to bortezomib.

Study

▶ Bosentan is predicted to decrease the exposure to cobicistat.

Avoid.rTheoretical

▶ Cobicistat is predicted to markedly increase the exposure to

bosutinib. Avoid or adjust dose.rStudy

▶ Cobicistat is predicted to increase the exposure to brigatinib.

Adjust brigatinib dose, p. 971.rStudy

▶ Cobicistat is predicted to increase the exposure to buspirone.

Adjust buspirone dose, p. 342.rStudy

1430 Clopidogrel — Cobicistat BNF 78

Interactions | Appendix 1

A1

▶ Cobicistat

o

slightly increases the exposure to cabozantinib.

Study

▶ Cobicistat is predicted to increase the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine, nicardipine,

nifedipine, nimodipine)

Study

. Monitor and adjust dose.o ▶ Cobicistat is predicted to increase the exposure to calcium

channel blockers (diltiazem, verapamil).rStudy

▶ Cobicistat is predicted to markedly increase the exposure to

calcium channel blockers (lercanidipine). Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to cannabis

extract. Use with caution and adjust dose.oTheoretical

▶ Cobicistat is predicted to moderately increase the exposure to

cariprazine. Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to ceritinib.

Avoid or adjust ceritinib dose, p. 973.rStudy

▶ Cobicistat

Study

increases the concentration of ciclosporin.r

▶ Cobicistat is predicted to moderately increase the exposure to

cilostazol. Adjust cilostazol dose, p. 232.oStudy

▶ Cobicistat is predicted to moderately increase the exposure to

cinacalcet. Adjust dose.oStudy

▶ Cobicistat is predicted to markedly increase the exposure to

cobimetinib. Avoid or monitor for toxicity.rStudy

▶ Cobicistat is predicted to increase the exposure to colchicine.

Avoid potent inhibitors of CYP3A4 or adjust colchicine dose,

p. 1120.rStudy

▶ Cobicistat is predicted to decrease the efficacy of combined

hormonal contraceptives. Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to

corticosteroids (beclometasone) (risk with beclometasone is

Theoretical

likely to be lower than with other corticosteroids).o ▶ Cobicistat is predicted to increase the exposure to

corticosteroids (betamethasone, budesonide, ciclesonide,

deflazacort, dexamethasone, fludrocortisone, fluticasone,

hydrocortisone, methylprednisolone, mometasone,

prednisolone, triamcinolone)

r

. Avoid or monitor side effects.

Study

▶ Cobicistat is predicted to moderately increase the exposure to

crizotinib. Avoid.oStudy

▶ Cobicistat is predicted to increase the exposure to dabigatran.

Avoid.rTheoretical

▶ Cobicistat is predicted to increase the exposure to dabrafenib.

Use with caution or avoid.oStudy

▶ Cobicistat is predicted to markedly to very markedly increase

the exposure to darifenacin. Avoid.rStudy

▶ Cobicistat is predicted to markedly increase the exposure to

dasatinib

r

. Avoid or adjust dose—consult product literature.

Study

▶ Cobicistat

r

very slightly increases the exposure to delamanid.

Study

▶ Cobicistat increases the risk of QT-prolongation when given

with domperidone. Avoid.rStudy

▶ Cobicistat increases the exposure to dopamine receptor agonists

(bromocriptine).rStudy

▶ Cobicistat is predicted to increase the concentration of

dopamine receptor agonists (cabergoline).oAnecdotal

▶ Cobicistat is predicted to increase the exposure to doravirine.

nStudy

▶ Cobicistat is predicted to increase the exposure to dutasteride.

Monitor side effects and adjust dose.oTheoretical

▶ Cobicistat is predicted to increase the exposure to edoxaban.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to cobicistat.

Avoid.rTheoretical

▶ Cobicistat is predicted to markedly increase the exposure to

eletriptan. Avoid.rStudy

▶ Cobicistat is predicted to increase the exposure to eliglustat.

Avoid or adjust dose—consult product literature.rStudy

▶ Cobicistat is predicted to increase the exposure to encorafenib.

Avoid or monitor.rStudy

▶ Enzalutamide is predicted to decrease the exposure to

cobicistat. Avoid.rTheoretical

▶ Cobicistat is predicted to increase the risk of ergotism when

given with ergometrine. Avoid.rTheoretical

▶ Cobicistat is predicted to increase the risk of ergotism when

given with ergotamine. Avoid.rTheoretical

▶ Cobicistat is predicted to slightly increase the exposure to

erlotinib. Use with caution and adjust dose.oStudy

▶ Cobicistat is predicted to increase the exposure to esketamine.

Adjust dose.oStudy

▶ Cobicistat is predicted to increase the concentration of

everolimus. Avoid.rStudy

▶ Cobicistat is predicted to moderately increase the exposure to

fesoterodine. Adjust fesoterodine dose with potent inhibitors

of CYP3A4; avoid in hepatic and renal impairment,

r

p. 777.