clearance of caffeine citrate. Monitor and adjust dose.
decreases the clearance of theophylline.
Calcipotriol → see vitamin D substances
▶ Calcitonin (salmon) decreases the concentration of lithium.
Monitor concentration and adjust dose.oStudy
Calcitriol → see vitamin D substances
Calcium acetate → see calcium salts
Calcium carbonate → see calcium salts
Calcium channel blockers → see TABLE 6 p. 1376 (bradycardia),
increase the exposure to abemaciclib.oStudy
▶ Verapamil is predicted to increase the exposure to afatinib.
Separate administration by 12 hours.oStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to aldosterone antagonists (eplerenone).
Adjust eplerenone dose, p. 193.rStudy → Also see TABLE 8
1420 Buspirone — Calcium channel blockers BNF 78
moderately increases the exposure to aliskiren.
Study → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
Theoretical → Also see TABLE 8
(tamsulosin).o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to alprazolam.rStudy
▶ Verapamil moderately increases the exposure to anthracyclines
▶ Antiarrhythmics (disopyramide) are predicted to increase the
risk of cardiodepression when given with
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to calcium channel blockers (amlodipine, felodipine,
lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine).
Monitor and adjust dose.oStudy
▶ Antiarrhythmics (amiodarone) are predicted to increase the risk
of cardiodepression when given with calcium channel blockers
(diltiazem, verapamil). Avoid.rTheoretical → Also see
▶ Calcium channel blockers (diltiazem, verapamil) increase the
exposure to antiarrhythmics (dronedarone) and antiarrhythmics
(dronedarone) increase the exposure to calcium channel
blockers (diltiazem, verapamil).oStudy
▶ Verapamil increases the risk of cardiodepression when given
with antiarrhythmics (flecainide).rAnecdotal → Also see
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to antiarrhythmics (propafenone).
Monitor and adjust dose.oStudy
▶ Calcium channel blockers (diltiazem, verapamil) increase the risk
of bradycardia when given with anticholinesterases, centrally
acting.oAnecdotal → Also see TABLE 6 p. 1376
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to calcium channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Diltiazem increases the concentration of antiepileptics
(carbamazepine) and antiepileptics (carbamazepine) are
predicted to decrease the exposure to diltiazem. Monitor
concentration and adjust dose.rAnecdotal
▶ Verapamil increases the concentration of antiepileptics
(carbamazepine) and antiepileptics (carbamazepine) are
predicted to decrease the exposure to
▶ Antiepileptics (phenobarbital, primidone) are predicted to
decrease the exposure to calcium channel blockers (diltiazem,
▶ Calcium channel blockers (diltiazem, verapamil) potentially
increase the concentration of antiepileptics (fosphenytoin,
phenytoin) and antiepileptics (fosphenytoin, phenytoin) are
predicted to decrease the exposure to calcium channel blockers
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to lercanidipine.
▶ Antifungals, azoles (miconazole) are predicted to increase the
exposure to calcium channel blockers (amlodipine, clevidipine,
felodipine, lacidipine, lercanidipine, nicardipine, nifedipine,
. Use with caution and adjust dose.
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to calcium channel
blockers (amlodipine, felodipine, lacidipine, lercanidipine,
nicardipine, nifedipine, nimodipine)
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to calcium channel blockers
(amlodipine, felodipine, lacidipine, nicardipine, nifedipine,
nimodipine). Monitor and adjust dose.oStudy
▶ Antifungals, azoles (fluconazole) (high-dose) are predicted to
increase the exposure to calcium channel blockers (diltiazem,
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to calcium channel blockers
▶ Antifungals, azoles (posaconazole) are predicted to increase the
calcium channel blockers (diltiazem, verapamil).
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
antifungals, azoles (isavuconazole).
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to antihistamines, non-sedating
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to antihistamines, non-sedating
▶ Antimalarials (mefloquine) are predicted to increase the risk of
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
▶ Apalutamide is predicted to decrease the exposure to calcium
(felodipine, lercanidipine). Avoid or monitor.
is predicted to increase the exposure to apixaban.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to aprepitant and aprepitant is predicted
to increase the exposure to calcium channel blockers (diltiazem,
▶ Aprepitant 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 axitinib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to bedaquiline. Avoid prolonged use.
▶ Diltiazem is predicted to increase the risk of cardiodepression
when given with beta blockers, non-selective.rStudy →
Also see TABLE 6 p. 1376 → Also see TABLE 8 p. 1376
▶ Intravenous verapamil increases the risk of cardiovascular
side-effects when given with beta blockers, non-selective.
Avoid.rStudy → Also see TABLE 6 p. 1376 → Also see TABLE 8
▶ Oral verapamil increases the risk of cardiovascular side-effects
when given with beta blockers, non-selective.rStudy →
Also see TABLE 6 p. 1376 → Also see TABLE 8 p. 1376
▶ Diltiazem is predicted to increase the risk of cardiodepression
when given with beta blockers, selective.rStudy → Also see
TABLE 6 p. 1376 → Also see TABLE 8 p. 1376
▶ Intravenous verapamil increases the risk of cardiovascular
beta blockers, selective. Avoid.
Study → Also see TABLE 6 p. 1376 → Also see TABLE 8 p. 1376
▶ Oral verapamil increases the risk of cardiovascular side-effects
when given with beta blockers, selective.rStudy → Also see
TABLE 6 p. 1376 → Also see TABLE 8 p. 1376
▶ Verapamil is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Bosentan is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Bosentan is predicted to decrease the exposure to calcium
channel blockers (diltiazem, verapamil).oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
bosutinib. Avoid or adjust dose.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to buspirone. Use with caution and
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to cabozantinib.oTheoretical
BNF 78 Calcium channel blockers — Calcium channel blockers 1421
Calcium channel blockers (continued)
▶ Calcium channel blockers (diltiazem) are predicted to increase
the exposure to calcium channel blockers (amlodipine). Monitor
and adjust dose.oStudy → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (verapamil) are predicted to increase
the exposure to calcium channel blockers (amlodipine,
felodipine, lacidipine, lercanidipine, nicardipine, nifedipine,
nimodipine). Monitor and adjust dose.oStudy → Also
▶ Calcium channel blockers (diltiazem) are predicted to increase
the exposure to calcium channel blockers (felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
adjust dose.oStudy → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to cariprazine. Avoid.rStudy → Also
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ceritinib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of ciclosporin.rStudy
▶ Ciclosporin moderately increases the exposure to lercanidipine.
Use with caution or avoid.rStudy
increases the concentration of ciclosporin.r
▶ Cobicistat is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine, nicardipine,
. 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 (diltiazem, verapamil) are predicted to
increase the exposure to cobimetinib.rTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to colchicine. Adjust colchicine dose
with moderate inhibitors of CYP3A4, p. 1120.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to corticosteroids (methylprednisolone).
Monitor and adjust dose.oStudy
▶ Crizotinib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Verapamil increases the exposure to dabigatran. Adjust
dabigatran dose, p. 136.rStudy
▶ Intravenous dantrolene potentially increases the risk of acute
hyperkalaemia and cardiovascular collapse when given with
(diltiazem, verapamil). Avoid.r
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
slightly increase the exposure to darifenacin.oStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to dasatinib.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) increase the
▶ Calcium channel blockers (diltiazem, verapamil) increase the risk
of QT-prolongation when given with
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to dopamine receptor agonists
(bromocriptine).rTheoretical → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of dopamine receptor agonists
(cabergoline).oAnecdotal → Also see TABLE 8 p. 1376
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
moderately increase the exposure to dutasteride.nStudy
▶ Verapamil is predicted to slightly increase the exposure to
▶ Efavirenz is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Efavirenz 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 eliglustat. Avoid or adjust dose—
consult product literature.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
moderately increase the exposure to
encorafenib.o ▶ Enzalutamide is predicted to decrease the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Enzalutamide is predicted to decrease the exposure to calcium
channel blockers (diltiazem, verapamil).rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the risk of ergotism when given with
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the risk of ergotism when given with
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to erlotinib.oTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of everolimus. Avoid or adjust
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to fesoterodine. Adjust fesoterodine
dose with moderate inhibitors of CYP3A4 in hepatic and renal
▶ Verapamil is predicted to increase the exposure to fidaxomicin.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
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