clearance of caffeine citrate. Monitor and adjust dose.

Study

▶ Caffeine citrate

o

decreases the clearance of theophylline.

Study

Calcipotriol → see vitamin D substances

Calcitonin (salmon)

▶ 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),

TABLE 8 p. 1376 (hypotension)

amlodipine . clevidipine . diltiazem . felodipine . lacidipine . lercanidipine . nicardipine . nifedipine . nimodipine .verapamil. ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

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

p. 1376

1420 Buspirone — Calcium channel blockers BNF 78

Interactions | Appendix 1

A1

▶ Verapamil

o

moderately increases the exposure to aliskiren.

Study → Also see TABLE 8 p. 1376

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to

Theoretical → Also see TABLE 8

alpha blockers

p. 1376

(tamsulosin).o ▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to alprazolam.rStudy

▶ Verapamil moderately increases the exposure to anthracyclines

(doxorubicin).oStudy

▶ Antiarrhythmics (disopyramide) are predicted to increase the

risk of cardiodepression when given with

Theoretical

verapamil.r

▶ 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

TABLE 6 p. 1376

▶ 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

TABLE 6 p. 1376

▶ 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

adjust dose.oStudy

▶ 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

Anecdotal

verapamil.r

▶ Antiepileptics (phenobarbital, primidone) are predicted to

decrease the exposure to calcium channel blockers (diltiazem,

verapamil).rStudy

▶ 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

(diltiazem, verapamil).rStudy

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

predicted to markedly increase the exposure to lercanidipine.

Avoid.rStudy

▶ Antifungals, azoles (miconazole) are predicted to increase the

exposure to calcium channel blockers (amlodipine, clevidipine,

felodipine, lacidipine, lercanidipine, nicardipine, nifedipine,

nimodipine, verapamil)

o

. Use with caution and adjust dose.

Theoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to calcium channel

blockers (amlodipine, felodipine, lacidipine, lercanidipine,

nicardipine, nifedipine, nimodipine)

o

. Monitor and adjust dose.

Study

▶ 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,

verapamil).oTheoretical

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

predicted to increase the exposure to calcium channel blockers

(diltiazem, verapamil).rStudy

▶ Antifungals, azoles (posaconazole) are predicted to increase the

exposure to

o

calcium channel blockers (diltiazem, verapamil).

Theoretical

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to

o

antifungals, azoles (isavuconazole).

Theoretical

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to antihistamines, non-sedating

(mizolastine).rTheoretical

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to antihistamines, non-sedating

(rupatadine). Avoid.oStudy

▶ Antimalarials (mefloquine) are predicted to increase the risk of

bradycardia when given with

Theoretical

calcium channel blockers.r

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the concentration of

r

antimalarials (piperaquine).

Theoretical

▶ Apalutamide is predicted to decrease the exposure to calcium

channel blockers

o

(felodipine, lercanidipine). Avoid or monitor.

Study

▶ Verapamil

o

is predicted to increase the exposure to apixaban.

Theoretical

▶ 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,

verapamil).oStudy

▶ Aprepitant is predicted to increase the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine,

lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and

adjust dose.oStudy

▶ 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.

nTheoretical

▶ 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

p. 1376

▶ 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

side-effects when given with

r

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

adjust dose.oTheoretical

▶ Bosentan 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

r

bosutinib. Avoid or adjust dose.

Theoretical

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to buspirone. Use with caution and

adjust dose.oStudy

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to cabozantinib.oTheoretical

BNF 78 Calcium channel blockers — Calcium channel blockers 1421

Interactions | Appendix 1

A1

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

see TABLE 8 p. 1376

▶ 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

see TABLE 8 p. 1376

▶ 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

▶ Nicardipine

Study

increases the concentration of ciclosporin.r

▶ 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

lercanidipine. Avoid.rStudy

▶ 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

adjust dose.oStudy

▶ 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

calcium channel blockers

Anecdotal

(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

concentration of

Study → Also see TABLE 6

digoxin

p. 1376

. Monitor and adjust dose.r

▶ Calcium channel blockers (diltiazem, verapamil) increase the risk

of QT-prolongation when given with

r

domperidone. Avoid.

Study

▶ 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

edoxaban.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine,

lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and

adjust dose.oTheoretical

▶ 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

Study

encorafenib.o ▶ Enzalutamide is predicted to decrease the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine,

lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and

adjust dose.oStudy

▶ 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

r

ergometrine.

Theoretical

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the risk of ergotism when given with

r

ergotamine.

Theoretical

▶ 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

dose.oStudy

▶ 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

impairment, p. 777.nStudy

▶ Verapamil is predicted to increase the exposure to fidaxomicin.

Avoid.oStudy

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to

Theoretical → Also see TABLE 6

fingolimod

p. 1376

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