decreases the effects of metyrapone. Avoid.
Carboplatin → see platinum compounds
Carfilzomib → see TABLE 15 p. 1378 (myelosuppression)
Cariprazine → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to cariprazine. Avoid.rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to cariprazine. Avoid.rTheoretical → Also see TABLE 11
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to cariprazine.
▶ Aprepitant is predicted to increase the exposure to cariprazine.
▶ Bosentan is predicted to decrease the exposure to cariprazine.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to cariprazine. Avoid.rStudy → Also
▶ Cobicistat is predicted to moderately increase the exposure to
▶ Crizotinib is predicted to increase the exposure to cariprazine.
▶ Efavirenz is predicted to decrease the exposure to cariprazine.
▶ Enzalutamide is predicted to decrease the exposure to
cariprazine. Avoid.rTheoretical
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to moderately increase
the exposure to cariprazine. Avoid.rStudy
▶ Idelalisib is predicted to moderately increase the exposure to
▶ Imatinib is predicted to increase the exposure to cariprazine.
▶ Macrolides (clarithromycin) are predicted to moderately
increase the exposure to cariprazine. Avoid.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to cariprazine. Avoid.rStudy
▶ Mitotane is predicted to decrease the exposure to cariprazine.
▶ Netupitant is predicted to increase the exposure to cariprazine.
▶ Nevirapine is predicted to decrease the exposure to
cariprazine. Avoid.rTheoretical
▶ Nilotinib is predicted to increase the exposure to cariprazine.
▶ Rifampicin is predicted to decrease the exposure to
cariprazine. Avoid.rTheoretical
▶ St John’s Wort is predicted to decrease the exposure to
cariprazine. Avoid.rTheoretical
Carmustine → see alkylating agents
Carvedilol → see beta blockers, non-selective
▶ Antiepileptics (carbamazepine, fosphenytoin, phenytoin) are
predicted to decrease the concentration of caspofungin. Adjust
caspofungin dose, p. 592.oTheoretical
slightly increases the exposure to caspofungin.
▶ Corticosteroids (dexamethasone) are predicted to decrease the
caspofungin. Adjust caspofungin dose, p. 592.
▶ Efavirenz is predicted to decrease the concentration of
caspofungin. Adjust dose.oStudy
▶ Nevirapine is predicted to decrease the concentration of
caspofungin. Adjust dose.oTheoretical
▶ Rifampicin decreases the concentration of caspofungin. Adjust
caspofungin dose, p. 592.oStudy
Cefadroxil → see cephalosporins
Cefalexin → see cephalosporins
Cefotaxime → see cephalosporins
Cefradine → see cephalosporins
Ceftaroline → see cephalosporins
Ceftazidime → see cephalosporins
Ceftobiprole → see cephalosporins
Ceftolozane → see cephalosporins
Ceftriaxone → see cephalosporins
Cefuroxime → see cephalosporins
Celiprolol → see beta blockers, selective
Cephalosporins → see TABLE 2 p. 1375 (nephrotoxicity)
BNF 78 Cannabis extract — Cephalosporins 1425
ROUTE-SPECIFIC INFORMATION Interactions do not generally
apply to topical use of cefuroxime unless specified.
is predicted to increase the exposure to bosentan.
▶ Ceftriaxone increases the risk of cardio-respiratory arrest
calcium salts (calcium chloride). Avoid.r
▶ Ceftriaxone increases the risk of cardio-respiratory arrest
when given with intravenous calcium salts (calcium gluconate).
▶ Ceftriaxone potentially increases the risk of bleeding events
when given with coumarins.rAnecdotal
is predicted to increase the exposure to cefaclor.
▶ Ceftriaxone potentially increases the risk of bleeding events
when given with phenindione.rAnecdotal
▶ Ceftobiprole is predicted to increase the concentration of
▶ Ceftobiprole is predicted to increase the concentration of
sulfonylureas (glibenclamide).oTheoretical
is predicted to increase the exposure to cefaclor.
Ceritinib → see TABLE 15 p. 1378 (myelosuppression), TABLE 9 p. 1377
is predicted to increase the exposure to aliskiren.
▶ Antacids are predicted to decrease the absorption of ceritinib.
Separate administration by 2 hours.oTheoretical
▶ Antiarrhythmics (amiodarone, dronedarone) are predicted to
increase the exposure to ceritinib.oTheoretical → Also
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Theoretical → Also see TABLE 9 p. 1377
ceritinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to ceritinib. Avoid or adjust
ceritinib dose, p. 973.rStudy → Also see TABLE 9 p. 1377
▶ Ceritinib is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).oTheoretical
is predicted to increase the exposure to ceritinib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ceritinib.oTheoretical
▶ Ceritinib is predicted to increase the exposure to ciclosporin.
▶ Cobicistat is predicted to increase the exposure to ceritinib.
Avoid or adjust ceritinib dose, p. 973.rStudy
is predicted to increase the exposure to colchicine.
▶ Ceritinib is predicted to increase the exposure to coumarins
(warfarin). Avoid.rTheoretical
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
is predicted to increase the exposure to dabigatran.
▶ Ceritinib is predicted to increase the risk of bradycardia when
given with digoxin. Avoid.rTheoretical
is predicted to increase the exposure to edoxaban.
▶ Enzalutamide is predicted to decrease the exposure to
▶ Ceritinib is predicted to increase the exposure to ergotamine.
is predicted to increase the exposure to everolimus.
Theoretical → Also see TABLE 15 p. 1378
▶ Grapefruit juice is predicted to increase the exposure to
▶ H2 receptor antagonists are predicted to decrease the
absorption of ceritinib.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
to ceritinib. Avoid or adjust ceritinib dose, p. 973.rStudy →
▶ Idelalisib is predicted to increase the exposure to ceritinib.
Avoid or adjust ceritinib dose, p. 973.rStudy → Also see
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 15 p. 1378
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 9 p. 1377
is predicted to increase the exposure to loperamide.
▶ Macrolides (azithromycin, erythromycin) are predicted to
increase the exposure to ceritinib.oTheoretical → Also
▶ Macrolides (clarithromycin) are predicted to increase the
ceritinib. Avoid or adjust ceritinib dose, p. 973.
Study → Also see TABLE 9 p. 1377
▶ Mitotane is predicted to decrease the exposure to ceritinib.
Avoid.rStudy → Also see TABLE 15 p. 1378
is predicted to increase the exposure to ceritinib.
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
▶ Ceritinib is predicted to increase the exposure to NSAIDs
(celecoxib, diclofenac). Adjust dose.oTheoretical
▶ Ceritinib is predicted to increase the exposure to opioids
(alfentanil, fentanyl). Avoid.rTheoretical
▶ Ceritinib is predicted to increase the exposure to pimozide.
Avoid.rTheoretical → Also see TABLE 9 p. 1377
▶ Proton pump inhibitors are predicted to decrease the
absorption of ceritinib.oTheoretical
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 9 p. 1377
▶ Rifampicin is predicted to decrease the exposure to ceritinib.
▶ Ceritinib is predicted to increase the exposure to sirolimus.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Ceritinib is predicted to increase the exposure to sulfonylureas
(glimepiride). Adjust dose.oTheoretical
▶ Ceritinib is predicted to increase the exposure to tacrolimus.
▶ Ceritinib is predicted to increase the exposure to taxanes
(paclitaxel).oTheoretical → Also see TABLE 15 p. 1378
is predicted to increase the exposure to topotecan.
Theoretical → Also see TABLE 15 p. 1378
Certolizumab pegol → see monoclonal antibodies
Cetirizine → see antihistamines, non-sedating
Cetuximab → see monoclonal antibodies
▶ Oral antacids (aluminium hydroxide) decrease the absorption of
▶ Antiepileptics (phenobarbital, primidone) are predicted to affect
ficacy of chenodeoxycholic acid. Monitor and adjust dose.
▶ Ciclosporin is predicted to affect the efficacy of
. Monitor and adjust dose.o ▶ Oral combined hormonal contraceptives potentially decrease
acid. Monitor and adjust dose.oTheoretical
Chloral hydrate → see TABLE 11 p. 1377 (CNS depressant effects)
▶ Intravenous loop diuretics (furosemide) potentially increase the
risk of sweating, variable blood pressure, and tachycardia
when given after chloral hydrate.oAnecdotal
Chlorambucil → see alkylating agents
ROUTE-SPECIFIC INFORMATION Since systemic absorption can
follow topical application, the possibility of interactions
1426 Cephalosporins — Chloramphenicol BNF 78
▶ Antiepileptics (phenobarbital, primidone) decrease the
concentration of chloramphenicol.oStudy
▶ Intravenous chloramphenicol increases the concentration of
antiepileptics (fosphenytoin, phenytoin) and antiepileptics
(fosphenytoin, phenytoin) affect the concentration of
intravenous chloramphenicol. Monitor concentration and
▶ Chloramphenicol potentially increases the anticoagulant effect
▶ Chloramphenicol is predicted to increase the exposure to
guanfacine. Adjust guanfacine dose, p. 352.oTheoretical
▶ Chloramphenicol decreases the efficacy of intravenous iron
decreases the efficacy of oral iron (oral).
decreases the concentration of chloramphenicol.
▶ Chloramphenicol is predicted to increase the exposure to
increases the concentration of tacrolimus.
Chlordiazepoxide → see TABLE 11 p. 1377 (CNS depressant effects)
▶ Chlordiazepoxide affects the concentration of antiepileptics
(fosphenytoin, phenytoin).rStudy
▶ Rifampicin is predicted to decrease the exposure to
Chloroquine → see antimalarials
Chlorothiazide → see thiazide diuretics
Chlorphenamine → see antihistamines, sedating
Chlorpromazine → see phenothiazines
Chlortalidone → see thiazide diuretics
▶ Antimalarials (chloroquine) decrease the efficacy of oral cholera
▶ Hydroxychloroquine is predicted to decrease the efficacy of
oral cholera vaccine.oTheoretical
▶ Antacids are predicted to decrease the absorption of cholic
acid. Separate administration by 5 hours.nTheoretical
▶ Antiepileptics (phenobarbital) decrease the effects of cholic acid.
affects the concentration of cholic acid. Avoid.
▶ Corticosteroids are predicted to decrease the concentration of
Ciclesonide → see corticosteroids
Ciclosporin → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 16 p. 1379
▶ Pomelo juice is predicted to increase ciclosporin exposure,
and purple grape juice is predicted to decrease ciclosporin
▶ Since systemic absorption can follow topical application,
the possibility of interactions should be borne in mind.
▶ Ciclosporin is predicted to increase the exposure to afatinib.
Separate administration by 12 hours.oStudy
▶ Ciclosporin markedly increases the exposure to aliskiren.
Avoid.rStudy → Also see TABLE 16 p. 1379
▶ Ciclosporin moderately increases the exposure to ambrisentan.
Adjust ambrisentan dose, p. 184.oStudy
▶ Ciclosporin increases the concentration of anthracyclines
(daunorubicin, doxorubicin, epirubicin, idarubicin,
▶ Antiarrhythmics (amiodarone) increase the concentration of
. Monitor concentration and adjust dose.r
▶ Antiarrhythmics (dronedarone) are predicted to increase the
concentration of ciclosporin.rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) decrease the concentration of
▶ Antiepileptics (oxcarbazepine) decrease the concentration of
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
increase the concentration of ciclosporin.rStudy
▶ Antifungals, azoles (miconazole) increase the concentration of
ciclosporin. Monitor and adjust dose.rAnecdotal
▶ Aprepitant is predicted to increase the concentration of
▶ Ciclosporin is predicted to increase the exposure to beta
blockers, non-selective (nadolol).oStudy
▶ Ciclosporin is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Bosentan moderately decreases the exposure to ciclosporin
and ciclosporin moderately increases the exposure to
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of ciclosporin.rStudy
▶ Calcium channel blockers (nicardipine) increase the
concentration of ciclosporin.rStudy
▶ Ciclosporin moderately increases the exposure to calcium
channel blockers (lercanidipine). Use with caution or avoid.
slightly increases the exposure to caspofungin.
▶ Ceritinib is predicted to increase the exposure to ciclosporin.
▶ Ciclosporin is predicted to affect the efficacy of
. Monitor and adjust dose.o ▶ Ciclosporin
affects the concentration of cholic acid. Avoid.
increases the concentration of ciclosporin.r
▶ Ciclosporin increases the exposure to colchicine. Avoid or
adjust colchicine dose, p. 1120.rStudy
▶ Crizotinib is predicted to increase the concentration of
▶ Ciclosporin is predicted to increase the exposure to dabigatran.
increases the concentration of ciclosporin.r
▶ Ciclosporin is predicted to increase the risk of rhabdomyolysis
when given with daptomycin.rTheoretical
▶ Ciclosporin is predicted to increase the exposure to
darifenacin. Avoid.oTheoretical
▶ Ciclosporin increases the concentration of digoxin. Monitor
▶ Ciclosporin slightly increases the exposure to edoxaban. Adjust
▶ Efavirenz decreases the concentration of ciclosporin. Monitor
concentration and adjust dose.oStudy
▶ Ciclosporin decreases the exposure to eltrombopag. Monitor
decreases the concentration of ciclosporin.
is predicted to increase the exposure to erlotinib.
▶ Ciclosporin increases the exposure to etoposide. Monitor and
▶ Ciclosporin moderately increases the exposure to everolimus.
▶ Ciclosporin moderately increases the exposure to ezetimibe
ezetimibe slightly increases the exposure to ciclosporin.
▶ Fibrates (bezafibrate) are predicted to increase the risk of
nephrotoxicity when given with ciclosporin.rTheoretical
▶ Fibrates (fenofibrate) increase the risk of nephrotoxicity when
▶ Ciclosporin is predicted to increase the exposure to
▶ Ciclosporin increases the exposure to glecaprevir. Avoid or
▶ Grapefruit juice increases the concentration of ciclosporin.
BNF 78 Chloramphenicol — Ciclosporin 1427
▶ Ciclosporin greatly increases the exposure to grazoprevir.
▶ H2 receptor antagonists (cimetidine) increase the concentration
▶ HIV-protease inhibitors increase the concentration of
increases the concentration of ciclosporin.r
▶ Imatinib is predicted to increase the concentration of
▶ Lanreotide is predicted to decrease the absorption of oral
ciclosporin. Adjust dose.rTheoretical
▶ Letermovir increases the exposure to ciclosporin and
ciclosporin increases the exposure to letermovir. Monitor and
adjust letermovir dose, p. 639.rStudy
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
ciclosporin. Public Health England advises avoid (refer to
▶ Ciclosporin is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
▶ Lumacaftor is predicted to decrease the exposure to
ciclosporin. Avoid.rTheoretical
▶ Macrolides (clarithromycin) increase the concentration of
▶ Macrolides (erythromycin) are predicted to increase the
concentration of ciclosporin.rStudy
▶ Ciclosporin is predicted to decrease the efficacy of
mifamurtide. Avoid.rTheoretical
decreases the concentration of ciclosporin.r
▶ Monoclonal antibodies (blinatumomab) are predicted to
transiently increase the exposure to ciclosporin. Monitor and
▶ Monoclonal antibodies (sarilumab) potentially affect the
ciclosporin. Monitor and adjust dose.o ▶ Netupitant is predicted to increase the concentration of
▶ Nevirapine is predicted to decrease the concentration of
▶ Nilotinib is predicted to increase the concentration of
is predicted to increase the exposure to nintedanib.
increases the concentration of NSAIDs (diclofenac).
Study → Also see TABLE 2 p. 1375 → Also see TABLE 16 p. 1379
▶ Octreotide decreases the absorption of oral ciclosporin. Adjust
ciclosporin dose, p. 838.rAnecdotal
▶ Palbociclib is predicted to increase the exposure to ciclosporin.
▶ Ciclosporin is predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical
▶ Pasireotide is predicted to decrease the absorption of oral
ciclosporin. Adjust dose.rTheoretical
▶ Pitolisant is predicted to decrease the exposure to ciclosporin.
▶ Ciclosporin is predicted to increase the concentration of
ranolazine and ranolazine is predicted to increase the
concentration of ciclosporin.oTheoretical
moderately increases the exposure to repaglinide.
▶ Ribociclib is predicted to increase the exposure to ciclosporin.
Use with caution and adjust dose.oTheoretical
decreases the concentration of ciclosporin.r
very markedly increases the exposure to rifaximin.
is predicted to increase the exposure to riociguat.
▶ Rucaparib is predicted to increase the exposure to ciclosporin.
Monitor and adjust dose.oStudy
▶ Ciclosporin moderately increases the exposure to sirolimus.
Separate administration by 4 hours.rStudy
▶ St John’s Wort decreases the concentration of ciclosporin.
▶ Ciclosporin very markedly increases the exposure to statins
. Avoid or adjust atorvastatin dose, p. 202.r
▶ Ciclosporin moderately increases the exposure to statins
▶ Ciclosporin markedly to very markedly increases the exposure
to statins (pravastatin). Adjust dose.rStudy
▶ Ciclosporin markedly increases the exposure to statins
(rosuvastatin, simvastatin). Avoid.rStudy
increases the concentration of tacrolimus. Avoid.
Study → Also see TABLE 2 p. 1375 → Also see TABLE 16 p. 1379
▶ Ciclosporin is predicted to increase the exposure to tenofovir
▶ Ciclosporin is predicted to increase the exposure to tenofovir
disoproxil.oTheoretical → Also see TABLE 2 p. 1375
▶ Ciclosporin is predicted to increase the exposure to ticagrelor.
Use with caution or avoid.rStudy
increases the exposure to tofacitinib. Avoid.r
is predicted to increase the exposure to topotecan.
▶ Ciclosporin is predicted to increase the concentration of
▶ Ursodeoxycholic acid affects the concentration of ciclosporin.
Use with caution and adjust dose.rAnecdotal
▶ Ciclosporin is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
affect the exposure to ciclosporin.
increases the concentration of voxilaprevir. Avoid.
Cidofovir → see TABLE 2 p. 1375 (nephrotoxicity)
Cilostazol → see TABLE 4 p. 1375 (antiplatelet effects)
GENERAL INFORMATION Concurrent use with 2 or more
antiplatelets or anticoagulants is contra-indicated.
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to alter the effects of
▶ Antifungals, azoles (fluconazole) are predicted to increase the
predicted to moderately increase the exposure to cilostazol.
Adjust cilostazol dose, p. 232.oStudy
▶ Antifungals, azoles (miconazole) are predicted to increase the
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