decreases the exposure to antimalarials (artemether).
▶ Etravirine is predicted to decrease the exposure to bedaquiline.
▶ Bosentan is predicted to decrease the exposure to etravirine.
▶ Etravirine is predicted to decrease the exposure to bosutinib.
▶ Etravirine is predicted to decrease the exposure to brigatinib.
increases the anticoagulant effect of coumarins.
▶ Etravirine is predicted to decrease the exposure to dasabuvir.
▶ Etravirine moderately decreases the exposure to dolutegravir.
Avoid unless given with atazanavir, darunavir, or lopinavir (all
boosted with ritonavir).rStudy
▶ Efavirenz is predicted to decrease the exposure to etravirine.
▶ Etravirine is predicted to decrease the exposure to elbasvir.
▶ Enzalutamide is predicted to decrease the exposure to
etravirine. Avoid.rTheoretical
▶ Etravirine is predicted to decrease the exposure to grazoprevir.
▶ HIV-protease inhibitors (tipranavir) decrease the exposure to
▶ Etravirine increases the exposure to HIV-protease inhibitors
(fosamprenavir boosted with ritonavir). Refer to specialist
is predicted to decrease the exposure to letermovir.
▶ Etravirine decreases the exposure to macrolides
(clarithromycin) and macrolides (clarithromycin) slightly
increase the exposure to etravirine.rStudy
▶ Etravirine (with a boosted protease inhibitor) increases the
exposure to maraviroc. Avoid or adjust dose.oStudy
▶ Mitotane is predicted to decrease the exposure to etravirine.
▶ Nevirapine is predicted to decrease the exposure to etravirine.
▶ Etravirine is predicted to decrease the exposure to ombitasvir.
▶ Etravirine is predicted to decrease the exposure to
paritaprevir. Avoid.rTheoretical
▶ Etravirine moderately decreases the exposure to
phosphodiesterase type-5 inhibitors
. Adjust dose.o ▶ Rifabutin decreases the exposure to etravirine.oStudy
▶ Rifampicin is predicted to decrease the exposure to etravirine.
▶ Etravirine is predicted to decrease the exposure to rilpivirine.
▶ St John’s Wort is predicted to decrease the exposure to
Everolimus → see TABLE 15 p. 1378 (myelosuppression)
▶ Everolimus potentially increases the risk of angioedema when
given with ACE inhibitors.rAnecdotal
▶ Antiarrhythmics (dronedarone) are predicted to increase the
everolimus. Avoid or adjust dose.o ▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the
concentration of everolimus. Avoid or adjust dose.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the concentration of everolimus.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the concentration of
▶ Apalutamide is predicted to decrease the exposure to
everolimus. Avoid or monitor.oStudy
▶ Aprepitant is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy
▶ Bosentan is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the concentration of everolimus. Avoid or adjust
is predicted to increase the exposure to everolimus.
Theoretical → Also see TABLE 15 p. 1378
▶ Ciclosporin moderately increases the exposure to everolimus.
▶ Cobicistat is predicted to increase the concentration of
▶ Crizotinib is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy → Also see
▶ Efavirenz is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Eliglustat is predicted to increase the exposure to everolimus.
▶ Enzalutamide is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Grapefruit juice is predicted to increase the exposure to
everolimus. Avoid.rTheoretical
▶ HIV-protease inhibitors are predicted to increase the
concentration of everolimus. Avoid.rStudy
▶ Idelalisib is predicted to increase the concentration of
everolimus. Avoid.rStudy → Also see TABLE 15 p. 1378
▶ Imatinib is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy → Also see
is predicted to increase the exposure to everolimus.
▶ Letermovir is predicted to increase the concentration of
everolimus. Monitor and adjust dose.rStudy
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
BNF 78 Etonogestrel — Everolimus 1455
everolimus. Public Health England advises avoid (refer to
▶ Everolimus is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
▶ Lumacaftor is predicted to decrease the exposure to
everolimus. Avoid.rTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
concentration of everolimus. Avoid.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
▶ Mitotane is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy → Also see
▶ Netupitant is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy
▶ Nevirapine is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Nilotinib is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy → Also see
▶ Palbociclib is predicted to increase the exposure to everolimus.
▶ Pibrentasvir (with glecaprevir) is predicted to increase the
▶ Pitolisant is predicted to decrease the exposure to everolimus.
▶ Ribociclib is predicted to increase the exposure to everolimus.
Use with caution and adjust dose.oTheoretical
▶ Rifampicin is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ St John’s Wort is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Velpatasvir is predicted to increase the exposure to
▶ Venetoclax is predicted to increase the exposure to everolimus.
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) moderately decrease the exposure to
▶ Enzalutamide moderately decreases the exposure to
moderately decreases the exposure to exemestane.
moderately decreases the exposure to exemestane.
▶ St John’s Wort is predicted to decrease the exposure to
Exenatide → see TABLE 14 p. 1378 (antidiabetic drugs)
SEPARATION OF ADMINISTRATION With standard-release
exenatide: some orally administered drugs should be taken at
least 1 hour before, or 4 hours after, exenatide injection.
▶ Ciclosporin moderately increases the exposure to ezetimibe
ezetimibe slightly increases the exposure to ciclosporin.
▶ Fibrates are predicted to increase the risk of gallstones when
given with ezetimibe.rTheoretical
▶ Ezetimibe potentially increases the risk of rhabdomyolysis
when given with statins.rAnecdotal
Famotidine → see H2 receptor antagonists
▶ H2 receptor antagonists (cimetidine) increase the concentration
of fampridine. Avoid.rTheoretical
▶ Febuxostat is predicted to increase the exposure to
azathioprine. Avoid.rTheoretical
is predicted to increase the exposure to didanosine.
▶ Febuxostat is predicted to increase the exposure to
mercaptopurine. Avoid.rTheoretical
Felodipine → see calcium channel blockers
Ferric carboxymaltose → see iron (injectable)
Ferric maltol → see iron (oral)
Ferrous fumarate → see iron (oral)
Ferrous gluconate → see iron (oral)
Ferrous sulfate → see iron (oral)
Fesoterodine → see TABLE 10 p. 1377 (antimuscarinics)
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to fesoterodine. Adjust fesoterodine dose with
moderate inhibitors of CYP3A4 in hepatic and renal
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to fesoterodine. Adjust
fesoterodine dose with moderate inhibitors of CYP3A4 in
hepatic and renal impairment, p. 777.nStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to fesoterodine.
Adjust fesoterodine dose with potent inhibitors of CYP3A4;
avoid in hepatic and renal impairment, p. 777.rStudy
▶ Aprepitant is predicted to increase the exposure to
fesoterodine. Adjust fesoterodine dose with moderate
inhibitors of CYP3A4 in hepatic and renal impairment, p. 777.
▶ 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
▶ Cobicistat is predicted to moderately increase the exposure to
fesoterodine. Adjust fesoterodine dose with potent inhibitors
of CYP3A4; avoid in hepatic and renal impairment,
▶ Crizotinib is predicted to increase the exposure to
fesoterodine. Adjust fesoterodine dose with moderate
inhibitors of CYP3A4 in hepatic and renal impairment, p. 777.
▶ Enzalutamide is predicted to decrease the exposure to
▶ HIV-protease inhibitors are predicted to moderately increase
the exposure to fesoterodine. Adjust fesoterodine dose with
potent inhibitors of CYP3A4; avoid in hepatic and renal
▶ Idelalisib is predicted to moderately increase the exposure to
fesoterodine. Adjust fesoterodine dose with potent inhibitors
of CYP3A4; avoid in hepatic and renal impairment,
▶ Imatinib is predicted to increase the exposure to fesoterodine.
Adjust fesoterodine dose with moderate inhibitors of CYP3A4
in hepatic and renal impairment, p. 777.nStudy
▶ Macrolides (clarithromycin) are predicted to moderately
increase the exposure to fesoterodine. Adjust fesoterodine
dose with potent inhibitors of CYP3A4; avoid in hepatic and
renal impairment, p. 777.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to fesoterodine. Adjust fesoterodine dose with
moderate inhibitors of CYP3A4 in hepatic and renal
▶ Mitotane is predicted to decrease the exposure to fesoterodine.
▶ Netupitant is predicted to increase the exposure to
fesoterodine. Adjust fesoterodine dose with moderate
inhibitors of CYP3A4 in hepatic and renal impairment, p. 777.
▶ Nilotinib is predicted to increase the exposure to fesoterodine.
Adjust fesoterodine dose with moderate inhibitors of CYP3A4
in hepatic and renal impairment, p. 777.nStudy
▶ Rifampicin is predicted to decrease the exposure to
▶ St John’s Wort is predicted to decrease the exposure to
fesoterodine. Avoid.rTheoretical
1456 Everolimus — Fesoterodine BNF 78
Fexofenadine → see antihistamines, non-sedating
▶ Gemfibrozil is predicted to increase the exposure to
▶ Bezafibrate is predicted to increase the risk of nephrotoxicity
when given with ciclosporin.rTheoretical
▶ Fenofibrate increases the risk of nephrotoxicity when given
▶ Colchicine increases the risk of rhabdomyolysis when given
▶ Fibrates are predicted to increase the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rStudy
▶ Gemfibrozil is predicted to increase the exposure to
▶ Fibrates are predicted to increase the risk of rhabdomyolysis
when given with daptomycin.rTheoretical
▶ Gemfibrozil is predicted to very markedly increase the
exposure to dasabuvir. Avoid.rStudy
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