decreases the exposure to praziquantel.
▶ Rifampicin is predicted to decrease the exposure to
corticosteroids (budesonide, deflazacort, dexamethasone,
fludrocortisone, hydrocortisone, methylprednisolone,
is predicted to decrease the exposure to fluticasone.
▶ Dexamethasone is predicted to decrease the concentration of
. Avoid multiple-dose dexamethasone.r
▶ Corticosteroids potentially decrease the effects of sodium
▶ Corticosteroids are predicted to decrease the effects of
▶ Corticosteroids are predicted to decrease the effects of
Coumarins → see TABLE 3 p. 1375 (anticoagulant effects)
FOOD AND LIFESTYLE The effects of coumarins can be reduced
or abolished by vitamin K, including that found in health
foods, food supplements, enteral feeds, or large amounts of
some green vegetables or green tea. Major changes in diet
(especially involving salads and vegetables) and in alcohol
consumption can affect anticoagulant control. Pomegranate
juice is predicted to increase the INR in response to
▶ Alcohol (beverage)(in those who drink heavily) potentially
decreases the anticoagulant effect of coumarins.rStudy
▶ Antiarrhythmics (amiodarone) increase the anticoagulant effect
▶ Antiarrhythmics (propafenone) increase the anticoagulant
coumarins. Monitor INR and adjust dose.o ▶ Antiepileptics (carbamazepine) decrease the effects of
coumarins. Monitor and adjust dose.rStudy
▶ Antiepileptics (fosphenytoin, phenytoin) are predicted to alter
the anticoagulant effect of coumarins.oAnecdotal
▶ Antiepileptics (phenobarbital, primidone) decrease the
anticoagulant effect of coumarins. Monitor INR and adjust
▶ Antifungals, azoles (fluconazole) increase the anticoagulant
effect of coumarins. Monitor INR and adjust dose.rStudy
▶ Antifungals, azoles (itraconazole) potentially increase the
anticoagulant effect of coumarins.rAnecdotal
▶ Antifungals, azoles (ketoconazole) potentially increase the
warfarin. Monitor INR and adjust dose.
▶ Antifungals, azoles (miconazole) greatly increase the
anticoagulant effect of coumarins. MHRA advises avoid unless
INR can be monitored closely; monitor for signs of bleeding.
▶ Antifungals, azoles (voriconazole) increase the anticoagulant
coumarins. Monitor INR and adjust dose.o ▶ Apalutamide is predicted to decrease the exposure to
coumarins. Avoid or monitor.nStudy
decreases the anticoagulant effect of coumarins.
▶ Axitinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
decreases the anticoagulant effect of coumarins.
decreases the anticoagulant effect of coumarins.
▶ Bosutinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Cabozantinib is predicted to increase the risk of bleeding
events when given with coumarins.rTheoretical
▶ Capecitabine increases the effects of coumarins. Monitor INR
▶ Cephalosporins (ceftriaxone) potentially increase the risk of
bleeding events when given with coumarins.rAnecdotal
▶ Ceritinib is predicted to increase the exposure to warfarin.
▶ Chloramphenicol potentially increases the anticoagulant effect
▶ Corticosteroids are predicted to increase the effects of
▶ Cranberry juice potentially increases the anticoagulant effect
▶ Crizotinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Dabrafenib is predicted to decrease the anticoagulant effect of
▶ Danazol potentially increases the anticoagulant effect of
▶ Dasatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Disulfiram increases the anticoagulant effect of coumarins.
Monitor and adjust dose.rStudy
▶ Efavirenz is predicted to affect the concentration of coumarins.
▶ Elvitegravir is predicted to decrease the anticoagulant effect of
▶ Enteral feeds (vitamin-K containing) potentially decrease the
anticoagulant effect of coumarins.rAnecdotal
▶ Enzalutamide potentially decreases the exposure to coumarins.
Avoid or adjust dose and monitor INR.rStudy
increases the anticoagulant effect of coumarins.
increases the anticoagulant effect of coumarins.
▶ Fibrates are predicted to increase the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rStudy
increases the anticoagulant effect of coumarins.
▶ Fosaprepitant is predicted to decrease the anticoagulant effect
▶ Gefitinib is predicted to increase the anticoagulant effect of
increases the anticoagulant effect of warfarin.r
▶ Glucosamine potentially decreases the anticoagulant effect of
▶ Glucosamine potentially increases the anticoagulant effect of
▶ Griseofulvin potentially decreases the anticoagulant effect of
▶ H2 receptor antagonists (cimetidine) increase the anticoagulant
▶ HIV-protease inhibitors are predicted to affect the
anticoagulant effect of coumarins.oStudy
▶ Imatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Ivacaftor is predicted to increase the anticoagulant effect of
▶ Ivermectin potentially increases the anticoagulant effect of
▶ Lapatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
increases the anticoagulant effect of coumarins.
▶ Letermovir is predicted to decrease the concentration of
warfarin. Monitor and adjust dose.oTheoretical
▶ Lomitapide increases the exposure to warfarin. Monitor INR
▶ Macrolides (clarithromycin, erythromycin) increase the
anticoagulant effect of coumarins. Monitor INR and adjust
▶ Mercaptopurine decreases the anticoagulant effect of
▶ Metronidazole increases the anticoagulant effect of coumarins.
Monitor INR and adjust dose.rStudy
potentially affects the exposure to warfarin. Avoid.
1436 Corticosteroids — Coumarins BNF 78
▶ Monoclonal antibodies (blinatumomab) are predicted to
transiently increase the exposure to warfarin. Monitor and
▶ Monoclonal antibodies (sarilumab) potentially affect the
warfarin. Monitor and adjust dose.r
▶ Monoclonal antibodies (tocilizumab) are predicted to decrease
coumarins. Monitor and adjust dose.rTheoretical
▶ Nevirapine potentially alters the anticoagulant effect of
▶ Nilotinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
decreases the anticoagulant effect of warfarin.
increases the anticoagulant effect of coumarins.
increases the anticoagulant effect of coumarins.
▶ Paritaprevir (in fixed-dose combination with dasabuvir)
decreases the anticoagulant effect of acenocoumarol. Monitor
INR and adjust dose.rAnecdotal
▶ Paritaprevir (in fixed-dose combination) decreases the
anticoagulant effect of warfarin. Monitor INR and adjust dose.
▶ Pazopanib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Penicillins potentially alter the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rAnecdotal
▶ Pitolisant is predicted to decrease the exposure to warfarin.
▶ Ponatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
increase the anticoagulant effect of coumarins.
▶ Ranibizumab increases the risk of bleeding events when given
▶ Regorafenib is predicted to increase the risk of bleeding events
when given with coumarins.rStudy
decreases the anticoagulant effect of coumarins.
▶ Rucaparib slightly increases the exposure to warfarin. Monitor
▶ Ruxolitinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
increases the anticoagulant effect of coumarins.
▶ St John’s Wort decreases the anticoagulant effect of coumarins.
▶ Statins (fluvastatin, rosuvastatin) increase the anticoagulant
effect of coumarins. Monitor INR and adjust dose.rStudy
▶ Sucralfate potentially decreases the effects of warfarin.
Separate administration by 2 hours.oAnecdotal
▶ Sulfonamides (sulfadiazine) are predicted to increase the
anticoagulant effect of coumarins.rTheoretical
▶ Sulfonamides (sulfamethoxazole) increase the anticoagulant
▶ Sunitinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
increases the anticoagulant effect of coumarins.
increases the anticoagulant effect of coumarins.
affects the anticoagulant effect of coumarins.
▶ Tetracyclines increase the risk of bleeding events when given
▶ Tinidazole is predicted to increase the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rTheoretical
▶ Toremifene is predicted to increase the anticoagulant effect of
▶ Trimethoprim is predicted to increase the anticoagulant effect
▶ Vandetanib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
slightly increases the exposure to warfarin.
▶ Cranberry juice potentially increases the anticoagulant effect
of coumarins (warfarin). Avoid.rAnecdotal
Crisantaspase → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 15 p. 1378
▶ Crisantaspase is predicted to increase the risk of
hepatotoxicity when given with imatinib.rTheoretical →
▶ Crisantaspase potentially increases the risk of neurotoxicity
when given with vinca alkaloids (vincristine).Vincristine should
Anecdotal → Also see TABLE 1 p. 1375
Crizotinib → see TABLE 6 p. 1376 (bradycardia), TABLE 15 p. 1378
(myelosuppression), TABLE 9 p. 1377 (QT-interval prolongation)
GENERAL INFORMATION Caution with concurrent use of drugs
that cause gastrointestinal perforation—discontinue
treatment if gastrointestinal perforation occurs.
is predicted to increase the exposure to abemaciclib.
▶ Crizotinib is predicted to increase the exposure to aldosterone
(eplerenone). Adjust eplerenone dose, p. 193.r
▶ Crizotinib is predicted to increase the exposure to alpha
blockers (tamsulosin).oTheoretical
is predicted to increase the exposure to alprazolam.
▶ Crizotinib is predicted to increase the exposure to
(propafenone). Monitor and adjust dose.
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to markedly decrease the
exposure to crizotinib. Avoid.rStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to moderately increase the exposure to crizotinib.
Avoid.oStudy → Also see TABLE 9 p. 1377
▶ Crizotinib is predicted to increase the exposure to
antihistamines, non-sedating (mizolastine).rTheoretical
▶ Crizotinib is predicted to increase the exposure to
antihistamines, non-sedating (rupatadine). Avoid.oStudy
▶ Crizotinib is predicted to increase the concentration of
antimalarials (piperaquine).rTheoretical
is predicted to increase the exposure to axitinib.
Theoretical → Also see TABLE 15 p. 1378
▶ Crizotinib is predicted to increase the exposure to bedaquiline.
Avoid prolonged use.nTheoretical → Also see TABLE 9 p. 1377
▶ Bosentan is predicted to decrease the exposure to crizotinib.
▶ Crizotinib is predicted to increase the exposure to bosutinib.
Avoid or adjust dose.rTheoretical → Also see TABLE 15
p. 1378 → Also see TABLE 9 p. 1377
▶ Crizotinib is predicted to increase the exposure to buspirone.
Use with caution and adjust dose.oStudy
▶ Crizotinib is predicted to increase the exposure to
cabozantinib.oTheoretical → Also see TABLE 15 p. 1378 →
▶ Crizotinib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine,
lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and
▶ Crizotinib is predicted to increase the exposure to cariprazine.
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9
▶ Crizotinib is predicted to increase the concentration of
▶ Cobicistat is predicted to moderately increase the exposure to
BNF 78 Coumarins — Crizotinib 1437
is predicted to increase the exposure to cobimetinib.
▶ Crizotinib is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Crizotinib is predicted to increase the exposure to
corticosteroids (methylprednisolone). Monitor and adjust dose.
▶ Crizotinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
▶ Crizotinib is predicted to slightly increase the exposure to
is predicted to increase the exposure to dasatinib.
Study → Also see TABLE 15 p. 1378 → Also see TABLE 9 p. 1377
▶ Crizotinib increases the risk of QT-prolongation when given
with domperidone. Avoid.rStudy
▶ Crizotinib is predicted to increase the exposure to dopamine
receptor agonists (bromocriptine).rTheoretical
▶ Crizotinib is predicted to increase the concentration of
dopamine receptor agonists (cabergoline).oAnecdotal
▶ Crizotinib is predicted to moderately increase the exposure to
▶ Efavirenz is predicted to decrease the exposure to crizotinib.
Avoid.rTheoretical → Also see TABLE 9 p. 1377
▶ Crizotinib is predicted to increase the exposure to eliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶ Crizotinib is predicted to moderately increase the exposure to
encorafenib.oStudy → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to markedly decrease the exposure
▶ Crizotinib is predicted to increase the risk of ergotism when
given with ergometrine.rTheoretical
▶ Crizotinib is predicted to increase the risk of ergotism when
given with ergotamine.rTheoretical
is predicted to increase the exposure to erlotinib.
▶ Crizotinib is predicted to increase the concentration of
everolimus. Avoid or adjust dose.oStudy → Also see
▶ Crizotinib is predicted to increase the exposure to
fesoterodine. Adjust fesoterodine dose with moderate
inhibitors of CYP3A4 in hepatic and renal impairment, p. 777.
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