for 2 hours before or 1 hour after sodium clodronate.
▶ Aspirin (high-dose) is predicted to increase the risk of
gastrointestinal irritation when given with bisphosphonates
(alendronic acid, ibandronic acid).oStudy
▶ Aspirin (high-dose) is predicted to increase the risk of renal
impairment when given with sodium clodronate.r
▶ Oral calcium salts decrease the absorption of alendronic acid.
Alendronic acid should be taken at least 30 minutes before
▶ Oral calcium salts are predicted to decrease the absorption of
oral ibandronic acid. Avoid calcium salts for at least 6 hours
before or 1 hour after ibandronic acid.oTheoretical
▶ Oral calcium salts decrease the absorption of risedronate.
Separate administration by at least 2 hours.oStudy
▶ Oral calcium salts decrease the absorption of sodium
clodronate. Avoid calcium salts for 2 hours before or 1 hour
after sodium clodronate.oStudy
▶ Iron (oral) is predicted to decrease the absorption of oral
ibandronic acid. Avoid iron (oral) for at least 6 hours before or
1 hour after ibandronic acid.oTheoretical
▶ Iron (oral) decreases the absorption of risedronate. Separate
administration by at least 2 hours.oStudy
▶ Iron (oral) decreases the absorption of sodium clodronate.
Avoid iron (oral) for 2 hours before or 1 hour after sodium
▶ Bisphosphonates are predicted to increase the risk of
gastrointestinal bleeding when given with iron chelators
▶ Oral magnesium decreases the absorption of alendronic acid.
Alendronic acid should be taken at least 30 minutes before
▶ Oral magnesium is predicted to decrease the absorption of oral
ibandronic acid. Avoid magnesium for at least 6 hours before or
1 hour after ibandronic acid.oTheoretical
▶ Oral magnesium decreases the absorption of risedronate.
Separate administration by at least 2 hours.oStudy
▶ Oral magnesium decreases the absorption of sodium
clodronate. Avoid magnesium for 2 hours before or 1 hour after
▶ NSAIDs are predicted to increase the risk of gastrointestinal
irritation when given with bisphosphonates (alendronic acid,
▶ NSAIDs are predicted to increase the risk of renal impairment
when given with sodium clodronate.rTheoretical
▶ Bisphosphonates are predicted to decrease the effects of
parathyroid hormone. Avoid.oStudy
▶ Oral zinc decreases the absorption of oral alendronic acid. Zinc
should be taken at least 30 minutes before
▶ Oral zinc is predicted to decrease the absorption of oral
ibandronic acid. Avoid zinc for at least 6 hours before or 1 hour
after ibandronic acid.oTheoretical
▶ Oral zinc decreases the absorption of oral risedronate.
Separate administration by at least 2 hours.oStudy
▶ Oral zinc decreases the absorption of oral sodium clodronate.
Avoid zinc for 2 hours before or 1 hour after sodium
Bivalirudin → see TABLE 3 p. 1375 (anticoagulant effects)
▶ Ranibizumab is predicted to increase the risk of bleeding
events when given with bivalirudin.oTheoretical
Bleomycin → see TABLE 15 p. 1378 (myelosuppression), TABLE 5 p. 1375
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
bleomycin. Public Health England advises avoid (refer to
▶ Monoclonal antibodies (brentuximab vedotin) increase the risk of
pulmonary toxicity when given with
Study → Also see TABLE 15 p. 1378
▶ Platinum compounds (cisplatin) increase the risk of pulmonary
toxicity when given with bleomycin.rStudy → Also see
Blinatumomab → see monoclonal antibodies
Bortezomib → see TABLE 8 p. 1376 (hypotension), TABLE 15 p. 1378
(myelosuppression), TABLE 12 p. 1378 (peripheral neuropathy)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) slightly decrease the exposure to
bortezomib. Avoid.rStudy → Also see TABLE 12 p. 1378
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)
slightly increase the exposure to bortezomib.oStudy
1416 Bictegravir — Bortezomib BNF 78
slightly increases the exposure to bortezomib.
▶ Enzalutamide slightly decreases the exposure to bortezomib.
▶ HIV-protease inhibitors slightly increase the exposure to
slightly increases the exposure to bortezomib.
Study → Also see TABLE 15 p. 1378
▶ Macrolides (clarithromycin) slightly increase the exposure to
slightly decreases the exposure to bortezomib. Avoid.
Study → Also see TABLE 15 p. 1378
▶ Rifampicin slightly decreases the exposure to bortezomib.
▶ Bosentan is predicted to decrease the exposure to
antiarrhythmics (dronedarone).rTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
affect the exposure to bosentan. Avoid.
▶ Antifungals, azoles (fluconazole) are predicted to increase the
exposure to bosentan. Avoid.rStudy
▶ Antifungals, azoles (itraconazole) are predicted to increase the
exposure to bosentan.oTheoretical
▶ Antifungals, azoles (ketoconazole) moderately increase the
▶ Antifungals, azoles (voriconazole) are predicted to increase the
exposure to bosentan. Avoid.rTheoretical
▶ Bosentan is predicted to decrease the exposure to antifungals,
azoles (isavuconazole). Avoid.rTheoretical
is predicted to decrease the exposure to aprepitant.
is predicted to decrease the exposure to axitinib.
▶ Bosentan is predicted to decrease the exposure to bedaquiline.
▶ Bosentan is predicted to decrease the exposure to bosutinib.
▶ Bosentan is predicted to decrease the exposure to brigatinib.
▶ Bosentan is predicted to decrease the exposure to
▶ 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
▶ Bosentan is predicted to decrease the exposure to cariprazine.
▶ Cephalosporins (ceftobiprole) are predicted to increase the
exposure to bosentan.oTheoretical
▶ Bosentan moderately decreases the exposure to ciclosporin
and ciclosporin moderately increases the exposure to
▶ Bosentan is predicted to decrease the exposure to cobicistat.
▶ Bosentan is predicted to decrease the exposure to cobimetinib.
▶ Bosentan is predicted to decrease the efficacy of combined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactions p. 794.rStudy
decreases the anticoagulant effect of coumarins.
▶ Bosentan is predicted to decrease the exposure to crizotinib.
is predicted to decrease the exposure to dasatinib.
▶ Bosentan is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
decreases the exposure to dolutegravir. Adjust dose.
▶ Bosentan is predicted to decrease the exposure to doravirine.
Avoid or adjust doravirine dose, p. 644.rTheoretical
▶ Bosentan is predicted to moderately decrease the exposure to
is predicted to decrease the exposure to eliglustat.
▶ Bosentan is predicted to decrease the concentration of
elvitegravir. Avoid.rTheoretical
affects the exposure to bosentan. Avoid.r
is predicted to decrease the effects of ergotamine.
is predicted to decrease the exposure to erlotinib.
▶ Bosentan is predicted to decrease the efficacy of etonogestrel.
Contraceptives, interactions p. 794.
▶ Bosentan is predicted to decrease the exposure to etravirine.
▶ Bosentan is predicted to decrease the concentration of
everolimus. Avoid or adjust dose.rStudy
▶ Bosentan is predicted to decrease the exposure to
▶ Bosentan is predicted to decrease the exposure to gefitinib.
▶ Bosentan is predicted to decrease the exposure to glecaprevir.
▶ Bosentan is predicted to markedly decrease the exposure to
▶ Bosentan is predicted to decrease the concentration of
guanfacine. Adjust dose.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
▶ Bosentan is predicted to decrease the effects of hormone
replacement therapy.oAnecdotal
▶ Bosentan is predicted to decrease the exposure to idelalisib.
is predicted to decrease the exposure to imatinib.
is predicted to decrease the exposure to ivacaftor.
▶ Bosentan is predicted to decrease the exposure to lapatinib.
is predicted to increase the exposure to bosentan.
▶ Letermovir is predicted to increase the concentration of
▶ Bosentan is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Bosentan is predicted to decrease the exposure to lurasidone.
Monitor and adjust dose.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to bosentan.oTheoretical
▶ Bosentan is predicted to decrease the exposure to maraviroc.
▶ Bosentan is predicted to decrease the concentration of
midazolam. Monitor and adjust dose.oTheoretical
▶ Mitotane affects the exposure to bosentan. Avoid.rStudy
is predicted to decrease the exposure to netupitant.
is predicted to decrease the exposure to nevirapine.
▶ Bosentan is predicted to decrease the exposure to nilotinib.
▶ Bosentan is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Bosentan is predicted to decrease the exposure to olaparib.
▶ Bosentan decreases the exposure to opioids (methadone).
Monitor and adjust dose.rStudy
is predicted to decrease the exposure to osimertinib.
is predicted to decrease the exposure to ospemifene.
BNF 78 Bortezomib — Bosentan 1417
▶ Bosentan is predicted to decrease the exposure to paritaprevir
(with ritonavir and ombitasvir). Avoid.rStudy
▶ Bosentan decreases the exposure to phosphodiesterase type-5
▶ Bosentan is predicted to decrease the exposure to pibrentasvir.
is predicted to decrease the exposure to quetiapine.
is predicted to decrease the exposure to ribociclib.
affects the exposure to bosentan. Avoid.r
▶ Bosentan is predicted to decrease the exposure to rilpivirine.
▶ Bosentan is predicted to decrease the exposure to rolapitant.
▶ Bosentan is predicted to decrease the exposure to ruxolitinib.
Monitor and adjust dose.oTheoretical
▶ Bosentan is predicted to decrease the concentration of
sirolimus and sirolimus potentially increases the
concentration of bosentan. Avoid.rTheoretical
▶ St John’s Wort is predicted to decrease the exposure to
▶ Bosentan slightly decreases the exposure to statins
▶ Bosentan moderately decreases the exposure to statins
▶ Bosentan increases the risk of hepatotoxicity when given with
sulfonylureas (glibenclamide). Avoid.rStudy
▶ Bosentan is predicted to decrease the concentration of
tacrolimus and tacrolimus potentially increases the
concentration of bosentan. Avoid.rTheoretical
▶ Bosentan is predicted to decrease the exposure to taxanes
▶ Bosentan is predicted to decrease the concentration of
temsirolimus. Avoid.rTheoretical
▶ Teriflunomide is predicted to increase the exposure to
is predicted to decrease the exposure to ticagrelor.
is predicted to decrease the exposure to tofacitinib.
▶ Bosentan decreases the efficacy of ulipristal. For FSRH
Contraceptives, interactions p. 794.r
▶ Bosentan is predicted to decrease the exposure to velpatasvir.
▶ Bosentan is predicted to decrease the exposure to venetoclax.
is predicted to increase the exposure to bosentan.
▶ Bosentan is predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
Bosutinib → see TABLE 15 p. 1378 (myelosuppression), TABLE 9 p. 1377
▶ Antacids are predicted to decrease the absorption of bosutinib.
should be taken at least 12 hours before antacids.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
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