increases the exposure to theophylline. Avoid.
▶ Deferasirox is predicted to increase the exposure to tizanidine.
Iron dextran → see iron (injectable)
Iron isomaltoside 1000 → see iron (injectable)
Iron sucrose → see iron (injectable)
Isavuconazole → see antifungals, azoles
Isocarboxazid → see monoamine-oxidase A and B inhibitors, irreversible
Isoflurane → see volatile halogenated anaesthetics
Isometheptene → see sympathomimetics, vasoconstrictor
Isoniazid → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 12 p. 1378
FOOD AND LIFESTYLE Avoid tyramine-rich foods (such as
mature cheeses, salami, pickled herring, Bovril ®, Oxo ®,
Marmite ® or any similar meat or yeast extract or fermented
soya bean extract, and some beers, lagers or wines) or
histamine-rich foods (such as very mature cheese or fish from
the scromboid family (e.g. tuna, mackerel, salmon)), as
tachycardia, palpitation, hypotension, flushing, headache,
dizziness, and sweating reported.
is predicted to affect the clearance of aminophylline.
▶ Isoniazid markedly increases the concentration of antiepileptics
(carbamazepine) and antiepileptics (carbamazepine) increase
the risk of hepatotoxicity when given with isoniazid. Monitor
concentration and adjust dose.rStudy → Also see TABLE 1
▶ Isoniazid increases the concentration of antiepileptics
(fosphenytoin, phenytoin).oStudy → Also see TABLE 12
▶ Cycloserine increases the risk of CNS toxicity when given with
isoniazid. Monitor and adjust dose.oStudy
▶ Isoniazid is predicted to increase the risk of peripheral
neuropathy when given with didanosine.rTheoretical →
Also see TABLE 1 p. 1375 → Also see TABLE 12 p. 1378
▶ Isoniazid increases the risk of optic neuropathy when given
▶ Isoniazid decreases the effects of levodopa.oStudy
▶ Isoniazid is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.qTheoretical →
▶ Isoniazid is predicted to increase the risk of peripheral
neuropathy when given with stavudine.rTheoretical →
is predicted to affect the clearance of theophylline.
▶ Isoniazid potentially increases the risk of nephrotoxicity when
given with volatile halogenated anaesthetics (methoxyflurane).
Isosorbide dinitrate → see nitrates
Isosorbide mononitrate → see nitrates
Itraconazole → see antifungals, azoles
Ivabradine → see TABLE 6 p. 1376 (bradycardia), TABLE 9 p. 1377 (QTinterval prolongation)
▶ Antiarrhythmics (dronedarone) are predicted to increase the
ivabradine. Adjust ivabradine dose, p. 211.r
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to ivabradine. Adjust dose.oTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to ivabradine. Adjust
ivabradine dose, p. 211.rTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
▶ Aprepitant is predicted to increase the exposure to ivabradine.
Adjust ivabradine dose, p. 211.rTheoretical
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ivabradine. Avoid.oStudy →
▶ Cobicistat is predicted to increase the exposure to ivabradine.
▶ Crizotinib is predicted to increase the exposure to ivabradine.
Adjust ivabradine dose, p. 211.rTheoretical → Also see
1474 Iron (oral) — Ivabradine BNF 78
▶ Ivabradine is predicted to increase the risk of torsade de
pointes when given with drugs that prolong the QT interval.
▶ Enzalutamide is predicted to decrease the exposure to
ivabradine. Adjust dose.oTheoretical
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
▶ Idelalisib is predicted to increase the exposure to ivabradine.
▶ Imatinib is predicted to increase the exposure to ivabradine.
Adjust ivabradine dose, p. 211.rTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to ivabradine. Avoid.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ivabradine. Avoid.rTheoretical
▶ Mitotane is predicted to decrease the exposure to ivabradine.
▶ Netupitant is predicted to increase the exposure to ivabradine.
Adjust ivabradine dose, p. 211.rTheoretical
▶ Nilotinib is predicted to increase the exposure to ivabradine.
Adjust ivabradine dose, p. 211.rTheoretical
▶ Rifampicin is predicted to decrease the exposure to ivabradine.
o’s Wort decreases the exposure to ivabradine. Avoid.
FOOD AND LIFESTYLE Avoid bitter (Seville) oranges as they are
predicted to increase the exposure to ivacaftor.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to ivacaftor. Adjust ivacaftor p. 293 or tezacaftor with
p. 295 dose with moderate inhibitors of CYP3A4.
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to moderately to markedly
decrease the exposure to ivacaftor. Avoid.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to ivacaftor. Adjust
ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose with
moderate inhibitors of CYP3A4.rStudy
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to ivacaftor. Adjust
ivacaftor p. 293 or lumacaftor with ivacaftor p. 294 or tezacaftor
p. 295 dose with potent inhibitors of CYP3A4.
▶ Apalutamide is predicted to decrease the exposure to ivacaftor.
▶ Aprepitant is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose
with moderate inhibitors of CYP3A4.rStudy
is predicted to decrease the exposure to ivacaftor.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ivacaftor. Adjust ivacaftor p. 293 or
tezacaftor with ivacaftor p. 295 dose with moderate inhibitors
▶ Cobicistat is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or lumacaftor with ivacaftor p. 294 or
tezacaftor with ivacaftor p. 295 dose with potent inhibitors of
▶ Ivacaftor is predicted to increase the anticoagulant effect of
coumarins (warfarin).rTheoretical
▶ Crizotinib is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose
with moderate inhibitors of CYP3A4.rStudy
slightly increases the exposure to digoxin.o ▶ Efavirenz
is predicted to decrease the exposure to ivacaftor.
▶ Enzalutamide is predicted to moderately to markedly decrease
the exposure to ivacaftor. Avoid.rStudy
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to increase the exposure
to ivacaftor. Adjust ivacaftor p. 293 or lumacaftor with ivacaftor
p. 294 or tezacaftor with ivacaftor p. 295 dose with potent
▶ Idelalisib is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or lumacaftor with ivacaftor p. 294 or
tezacaftor with ivacaftor p. 295 dose with potent inhibitors of
▶ Imatinib is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose
with moderate inhibitors of CYP3A4.rStudy
▶ Ivacaftor is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to ivacaftor. Adjust ivacaftor p. 293 or lumacaftor with
ivacaftor p. 294 or tezacaftor with ivacaftor p. 295 dose with
potent inhibitors of CYP3A4.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ivacaftor. Adjust ivacaftor p. 293 or tezacaftor with
p. 295 dose with moderate inhibitors of CYP3A4.
▶ Mitotane is predicted to moderately to markedly decrease the
exposure to ivacaftor. Avoid.rStudy
▶ Netupitant is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose
with moderate inhibitors of CYP3A4.rStudy
is predicted to decrease the exposure to ivacaftor.
▶ Nilotinib is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or tezacaftor with ivacaftor p. 295 dose
with moderate inhibitors of CYP3A4.rStudy
▶ Rifampicin is predicted to moderately to markedly decrease
the exposure to ivacaftor. Avoid.rStudy
▶ St John’s Wort is predicted to decrease the exposure to
ROUTE-SPECIFIC INFORMATION Since systemic absorption can
follow topical application, the possibility of interactions
▶ Ivermectin potentially increases the anticoagulant effect of
increases the exposure to ivermectin.o
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Enzalutamide is predicted to decrease the exposure to
▶ Mitotane is predicted to decrease the exposure to ixazomib.
▶ Rifampicin is predicted to decrease the exposure to ixazomib.
▶ St John’s Wort is predicted to decrease the exposure to
Ixekizumab → see monoclonal antibodies
is predicted to decrease the absorption of tetracyclines.
Ketamine → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS
▶ Ketamine is predicted to increase the risk of elevated blood
pressure when given with ergometrine.rTheoretical
▶ Memantine is predicted to increase the risk of CNS side-effects
when given with ketamine. Avoid.rTheoretical
Ketoconazole → see antifungals, azoles
Ketotifen → see antihistamines, sedating
Labetalol → see beta blockers, non-selective
Lacidipine → see calcium channel blockers
Lacosamide → see antiepileptics
Lamivudine → see TABLE 12 p. 1378 (peripheral neuropathy)
slightly increases the exposure to lamivudine.
BNF 78 Ivabradine — Lamivudine 1475
▶ Zidovudine increases the risk of toxicity when given with
Lamotrigine → see antiepileptics
▶ Beta blockers, non-selective are predicted to increase the risk
of bradycardia when given with lanreotide.oTheoretical
▶ Beta blockers, selective are predicted to increase the risk of
bradycardia when given with lanreotide.oTheoretical
▶ Lanreotide is predicted to decrease the absorption of oral
ciclosporin. Adjust dose.rTheoretical
Lansoprazole → see proton pump inhibitors
▶ Lanthanum is predicted to decrease the absorption of
antifungals, azoles (ketoconazole). Separate administration by
▶ Lanthanum is predicted to decrease the absorption of
antimalarials (chloroquine). Separate administration by at least
▶ Lanthanum is predicted to decrease the absorption of
hydroxychloroquine. Separate administration by at least
▶ Lanthanum moderately decreases the exposure to quinolones.
Quinolones should be taken 2 hours before or 4 hours after
▶ Lanthanum is predicted to decrease the absorption of
. Separate administration by 2 hours.o ▶ Lanthanum decreases the absorption of thyroid hormones.
Separate administration by 2 hours.oStudy
Lapatinib → see TABLE 9 p. 1377 (QT-interval prolongation)
▶ Lapatinib is predicted to increase the exposure to afatinib.
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