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is predicted to decrease the exposure to duloxetine.

Theoretical

▶ SSRIs (fluvoxamine) markedly increase the exposure to

duloxetine. Avoid.rStudy → Also see TABLE 18 p. 1379 → Also

see TABLE 13 p. 1378 → Also see TABLE 4 p. 1375

▶ Teriflunomide is predicted to decrease the exposure to

duloxetine.oTheoretical

Dupilumab → see monoclonal antibodies

Durvalumab → see monoclonal antibodies

Dutasteride

▶ Antiarrhythmics (dronedarone) are predicted to moderately

increase the exposure to dutasteride.nStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to moderately increase the exposure to

dutasteride.nStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to increase the exposure to dutasteride. Monitor

side effects and adjust dose.oTheoretical

▶ Aprepitant is predicted to moderately increase the exposure to

dutasteride.nStudy

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

moderately increase the exposure to dutasteride.nStudy

▶ Cobicistat is predicted to increase the exposure to dutasteride.

Monitor side effects and adjust dose.oTheoretical

▶ Crizotinib is predicted to moderately increase the exposure to

dutasteride.nStudy

▶ HIV-protease inhibitors are predicted to increase the exposure

to

Theoretical

dutasteride. Monitor side effects and adjust dose.o ▶ Idelalisib is predicted to increase the exposure to dutasteride.

Monitor side effects and adjust dose.oTheoretical

▶ Imatinib is predicted to moderately increase the exposure to

dutasteride.nStudy

▶ Macrolides (clarithromycin) are predicted to increase the

exposure to

o

dutasteride. Monitor side effects and adjust dose.

Theoretical

▶ Macrolides (erythromycin) are predicted to moderately increase

the exposure to dutasteride.nStudy

▶ Netupitant is predicted to moderately increase the exposure to

dutasteride.nStudy

▶ Nilotinib is predicted to moderately increase the exposure to

dutasteride.nStudy

Eculizumab → see monoclonal antibodies

Edoxaban → see TABLE 3 p. 1375 (anticoagulant effects)

▶ Antiarrhythmics (amiodarone) slightly increase the exposure to

edoxaban.rStudy

▶ Antiarrhythmics (dronedarone) slightly increase the exposure to

edoxaban. Adjust edoxaban dose, p. 126.rStudy

▶ Antiepileptics (carbamazepine) are predicted to decrease the

exposure to edoxaban.oStudy

▶ Antiepileptics (phenytoin) are predicted to decrease the

exposure to edoxaban.oTheoretical

▶ Antifungals, azoles (itraconazole) are predicted to slightly

increase the exposure to edoxaban.rTheoretical

▶ Antifungals, azoles (ketoconazole) slightly increase the exposure

to edoxaban. Adjust edoxaban dose, p. 126.rStudy

▶ Calcium channel blockers (verapamil) are predicted to slightly

increase the exposure to edoxaban.rTheoretical

▶ Ceritinib

o

is predicted to increase the exposure to edoxaban.

Theoretical

▶ Ciclosporin slightly increases the exposure to edoxaban. Adjust

edoxaban dose, p. 126.rStudy

▶ Cobicistat is predicted to increase the exposure to edoxaban.

Avoid.rTheoretical

▶ Eliglustat is predicted to increase the exposure to edoxaban.

Adjust dose.oStudy

▶ HIV-protease inhibitors (lopinavir, ritonavir, saquinavir) are

predicted to slightly increase the exposure to

r

edoxaban.

Theoretical

▶ Lapatinib is predicted to slightly increase the exposure to

edoxaban.rTheoretical

▶ Macrolides (azithromycin, clarithromycin) are predicted to

slightly increase the exposure to edoxaban.rTheoretical

▶ Macrolides (erythromycin) slightly increase the exposure to

edoxaban. Adjust edoxaban dose, p. 126.rStudy

▶ Mirabegron is predicted to increase the exposure to edoxaban.

nTheoretical

▶ Paritaprevir (with ritonavir and ombitasvir) is predicted to

increase the exposure to edoxaban.rStudy

▶ Pibrentasvir (with glecaprevir) is predicted to increase the

exposure to edoxaban.oStudy

▶ Pitolisant is predicted to decrease the exposure to edoxaban.

nTheoretical

▶ Ranolazine is predicted to slightly increase the exposure to

edoxaban.rTheoretical

▶ Rifampicin

o

is predicted to decrease the exposure to edoxaban.

Study

▶ St John’s Wort is predicted to decrease the exposure to

edoxaban.oStudy

▶ Velpatasvir

r

is predicted to increase the exposure to edoxaban.

Theoretical

▶ Vemurafenib is predicted to slightly increase the exposure to

edoxaban.rTheoretical

▶ Voxilaprevir (with sofosbuvir and velpatasvir) is predicted to

increase the concentration of

Theoretical

edoxaban. Avoid.r

Efavirenz → see TABLE 9 p. 1377 (QT-interval prolongation)

▶ Efavirenz is predicted to decrease the exposure to

antiarrhythmics (dronedarone).rTheoretical → Also see

TABLE 9 p. 1377

1446 Dorzolamide — Efavirenz BNF 78

Interactions | Appendix 1

A1

▶ Antiepileptics (carbamazepine) slightly decrease the exposure

to efavirenz and efavirenz slightly decreases the exposure to

antiepileptics (carbamazepine).rStudy

▶ Antiepileptics (fosphenytoin, phenytoin) slightly decrease the

exposure to efavirenz and efavirenz affects the concentration

of antiepileptics (fosphenytoin, phenytoin).rTheoretical

▶ Antiepileptics (phenobarbital) are predicted to decrease the

exposure to efavirenz and efavirenz affects the concentration

of antiepileptics (phenobarbital).rTheoretical

▶ Efavirenz is predicted to affect the efficacy of antiepileptics

(primidone) and antiepileptics (primidone) are predicted to

slightly decrease the exposure to efavirenz.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to antifungals,

azoles (isavuconazole). Avoid.rTheoretical

▶ Efavirenz slightly decreases the exposure to antifungals, azoles

(itraconazole)

o

. Avoid and for 14 days after stopping efavirenz.

Study

▶ Efavirenz moderately decreases the exposure to antifungals,

azoles (ketoconazole).rStudy

▶ Efavirenz slightly decreases the exposure to antifungals, azoles

(posaconazole). Avoid.oStudy

▶ Efavirenz moderately decreases the exposure to antifungals,

azoles (voriconazole) and antifungals, azoles (voriconazole)

slightly increase the exposure to

Study → Also see TABLE 9 p. 1377

efavirenz. Adjust dose.r

▶ Efavirenz decreases the concentration of antimalarials

(artemether).rStudy → Also see TABLE 9 p. 1377

▶ Efavirenz moderately decreases the exposure to antimalarials

(atovaquone). Avoid.oStudy

▶ Efavirenz affects the exposure to antimalarials (proguanil).

Avoid.oStudy

▶ Efavirenz

o

is predicted to decrease the exposure to aprepitant.

Study

▶ Efavirenz

o

is predicted to decrease the exposure to axitinib.

Theoretical

▶ Efavirenz is predicted to decrease the exposure to bedaquiline.

Avoid.rStudy → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the exposure to bosutinib.

Avoid.rTheoretical → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the exposure to brigatinib.

Avoid.rStudy

▶ Efavirenz

o

is predicted to decrease the exposure to bupropion.

Study

▶ Efavirenz is predicted to decrease the exposure to

cabozantinib.oTheoretical → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the exposure to calcium

channel blockers (amlodipine, felodipine, lacidipine,

lercanidipine, nicardipine, nifedipine, nimodipine). Monitor and

adjust dose.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to calcium

channel blockers (diltiazem, verapamil).oTheoretical

▶ Efavirenz is predicted to decrease the exposure to cariprazine.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the concentration of

caspofungin. Adjust dose.oStudy

▶ Efavirenz decreases the concentration of ciclosporin. Monitor

concentration and adjust dose.oStudy

▶ Efavirenz is predicted to decrease the exposure to cobicistat.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to cobimetinib.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the efficacy of combined

hormonal contraceptives. For FSRH guidance, see

Contraceptives, interactions p. 794.rStudy

▶ Efavirenz is predicted to affect the concentration of coumarins.

Adjust dose.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to crizotinib.

Avoid.rTheoretical → Also see TABLE 9 p. 1377

▶ Efavirenz increases the risk of increased ALT concentrations

when given with dasabuvir. Avoid.rStudy

▶ Efavirenz

r

is predicted to decrease the exposure to dasatinib.

Study → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Efavirenz

r

decreases the exposure to dolutegravir. Adjust dose.

Study

▶ Efavirenz is predicted to decrease the exposure to doravirine.

Avoid or adjust doravirine dose, p. 644.rTheoretical

▶ Efavirenz is predicted to moderately decrease the exposure to

elbasvir. Avoid.rStudy

▶ Efavirenz

o

is predicted to decrease the exposure to eliglustat.

Theoretical

▶ Efavirenz is predicted to decrease the concentration of

elvitegravir. Avoid.rTheoretical

▶ Efavirenz

o

is predicted to decrease the effects of ergotamine.

Theoretical

▶ Efavirenz

r

is predicted to decrease the exposure to erlotinib.

Theoretical

▶ Efavirenz is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Efavirenz is predicted to decrease the exposure to etravirine.

Avoid.rStudy

▶ Efavirenz is predicted to decrease the concentration of

everolimus. Avoid or adjust dose.rStudy

▶ Efavirenz is predicted to decrease the exposure to

fosaprepitant.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to gefitinib.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to glecaprevir.

Avoid.rStudy

▶ Efavirenz is predicted to markedly decrease the exposure to

grazoprevir. Avoid.rStudy

▶ Efavirenz is predicted to decrease the concentration of

guanfacine. Adjust dose.oTheoretical

▶ Efavirenz decreases the exposure to HIV-protease inhibitors.

Refer to specialist literature.rStudy → Also see TABLE 9

p. 1377

▶ Efavirenz is predicted to decrease the effects of hormone

replacement therapy.oAnecdotal

▶ Efavirenz is predicted to decrease the exposure to idelalisib.

Avoid.oTheoretical

▶ Efavirenz

o

is predicted to decrease the exposure to imatinib.

Study

▶ Efavirenz

r

is predicted to decrease the exposure to ivacaftor.

Theoretical

▶ Efavirenz is predicted to decrease the exposure to lapatinib.

Avoid.rStudy → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the concentration of

letermovir.oTheoretical

▶ Efavirenz is predicted to decrease the efficacy of

levonorgestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to lurasidone.

Monitor and adjust dose.oTheoretical

▶ Efavirenz decreases the exposure to macrolides

(clarithromycin).oStudy → Also see TABLE 9 p. 1377

▶ Efavirenz decreases the exposure to maraviroc. Refer to

specialist literature.rTheoretical

▶ Efavirenz

o

is predicted to alter the effects of midazolam. Avoid.

Theoretical

▶ Efavirenz

o

is predicted to decrease the exposure to netupitant.

Theoretical

▶ Nevirapine

r

decreases the concentration of efavirenz. Avoid.

Study

▶ Efavirenz is predicted to decrease the exposure to nilotinib.

Avoid.rTheoretical → Also see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the efficacy of

norethisterone. For FSRH guidance, see Contraceptives,

interactions p. 794.rAnecdotal

▶ Efavirenz is predicted to decrease the exposure to olaparib.

Avoid.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to ombitasvir.

Avoid.rTheoretical

▶ Efavirenz decreases the exposure to opioids (methadone).

Monitor and adjust dose.rStudy → Also see TABLE 9 p. 1377

▶ Efavirenz

o

is predicted to decrease the exposure to osimertinib.

Theoretical → Also see TABLE 9 p. 1377

BNF 78 Efavirenz — Efavirenz 1447

Interactions | Appendix 1

A1

Efavirenz (continued)

▶ Efavirenz

o

is predicted to decrease the exposure to ospemifene.

Study

▶ Efavirenz is predicted to decrease the exposure to paritaprevir

(with ritonavir and ombitasvir). Avoid.rStudy

▶ Efavirenz is predicted to decrease the exposure to

phosphodiesterase type-5 inhibitors.oTheoretical → Also

see TABLE 9 p. 1377

▶ Efavirenz is predicted to decrease the exposure to pibrentasvir.

Avoid.rStudy

▶ Pitolisant is predicted to decrease the exposure to efavirenz.

nTheoretical

▶ Efavirenz

o

is predicted to decrease the exposure to quetiapine.

Study

▶ Efavirenz

o

is predicted to decrease the exposure to ribociclib.

Study → Also see TABLE 9 p. 1377

▶ Efavirenz slightly decreases the exposure to rifabutin. Adjust

dose.rStudy

▶ Rifampicin slightly decreases the exposure to efavirenz. Adjust

dose.rStudy

▶ Efavirenz is predicted to decrease the exposure to rilpivirine.

Avoid.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to rolapitant.

Avoid.rStudy

▶ Efavirenz is predicted to decrease the exposure to ruxolitinib.

Monitor and adjust dose.oTheoretical

▶ Efavirenz is predicted to decrease the concentration of

sirolimus. Monitor and adjust dose.oTheoretical

▶ St John’s Wort is predicted to decrease the concentration of

efavirenz. Avoid.rTheoretical

▶ Efavirenz slightly decreases the exposure to statins

(atorvastatin).nStudy

▶ Efavirenz moderately decreases the exposure to statins

(simvastatin).oStudy

▶ Efavirenz is predicted to decrease the concentration of

tacrolimus. Monitor and adjust dose.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to taxanes

(cabazitaxel). Avoid.rStudy

▶ Efavirenz is predicted to decrease the concentration of

temsirolimus. Avoid.rTheoretical

▶ Efavirenz

o

is predicted to decrease the exposure to ticagrelor.

Theoretical

▶ Efavirenz

o

is predicted to decrease the exposure to tofacitinib.

Study

▶ Efavirenz decreases the efficacy of ulipristal. For FSRH

guidance, see

Anecdotal

Contraceptives, interactions p. 794.r

▶ Efavirenz is predicted to decrease the exposure to velpatasvir.

Avoid.oTheoretical

▶ Efavirenz is predicted to decrease the exposure to venetoclax.

Avoid.rStudy

▶ Efavirenz is predicted to decrease the concentration of

voxilaprevir. Avoid.rTheoretical

Elbasvir

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to elbasvir. Avoid.rStudy

▶ Bosentan is predicted to moderately decrease the exposure to

elbasvir. Avoid.rStudy

▶ Elbasvir is predicted to increase the concentration of

dabigatran.oTheoretical

▶ Efavirenz is predicted to moderately decrease the exposure to

elbasvir. Avoid.rStudy

▶ Enzalutamide is predicted to decrease the exposure to elbasvir.

Avoid.rStudy

▶ Etravirine is predicted to decrease the exposure to elbasvir.

Avoid.qTheoretical

▶ Mitotane is predicted to decrease the exposure to elbasvir.

Avoid.rStudy

▶ Modafinil is predicted to decrease the exposure to elbasvir.

Avoid.qTheoretical

▶ Nevirapine is predicted to moderately decrease the exposure

to elbasvir. Avoid.rStudy

▶ Rifampicin is predicted to decrease the exposure to elbasvir.

Avoid.rStudy

▶ St John’s Wort is predicted to moderately decrease the

exposure to elbasvir. Avoid.rStudy

▶ Elbasvir increases the exposure to statins (atorvastatin). Adjust

atorvastatin dose, p. 202.oStudy

▶ Elbasvir is predicted to increase the exposure to statins

(fluvastatin). Adjust fluvastatin dose, p. 203.qTheoretical

▶ Elbasvir increases the exposure to statins (rosuvastatin). Adjust

rosuvastatin dose, p. 204.oStudy

▶ Elbasvir is predicted to increase the exposure to statins

(simvastatin)

Theoretical

. Adjust simvastatin dose, p. 205.q ▶ Elbasvir is predicted to increase the concentration of sunitinib.

Use with caution and adjust dose.oTheoretical

Eletriptan → see TABLE 13 p. 1378 (serotonin syndrome)

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to markedly increase the exposure to eletriptan.

Avoid.rStudy

▶ Aprepitant

o

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