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is predicted to increase the exposure to gefitinib.

Theoretical → Also see TABLE 15 p. 1378

▶ Crizotinib potentially decreases the exposure to glecaprevir.

Avoid.rTheoretical

▶ Grapefruit juice is predicted to increase the exposure to

crizotinib. Avoid.oTheoretical

▶ Crizotinib is predicted to increase the concentration of

guanfacine. Adjust guanfacine dose, p. 352.oTheoretical

▶ HIV-protease inhibitors 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 ibrutinib.

Adjust ibrutinib dose with moderate inhibitors of CYP3A4,

p. 983.rStudy → Also see TABLE 15 p. 1378

▶ Idelalisib is predicted to moderately increase the exposure to

crizotinib. Avoid.oStudy → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the exposure to ivabradine.

Adjust ivabradine dose, p. 211.rTheoretical → Also see

TABLE 6 p. 1376

▶ 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

▶ Crizotinib

o

is predicted to increase the exposure to lapatinib.

Study → Also see TABLE 9 p. 1377

▶ Crizotinib is predicted to increase the exposure to lomitapide.

Avoid.oTheoretical

▶ Crizotinib is predicted to increase the exposure to lurasidone.

Adjust lurasidone dose, p. 398.oStudy

▶ Macrolides (clarithromycin) 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 midazolam.

Monitor side effects and adjust dose.rStudy

▶ Crizotinib

o

is predicted to increase the exposure to midostaurin.

Theoretical

▶ Mitotane is predicted to markedly decrease the exposure to

crizotinib. Avoid.rStudy → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the exposure to naloxegol.

Adjust

Study

naloxegol dose and monitor side effects, p. 65.o ▶ Nevirapine is predicted to decrease the exposure to crizotinib.

Avoid.rTheoretical

▶ Crizotinib is predicted to increase the exposure to olaparib.

Avoid moderate inhibitors of CYP3A4 or adjust olaparib dose,

p. 1005.oTheoretical → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the exposure to opioids

(alfentanil, buprenorphine, fentanyl, oxycodone). Monitor and

adjust dose.oStudy → Also see TABLE 6 p. 1376

▶ Crizotinib is predicted to increase the exposure to opioids

(methadone, sufentanil).oTheoretical → Also see TABLE 6

p. 1376 → Also see TABLE 9 p. 1377

▶ Crizotinib is predicted to increase the exposure to oxybutynin.

nTheoretical

▶ Crizotinib

o

is predicted to increase the exposure to pazopanib.

Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9

p. 1377

▶ Crizotinib is predicted to increase the risk of bleeding events

when given with phenindione.rTheoretical

▶ Crizotinib is predicted to increase the exposure to

phosphodiesterase type-5 inhibitors (avanafil). Adjust avanafil

dose, p. 812.oTheoretical

▶ Crizotinib is predicted to increase the exposure to

phosphodiesterase type-5 inhibitors (sildenafil). Monitor or

adjust sildenafil dose with moderate inhibitors of CYP3A4,

p. 813.oStudy → Also see TABLE 9 p. 1377

▶ Crizotinib is predicted to increase the exposure to

phosphodiesterase type-5 inhibitors (tadalafil).rTheoretical

▶ Crizotinib is predicted to increase the exposure to

r

phosphodiesterase type-5 inhibitors (vardenafil). Adjust dose.

Theoretical → Also see TABLE 9 p. 1377

▶ Crizotinib potentially decreases the exposure to pibrentasvir.

Avoid.rTheoretical

▶ Crizotinib is predicted to increase the exposure to pimozide.

Avoid.rTheoretical → Also see TABLE 9 p. 1377

▶ Pitolisant is predicted to decrease the exposure to crizotinib.

Avoid.rTheoretical

▶ Crizotinib is predicted to increase the exposure to quetiapine.

Avoid.oStudy

▶ Crizotinib

r

is predicted to increase the exposure to ranolazine.

Study → Also see TABLE 9 p. 1377

▶ Crizotinib

o

is predicted to increase the exposure to ribociclib.

Study → Also see TABLE 9 p. 1377

▶ Rifampicin is predicted to markedly decrease the exposure to

crizotinib. Avoid.rStudy

▶ Crizotinib

o

is predicted to increase the exposure to ruxolitinib.

Theoretical → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the exposure to saxagliptin.

nStudy

▶ Crizotinib increases the concentration of sirolimus. Monitor

and adjust dose.oStudy

▶ Crizotinib is predicted to increase the exposure to SSRIs

(dapoxetine). Adjust dapoxetine dose with moderate inhibitors

of CYP3A4, p. 821.oTheoretical

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

crizotinib. Avoid.rTheoretical

▶ Crizotinib is predicted to increase the exposure to statins

(atorvastatin). Monitor and adjust dose.rStudy

▶ Crizotinib is predicted to increase the exposure to statins

(simvastatin). Use with caution and adjust simvastatin dose,

p. 205.rStudy

▶ Crizotinib

o

is predicted to increase the exposure to sunitinib.

Theoretical → Also see TABLE 15 p. 1378 → Also see TABLE 9

p. 1377

▶ Crizotinib is predicted to increase the concentration of

tacrolimus.rStudy

1438 Crizotinib — Crizotinib BNF 78

Interactions | Appendix 1

A1

▶ Crizotinib is predicted to increase the exposure to taxanes

(cabazitaxel).oTheoretical → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the concentration of

temsirolimus.oTheoretical → Also see TABLE 15 p. 1378

▶ Crizotinib is predicted to increase the exposure to tezacaftor.

Adjust tezacaftor with ivacaftor p. 295 dose with moderate

inhibitors of CYP3A4.rStudy

▶ Crizotinib given with a potent CYP2C19 inhibitor is predicted

to increase the exposure to tofacitinib. Adjust tofacitinib dose,

p. 1105.oStudy

▶ Crizotinib is predicted to increase the exposure to tolterodine.

nTheoretical → Also see TABLE 9 p. 1377

▶ Crizotinib is predicted to increase the exposure to tolvaptan.

Manufacturer advises caution or adjust tolvaptan dose with

moderate inhibitors of CYP3A4, p. 669.oStudy

▶ Crizotinib

o

is predicted to increase the exposure to trazodone.

Theoretical

▶ Crizotinib is predicted to increase the exposure to ulipristal.

Avoid if used for uterine fibroids.oStudy

▶ Crizotinib is predicted to increase the exposure to venetoclax.

Avoid or adjust dose—consult product literature.rStudy

▶ Crizotinib is predicted to increase the exposure to vinca

alkaloids.rTheoretical → Also see TABLE 15 p. 1378 → Also see

TABLE 9 p. 1377

▶ Crizotinib is predicted to increase the exposure to zopiclone.

Adjust dose.oStudy

Cyclizine → see antihistamines, sedating

Cyclopentolate → see TABLE 10 p. 1377 (antimuscarinics)

Cyclophosphamide → see alkylating agents

Cycloserine

▶ Cycloserine increases the risk of CNS toxicity when given with

isoniazid. Monitor and adjust dose.oStudy

Cyproheptadine → see antihistamines, sedating

Cytarabine → see TABLE 15 p. 1378 (myelosuppression)

▶ Cytarabine

r

decreases the concentration of flucytosine. Avoid.

Study

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

cytarabine. Public Health England advises avoid (refer to

Green Book).rTheoretical

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

▶ Antiarrhythmics (amiodarone) increase the exposure to

dabigatran. Adjust dabigatran dose, p. 136.oStudy

▶ Antiarrhythmics (dronedarone) slightly increase the exposure to

dabigatran. Avoid.rStudy

▶ Antiepileptics (carbamazepine) are predicted to decrease the

exposure to dabigatran. Avoid.rStudy

▶ Antiepileptics (phenytoin) are predicted to decrease the

exposure to dabigatran. Avoid.rTheoretical

▶ Antifungals, azoles (isavuconazole) are predicted to increase the

exposure to

Study

dabigatran. Monitor and adjust dose.o ▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to

increase the exposure to dabigatran. Avoid.rStudy

▶ Apalutamide is predicted to decrease the exposure to

dabigatran.nStudy

▶ Brigatinib potentially increases the concentration of

dabigatran.oTheoretical

▶ Calcium channel blockers (verapamil) increase the exposure to

dabigatran. Adjust dabigatran dose, p. 136.rStudy

▶ Ceritinib

o

is predicted to increase the exposure to dabigatran.

Theoretical

▶ Ciclosporin is predicted to increase the exposure to dabigatran.

Avoid.rTheoretical

▶ Cobicistat is predicted to increase the exposure to dabigatran.

Avoid.rTheoretical

▶ Elbasvir is predicted to increase the concentration of

dabigatran.oTheoretical

▶ Eliglustat is predicted to increase the exposure to dabigatran.

Adjust dose.oStudy

▶ Glecaprevir (with pibrentasvir) increases the exposure to

dabigatran. Avoid.oStudy

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

predicted to increase the exposure to

r

dabigatran. Avoid.

Theoretical

▶ Lapatinib

r

is predicted to increase the exposure to dabigatran.

Theoretical

▶ Ledipasvir

o

is predicted to increase the exposure to dabigatran.

Theoretical

▶ Letermovir is predicted to decrease the concentration of

dabigatran. Avoid.rTheoretical

▶ Macrolides are predicted to increase the exposure to

dabigatran.oTheoretical

▶ Mirabegron is predicted to increase the exposure to

dabigatran.rTheoretical

▶ Paritaprevir (with ritonavir and ombitasvir) is predicted to

increase the exposure to dabigatran.rStudy

▶ Pibrentasvir (with glecaprevir) increases the exposure to

dabigatran. Avoid.oStudy

▶ Pitolisant is predicted to decrease the exposure to dabigatran.

nTheoretical

▶ Ranolazine

r

is predicted to increase the exposure to dabigatran.

Theoretical

▶ Rifampicin is predicted to decrease the exposure to dabigatran.

Avoid.rStudy

▶ Rolapitant

o

is predicted to increase the exposure to dabigatran.

Study

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

dabigatran. Avoid.rStudy

▶ Tacrolimus is predicted to increase the exposure to dabigatran.

Avoid.rTheoretical

▶ Velpatasvir

r

increases the exposure to dabigatran. Avoid.

Study

▶ Vemurafenib increases the exposure to dabigatran. Use with

caution and adjust dose.rTheoretical

▶ Venetoclax is predicted to increase the exposure to dabigatran.

Avoid or adjust dose.rStudy

▶ Voxilaprevir (with sofosbuvir and velpatasvir) increases the

concentration of dabigatran. Avoid.rStudy

Dabrafenib → see TABLE 15 p. 1378 (myelosuppression)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to dabrafenib. Avoid.oTheoretical

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

predicted to increase the exposure to dabrafenib. Use with

caution or avoid.oStudy

▶ Clopidogrel is predicted to increase the exposure to

dabrafenib.oTheoretical

▶ Cobicistat is predicted to increase the exposure to dabrafenib.

Use with caution or avoid.oStudy

▶ Dabrafenib is predicted to decrease the anticoagulant effect of

coumarins.rTheoretical

▶ Dabrafenib is predicted to decrease the exposure to doravirine.

Avoid or adjust doravirine dose, p. 644.rTheoretical

▶ Enzalutamide is predicted to decrease the exposure to

dabrafenib. Avoid.oTheoretical

▶ Fibrates (gemfibrozil) are predicted to increase the exposure to

dabrafenib.oTheoretical

▶ HIV-protease inhibitors are predicted to increase the exposure

to dabrafenib. Use with caution or avoid.oStudy

▶ Idelalisib is predicted to increase the exposure to dabrafenib.

Use with caution or avoid.oStudy → Also see TABLE 15

p. 1378

▶ Macrolides (clarithromycin) are predicted to increase the

exposure to

Study

dabrafenib. Use with caution or avoid.o ▶ Dabrafenib decreases the exposure to midazolam. Monitor and

adjust dose.oStudy

▶ Mitotane is predicted to decrease the exposure to dabrafenib.

Avoid.oTheoretical → Also see TABLE 15 p. 1378

▶ Rifampicin is predicted to decrease the exposure to dabrafenib.

Avoid.oTheoretical

Dacarbazine → see alkylating agents

Dactinomycin → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 15 p. 1378

(myelosuppression)

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

dactinomycin. Public Health England advises avoid (refer to

Green Book).rTheoretical

BNF 78 Crizotinib — Dactinomycin 1439

Interactions | Appendix 1

A1

Dairy products

▶ Dairy products are predicted to decrease the absorption of

eltrombopag. Eltrombopag should be taken 2 hours before or

4 hours after dairy products.rTheoretical

▶ Dairy products decrease the exposure to tetracyclines

(demeclocycline, oxytetracycline, tetracycline)

Study

. Avoid.o

Dalteparin → see low molecular-weight heparins

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

▶ Ranibizumab is predicted to increase the risk of bleeding

events when given with danaparoid.rTheoretical

Danazol

▶ Danazol moderately increases the concentration of

antiepileptics

Study

(carbamazepine). Monitor and adjust dose.r

▶ Danazol

Study

increases the concentration of ciclosporin.r

▶ Danazol potentially increases the anticoagulant effect of

coumarins.rAnecdotal

▶ Danazol is predicted to increase the risk of rhabdomyolysis

when given with statins (atorvastatin).rTheoretical

▶ Danazol increases the risk of rhabdomyolysis when given with

statins (simvastatin). Avoid.rAnecdotal

▶ Danazol

r

potentially increases the concentration of tacrolimus.

Anecdotal

Dantrolene → see TABLE 1 p. 1375 (hepatotoxicity)

▶ Intravenous dantrolene potentially increases the risk of acute

hyperkalaemia and cardiovascular collapse when given with

calcium channel blockers

Anecdotal

(diltiazem, verapamil). Avoid.r

Dapagliflozin → see TABLE 14 p. 1378 (antidiabetic drugs), TABLE 8

p. 1376 (hypotension)

Dapoxetine → see SSRIs

Dapsone

▶ Aminosalicylic acid is predicted to increase the risk of

methaemoglobinaemia when given with

Theoretical

dapsone.r

▶ Dapsone is predicted to increase the risk of

methaemoglobinaemia when given with topical anaesthetics,

local (prilocaine). Use with caution or avoid.rTheoretical

▶ Antiepileptics (fosphenytoin, phenobarbital, phenytoin,

primidone) are predicted to increase the risk of

Theoretical

methaemoglobinaemia when given with dapsone.r

▶ Antimalarials (chloroquine, primaquine) are predicted to

increase the risk of methaemoglobinaemia when given with

dapsone.rTheoretical

▶ Nitrates are predicted to increase the risk of

methaemoglobinaemia when given with

Theoretical

dapsone.r

▶ Nitrofurantoin is predicted to increase the risk of

methaemoglobinaemia when given with

Theoretical

dapsone.r

▶ Paracetamol is predicted to increase the risk of

Theoretical

methaemoglobinaemia when given with dapsone.r

▶ Rifabutin decreases the exposure to dapsone.oStudy

▶ Rifampicin decreases the exposure to dapsone.oStudy

▶ Sodium nitroprusside is predicted to increase the risk of

methaemoglobinaemia when given with

Theoretical

dapsone.r

▶ Sulfonamides are predicted to increase the risk of

Theoretical

methaemoglobinaemia when given with dapsone.r

▶ Dapsone increases the exposure to trimethoprim and

trimethoprim increases the exposure to dapsone.rStudy

Daptomycin

▶ Aspirin (high-dose) increases the risk of renal impairment

when given with daptomycin.oTheoretical

▶ Ciclosporin is predicted to increase the risk of rhabdomyolysis

when given with daptomycin.rTheoretical

▶ Fibrates are predicted to increase the risk of rhabdomyolysis

when given with daptomycin.rTheoretical

▶ NSAIDs increase the risk of renal impairment when given with

daptomycin.oTheoretical

▶ Statins are predicted to increase the risk of rhabdomyolysis

when given with daptomycin.rTheoretical

Daratumumab → see monoclonal antibodies

Darbepoetin alfa → see TABLE 5 p. 1375 (thromboembolism), TABLE 16

p. 1379 (increased serum potassium)

Darifenacin → see TABLE 10 p. 1377 (antimuscarinics)

▶ Antiarrhythmics (dronedarone) are predicted to slightly

increase the exposure to darifenacin.oStudy

▶ Darifenacin is predicted to increase the concentration of

antiarrhythmics (flecainide).oTheoretical

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to darifenacin.oTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to slightly increase the exposure to

o

darifenacin.

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