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is predicted to increase the exposure to trazodone.

Theoretical

▶ Imatinib is predicted to increase the exposure to ulipristal.

Avoid if used for uterine fibroids.oStudy

▶ Imatinib is predicted to increase the exposure to venetoclax.

Avoid or adjust dose—consult product literature.rStudy

▶ Imatinib is predicted to increase the exposure to vinca

alkaloids.rTheoretical → Also see TABLE 15 p. 1378

▶ Imatinib is predicted to increase the exposure to zopiclone.

Adjust dose.oStudy

Imidapril → see ACE inhibitors

Imipenem → see carbapenems

Imipramine → see tricyclic antidepressants

Immunoglobulins

Anti-D (Rh0) immunoglobulin . antithymocyte immunoglobulin

(rabbit) . hepatitis B immunoglobulin . normal immunoglobulin . rabies immunoglobulin .tetanus immunoglobulin .varicella-zoster

immunoglobulin. ▶ Immunoglobulins are predicted to alter the effects of

monoclonal antibodies (dinutuximab). Avoid.rTheoretical

Indacaterol → see beta2 agonists

Indapamide → see thiazide diuretics

Indometacin → see NSAIDs

Indoramin → see alpha blockers

Infliximab → see monoclonal antibodies

Influenza vaccine (live) → see live vaccines

Inotersen → see TABLE 4 p. 1375 (antiplatelet effects)

Inotuzumab ozogamicin → see monoclonal antibodies

Insulins → see TABLE 14 p. 1378 (antidiabetic drugs)

▶ Fibrates are predicted to increase the risk of hypoglycaemia

when given with insulins.oTheoretical

Interferon alfa → see interferons

Interferon beta → see interferons

Interferons → see TABLE 15 p. 1378 (myelosuppression)

interferon alfa .interferon beta . peginterferon alfa. ▶ Interferons are predicted to slightly increase the exposure to

aminophylline. Adjust dose.oTheoretical

▶ Interferon alfa is predicted to increase the risk of peripheral

Theoretical

neuropathy when given with telbivudine. Avoid.r

▶ Peginterferon alfa increases the risk of peripheral neuropathy

when given with telbivudine. Avoid.rStudy

▶ Interferons slightly increase the exposure to theophylline.

Adjust dose.oStudy

Ipilimumab → see monoclonal antibodies

Ipratropium → see TABLE 10 p. 1377 (antimuscarinics)

▶ Beta2 agonists are predicted to increase the risk of glaucoma

when given with ipratropium.oAnecdotal

Irbesartan → see angiotensin-II receptor antagonists

Irinotecan → see TABLE 15 p. 1378 (myelosuppression)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to irinotecan. Avoid.rStudy

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

predicted to increase the risk of toxicity when given with

irinotecan. Avoid.oStudy

▶ Aprepitant is predicted to increase the exposure to

intravenous irinotecan.rTheoretical

▶ Cobicistat is predicted to increase the risk of toxicity when

given with irinotecan. Avoid.oStudy

▶ Enzalutamide is predicted to decrease the exposure to

irinotecan. Avoid.rStudy

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

irinotecan. Avoid.oTheoretical

▶ Fosaprepitant is predicted to increase the exposure to

intravenous irinotecan.rTheoretical

▶ HIV-protease inhibitors are predicted to increase the risk of

toxicity when given with irinotecan. Avoid.oStudy

▶ Idelalisib is predicted to increase the risk of toxicity when

given with irinotecan. Avoid.oStudy → Also see TABLE 15

p. 1378

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

irinotecan. Public Health England advises avoid (refer to

Green Book).rTheoretical

▶ Macrolides (clarithromycin) are predicted to increase the risk of

toxicity when given with irinotecan. Avoid.oStudy

▶ Mitotane is predicted to decrease the exposure to irinotecan.

Avoid.rStudy → Also see TABLE 15 p. 1378

▶ Netupitant

o

is predicted to increase the exposure to irinotecan.

Study

▶ Irinotecan is predicted to decrease the effects of

neuromuscular blocking drugs, non-depolarising

Theoretical

.o ▶ Pitolisant is predicted to decrease the exposure to irinotecan.

nTheoretical

▶ Rifampicin is predicted to decrease the exposure to irinotecan.

Avoid.rStudy

▶ Rolapitant is predicted to increase the exposure to irinotecan.

Avoid or monitor.oStudy

▶ St John’s Wort slightly decreases the exposure to irinotecan.

Avoid.rStudy

▶ Irinotecan is predicted to increase the risk of prolonged

neuromuscular blockade when given with

o

suxamethonium.

Theoretical

Iron (injectable)

ferric carboxymaltose .iron dextran .iron isomaltoside 1000 .iron

sucrose. ▶ Chloramphenicol decreases the efficacy of intravenous iron

(injectable).oAnecdotal

Iron (oral)

ferric maltol . ferrous fumarate . ferrous gluconate . ferrous sulfate . sodium feredetate. ▶ Antacids decrease the absorption of iron (oral). Iron (oral)

should be taken 1 hour before or 2 hours after

o

antacids.

Study

▶ Iron (oral) decrease the exposure to bictegravir. Bictegravir

should be taken 2 hours before iron (oral).oStudy

▶ Iron (oral) is predicted to decrease the absorption of oral

bisphosphonates (ibandronic acid). Avoid iron (oral) for at least

6 hours before or 1 hour after

Theoretical

ibandronic acid.o ▶ Iron (oral) decreases the absorption of bisphosphonates

(risedronate)

o

. Separate administration by at least 2 hours.

Study

▶ Iron (oral) decreases the absorption of bisphosphonates (sodium

clodronate). Avoid iron (oral) for 2 hours before or 1 hour after

sodium clodronate.oStudy

▶ Calcium salts (calcium carbonate) decrease the absorption of

iron (oral). Calcium carbonate should be taken 1 hour before or

2 hours after iron (oral).oStudy

▶ Iron (oral)

o

is predicted to decrease the exposure to carbidopa.

Theoretical

BNF 78 Imatinib — Iron (oral) 1473

Interactions | Appendix 1

A1

Iron (oral) (continued)

▶ Chloramphenicol

o

decreases the efficacy of oral iron (oral).

Theoretical

▶ Iron (oral) decreases the absorption of dolutegravir.

Dolutegravir should be taken 2 hours before or 6 hours after

iron (oral).oStudy

▶ Iron (oral) is predicted to decrease the absorption of

eltrombopag. Eltrombopag should be taken 2 hours before or

4 hours after iron (oral).rTheoretical

▶ Iron (oral) is predicted to decrease the absorption of

entacapone

o

. Separate administration by at least 2 hours.

Theoretical

▶ Iron (oral)

Study

decreases the absorption of levodopa.o ▶ Iron (oral) decreases the effects of methyldopa.oStudy

▶ Iron (oral) is predicted to decrease the absorption of

penicillamine. Separate administration by at least 2 hours.

nStudy

▶ Iron (oral) decreases the exposure to quinolones. Separate

administration by at least 2 hours.oStudy

▶ Iron (oral) decreases the absorption of tetracyclines.

Tetracyclines

o

should be taken 2 to 3 hours after iron (oral).

Study

▶ Iron (oral) decreases the absorption of thyroid hormones

(levothyroxine)

o

. Separate administration by at least 4 hours.

Study

▶ Trientine

o

potentially decreases the absorption of iron (oral).

Theoretical

▶ Zinc is predicted to decrease the efficacy of iron (oral) and iron

(oral)

Study

is predicted to decrease the efficacy of zinc.o

Iron chelators

deferasirox . desferrioxamine . dexrazoxane. ▶ Deferasirox is predicted to increase the exposure to

aminophylline. Avoid.oTheoretical

▶ Antacids (aluminium hydroxide) are predicted to decrease the

exposure to deferasirox. Avoid.oTheoretical

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to

o

deferasirox. Monitor serum ferritin and adjust dose.

Theoretical

▶ Ascorbic acid is predicted to increase the risk of cardiovascular

Theoretical

side-effects when given with desferrioxamine.r

▶ Aspirin (high-dose) is predicted to increase the risk of

Theoretical

gastrointestinal bleeds when given with deferasirox.r

▶ Bisphosphonates are predicted to increase the risk of

gastrointestinal bleeding when given with

Theoretical

deferasirox.r

▶ Deferasirox is predicted to increase the exposure to clozapine.

Avoid.oTheoretical

▶ Corticosteroids are predicted to increase the risk of

gastrointestinal bleeding when given with

Theoretical

deferasirox.r

▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the

exposure to deferasirox. Monitor serum ferritin and adjust

dose.oTheoretical

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

dexrazoxane. Avoid.rTheoretical

▶ NSAIDs are predicted to increase the risk of gastrointestinal

bleeding when given with deferasirox.rTheoretical

▶ Deferasirox moderately increases the exposure to repaglinide.

Avoid.oStudy

▶ Rifampicin is predicted to decrease the exposure to

deferasirox

Study

. Monitor serum ferritin and adjust dose.o ▶ Deferasirox is predicted to increase the exposure to selexipag.

Adjust dose.oStudy

▶ Deferasirox

o

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