is predicted to increase the exposure to aliskiren.
▶ Antacids are predicted to decrease the absorption of lapatinib.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to lapatinib.oStudy → Also see TABLE 9 p. 1377
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
lapatinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
▶ Lapatinib is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).oTheoretical
is predicted to increase the exposure to lapatinib.
▶ Lapatinib is predicted to increase the exposure to beta blockers,
non-selective (nadolol).oStudy
▶ Lapatinib is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Bosentan is predicted to decrease the exposure to lapatinib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to lapatinib.oStudy
is predicted to increase the exposure to ceritinib.
Theoretical → Also see TABLE 9 p. 1377
▶ Cobicistat is predicted to increase the exposure to lapatinib.
▶ Lapatinib is predicted to increase the exposure to colchicine.
Avoid or adjust colchicine dose, p. 1120.oTheoretical
▶ Lapatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
is predicted to increase the exposure to lapatinib.
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to dabigatran.
is predicted to increase the exposure to digoxin.
▶ Lapatinib is predicted to slightly increase the exposure to
▶ Efavirenz is predicted to decrease the exposure to lapatinib.
Avoid.rStudy → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to decrease the exposure to
is predicted to increase the exposure to erlotinib.
is predicted to increase the exposure to everolimus.
▶ Lapatinib is predicted to increase the exposure to fidaxomicin.
▶ Grapefruit juice is predicted to increase the exposure to
▶ H2 receptor antagonists are predicted to decrease the
absorption of lapatinib. Avoid.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
to lapatinib. Avoid.oStudy → Also see TABLE 9 p. 1377
▶ Idelalisib is predicted to increase the exposure to lapatinib.
is predicted to increase the exposure to lapatinib.
▶ Lapatinib is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
is predicted to increase the exposure to loperamide.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to lapatinib. Avoid.oStudy → Also see TABLE 9
▶ Macrolides (erythromycin) are predicted to increase the
exposure to lapatinib.oStudy → Also see TABLE 9 p. 1377
▶ Mitotane is predicted to decrease the exposure to lapatinib.
is predicted to increase the exposure to lapatinib.
▶ Nevirapine is predicted to decrease the exposure to lapatinib.
is predicted to increase the exposure to lapatinib.
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to nintedanib.
▶ Lapatinib is predicted to increase the exposure to
panobinostat. Adjust dose.oTheoretical → Also see
▶ Lapatinib is predicted to increase the risk of bleeding events
when given with phenindione.rTheoretical
is predicted to increase the exposure to pibrentasvir.
▶ Pitolisant is predicted to decrease the exposure to lapatinib.
▶ Rifampicin is predicted to decrease the exposure to lapatinib.
is predicted to increase the exposure to sirolimus.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Lapatinib slightly increases the exposure to taxanes
▶ Tedizolid is predicted to increase the exposure to lapatinib.
is predicted to increase the exposure to topotecan.
▶ Lapatinib is predicted to increase the concentration of
▶ Lapatinib is predicted to increase the exposure to venetoclax.
Avoid or monitor for toxicity.rTheoretical
▶ Antimalarials (chloroquine) are predicted to decrease the
laronidase. Avoid simultaneous administration.
▶ Hydroxychloroquine is predicted to decrease the exposure to
. Avoid simultaneous administration.r
1476 Lamivudine — Laronidase BNF 78
▶ Antacids are predicted to decrease the exposure to ledipasvir.
Separate administration by 4 hours.oTheoretical
▶ Ledipasvir increases the risk of severe bradycardia or heart
block when given with antiarrhythmics (amiodarone). Refer to
specialist literature.rAnecdotal
▶ Antiepileptics (carbamazepine) are predicted to decrease the
exposure to ledipasvir. Avoid.rStudy
▶ Antiepileptics (fosphenytoin, oxcarbazepine, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to ledipasvir. Avoid.rTheoretical
▶ Calcium salts (calcium carbonate) are predicted to decrease the
ledipasvir. Separate administration by 4 hours.
is predicted to increase the exposure to dabigatran.
▶ Ledipasvir is predicted to increase the exposure to digoxin.
Monitor and adjust dose.oTheoretical
▶ H2 receptor antagonists are predicted to decrease the exposure
oto ledipasvir. Adjust dose, see ledipasvir with sofosbuvir p. 628.
▶ HIV-protease inhibitors (tipranavir boosted with ritonavir) are
predicted to decrease the exposure to
▶ Proton pump inhibitors are predicted to decrease the exposure
oto ledipasvir. Adjust dose, see ledipasvir with sofosbuvir p. 628.
▶ Rifabutin is predicted to decrease the exposure to ledipasvir.
▶ Rifampicin is predicted to decrease the exposure to ledipasvir.
▶ St John’s Wort is predicted to decrease the exposure to
▶ Ledipasvir is predicted to increase the exposure to statins
(atorvastatin, fluvastatin, pravastatin, simvastatin). Monitor
▶ Ledipasvir is predicted to increase the exposure to statins
(rosuvastatin). Avoid.rTheoretical
▶ Ledipasvir (with sofosbuvir) slightly increases the exposure to
Leflunomide → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 15 p. 1378
PHARMACOLOGY Leflunomide has a long half-life; washout
procedure recommended before switching to other DMARDs
is predicted to increase the exposure to adefovir.
▶ Leflunomide is predicted to decrease the exposure to
▶ Leflunomide decreases the exposure to aminophylline. Adjust
▶ Leflunomide is predicted to decrease the exposure to
anaesthetics, local (ropivacaine).oTheoretical
▶ Leflunomide is predicted to increase the exposure to
(daunorubicin, doxorubicin, mitoxantrone).
Theoretical → Also see TABLE 15 p. 1378
▶ Leflunomide is predicted to increase the exposure to
antihistamines, non-sedating (fexofenadine).oStudy
potentially increases the exposure to baricitinib.
is predicted to increase the exposure to bosentan.
▶ Leflunomide is predicted to moderately increase the clearance
of caffeine citrate. Monitor and adjust dose.oStudy
▶ Leflunomide is predicted to increase the exposure to
cephalosporins (cefaclor).oTheoretical
is predicted to decrease the exposure to clozapine.
Theoretical → Also see TABLE 15 p. 1378
increases the anticoagulant effect of coumarins.
▶ Leflunomide is predicted to decrease the exposure to
▶ Leflunomide is predicted to increase the exposure to
ganciclovir.oTheoretical → Also see TABLE 15 p. 1378
▶ Leflunomide is predicted to increase the exposure to H2
(cimetidine, famotidine).o ▶ Leflunomide is predicted to increase the concentration of
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
leflunomide. Public Health England advises avoid (refer to
▶ Leflunomide is predicted to increase the exposure to loop
diuretics (furosemide).oTheoretical
▶ Leflunomide is predicted to decrease the exposure to
▶ Leflunomide is predicted to increase the exposure to
methotrexate.oTheoretical → Also see TABLE 1 p. 1375 →
▶ Leflunomide is predicted to increase the clearance of
mexiletine. Monitor and adjust dose.oStudy
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to increase the exposure to NSAIDs
(indometacin, ketoprofen).oTheoretical
▶ Leflunomide is predicted to decrease the exposure to
olanzapine. Monitor and adjust dose.oStudy → Also see
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to increase the exposure to penicillins
(benzylpenicillin).oTheoretical
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to decrease the exposure to
▶ Leflunomide is predicted to increase the exposure to quinolones
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to increase the exposure to
▶ Leflunomide is predicted to increase the exposure to selexipag.
▶ Leflunomide is predicted to increase the exposure to statins
(atorvastatin, fluvastatin, pravastatin, simvastatin)
Study → Also see TABLE 1 p. 1375
.o ▶ Leflunomide is predicted to increase the exposure to statins
(rosuvastatin). Adjust dose.oStudy → Also see TABLE 1
▶ Leflunomide is predicted to increase the exposure to
sulfasalazine.oStudy → Also see TABLE 1 p. 1375 → Also see
▶ Leflunomide is predicted to increase the exposure to
sulfonylureas (glibenclamide).oStudy
▶ Leflunomide is predicted to increase the concentration of
taxanes (paclitaxel).rAnecdotal → Also see TABLE 15 p. 1378
▶ Leflunomide is predicted to increase the exposure to tenofovir
▶ Leflunomide is predicted to increase the exposure to tenofovir
▶ Leflunomide is predicted to decrease the exposure to
theophylline. Adjust dose.oStudy
▶ Leflunomide moderately decreases the exposure to tizanidine.
▶ Leflunomide is predicted to increase the exposure to
topotecan.oStudy → Also see TABLE 15 p. 1378
▶ Leflunomide is predicted to increase the exposure to
zidovudine.oTheoretical → Also see TABLE 15 p. 1378
Lenalidomide → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 15 p. 1378
(myelosuppression), TABLE 5 p. 1375 (thromboembolism)
▶ Combined hormonal contraceptives are predicted to increase
the risk of venous thromboembolism when given with
lenalidomide. Avoid.rTheoretical
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