▶ Hormone replacement therapy is predicted to increase the risk
of venous thromboembolism when given with
Lenvatinib → see TABLE 9 p. 1377 (QT-interval prolongation)
Lercanidipine → see calcium channel blockers
▶ Letermovir is predicted to increase the concentration of
antiarrhythmics (amiodarone).oTheoretical
▶ Antiepileptics (carbamazepine, phenobarbital, primidone) are
predicted to decrease the concentration of
▶ Letermovir is predicted to decrease the concentration of
antiepileptics (fosphenytoin, phenytoin) and antiepileptics
(fosphenytoin, phenytoin) are predicted to decrease the
concentration of letermovir.oTheoretical
▶ Letermovir slightly decreases the exposure to antifungals,
▶ Letermovir is predicted to increase the concentration of
antihistamines, non-sedating (fexofenadine).oTheoretical
▶ Letermovir is predicted to increase the concentration of
▶ Letermovir increases the exposure to ciclosporin and
ciclosporin increases the exposure to letermovir. Monitor and
adjust letermovir dose, p. 639.rStudy
▶ Letermovir is predicted to decrease the concentration of
dabigatran. Avoid.rTheoretical
▶ Efavirenz is predicted to decrease the concentration of
▶ Eltrombopag is predicted to increase the concentration of
▶ Letermovir is predicted to increase the concentration of
ergometrine. Avoid.rTheoretical
▶ Letermovir is predicted to increase the concentration of
ergotamine. Avoid.rTheoretical
is predicted to decrease the exposure to letermovir.
▶ Letermovir is predicted to increase the concentration of
everolimus. Monitor and adjust dose.rStudy
▶ Fibrates (gemfibrozil) are predicted to increase the
concentration of letermovir.oStudy
▶ HIV-protease inhibitors (atazanavir, lopinavir) (boosted with
ritonavir) are predicted to increase the concentration of
▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the
concentration of letermovir.oTheoretical
▶ Leflunomide is predicted to increase the concentration of
▶ Macrolides (clarithromycin, erythromycin) are predicted to
increase the concentration of letermovir.oStudy
▶ Letermovir slightly to moderately increases the exposure to
midazolam. Monitor and adjust dose.oStudy
▶ Modafinil is predicted to decrease the concentration of
▶ Letermovir is predicted to increase the exposure to opioids
(alfentanil, fentanyl). Monitor and adjust dose.oStudy
▶ Letermovir is predicted to increase the concentration of
▶ Letermovir is predicted to increase the concentration of
repaglinide. Avoid.oTheoretical
▶ Rifabutin is predicted to decrease the concentration of
▶ Rifampicin is predicted to affect the concentration of
▶ Letermovir moderately increases the exposure to sirolimus.
Monitor and adjust dose.rStudy
▶ St John’s Wort is predicted to decrease the concentration of
▶ Letermovir moderately increases the exposure to statins
. Avoid or adjust atorvastatin dose, p. 202.r
▶ Letermovir is predicted to increase the exposure to statins
(fluvastatin). Monitor and adjust dose.oTheoretical
▶ Letermovir is predicted to increase the exposure to statins
(pravastatin). Avoid or adjust dose.oTheoretical
▶ Letermovir is predicted to increase the exposure to statins
(rosuvastatin, simvastatin). Avoid.rStudy
▶ Letermovir is predicted to increase the concentration of
sulfonylureas (glibenclamide).oTheoretical
▶ Letermovir moderately increases the exposure to tacrolimus.
Monitor and adjust dose.rStudy
▶ Teriflunomide is predicted to increase the concentration of
▶ Albendazole slightly decreases the exposure to levamisole and
moderately decreases the exposure to albendazole.
▶ Alcohol (beverage) potentially causes a disulfiram-like
reaction when given with levamisole.oStudy
increases the exposure to ivermectin.o
Levetiracetam → see antiepileptics
Levobunolol → see beta blockers, non-selective
Levobupivacaine → see anaesthetics, local
Levocetirizine → see antihistamines, non-sedating
Levodopa → see TABLE 8 p. 1376 (hypotension)
GENERAL INFORMATION Drugs with antimuscarinic effects
might reduce the absorption of levodopa, see TABLE 10 p. 1377.
▶ Amisulpride is predicted to decrease the effects of levodopa.
▶ Antiepileptics (fosphenytoin, phenytoin) decrease the effects of
is predicted to decrease the effects of levodopa.
Theoretical → Also see TABLE 8 p. 1376
▶ Asenapine is predicted to decrease the effects of levodopa.
Adjust dose.rTheoretical → Also see TABLE 8 p. 1376
▶ Baclofen is predicted to increase the risk of side-effects when
given with levodopa.rAnecdotal → Also see TABLE 8 p. 1376
is predicted to decrease the effects of levodopa.
Study → Also see TABLE 8 p. 1376
▶ Bupropion increases the risk of side-effects when given with
is predicted to decrease the effects of levodopa.
Theoretical → Also see TABLE 8 p. 1376
▶ Droperidol decreases the effects of levodopa.rStudy →
▶ Entacapone increases the exposure to levodopa. Monitor side
effects and adjust dose.oStudy
▶ Flupentixol decreases the effects of levodopa. Avoid or monitor
worsening parkinsonian symptoms.rTheoretical → Also
▶ Haloperidol decreases the effects of levodopa.rStudy →
decreases the absorption of levodopa.o ▶ Isoniazid decreases the effects of levodopa.oStudy
▶ Levodopa is predicted to increase the risk of elevated blood
pressure when given with linezolid. Avoid.rTheoretical
is predicted to decrease the effects of levodopa.
Theoretical → Also see TABLE 8 p. 1376
is predicted to decrease the effects of levodopa.
Theoretical → Also see TABLE 8 p. 1376
is predicted to increase the effects of levodopa.
decreases the effects of levodopa. Avoid.
▶ Levodopa increases the risk of side-effects when given with
▶ Levodopa increases the risk of a hypertensive crisis when
given with monoamine-oxidase A and B inhibitors, irreversible.
Avoid and for 14 days after stopping the MAOI.rStudy →
▶ Monoamine-oxidase B inhibitors are predicted to increase the
effects of levodopa. Adjust dose.nStudy → Also see TABLE 8
1478 Lenalidomide — Levodopa BNF 78
▶ Olanzapine decreases the effects of levodopa. Avoid or monitor
worsening parkinsonian symptoms.rAnecdotal → Also see
increases the exposure to levodopa. Adjust dose.
is predicted to decrease the effects of levodopa.
Theoretical → Also see TABLE 8 p. 1376
▶ Phenothiazines decrease the effects of levodopa. Avoid or
monitor worsening parkinsonian symptoms.rStudy →
▶ Pimozide decreases the effects of levodopa.rTheoretical →
▶ Risperidone is predicted to decrease the effects of levodopa.
Avoid or adjust dose.rAnecdotal → Also see TABLE 8 p. 1376
▶ Sulpiride is predicted to decrease the effects of levodopa.
Avoid.rTheoretical → Also see TABLE 8 p. 1376
▶ Tetrabenazine is predicted to decrease the effects of levodopa.
Use with caution or avoid.oTheoretical
▶ Tolcapone increases the exposure to levodopa. Monitor and
greatly decreases the concentration of levodopa.
▶ Zuclopenthixol is predicted to decrease the effects of levodopa.
Avoid or monitor worsening parkinsonian symptoms.
Theoretical → Also see TABLE 8 p. 1376
Levofolinic acid → see folates
Levomepromazine → see phenothiazines
▶ Antiepileptics (carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate) are predicted to decrease
the efficacy of levonorgestrel. For FSRH guidance, see
Contraceptives, interactions p. 794.rTheoretical
▶ Aprepitant is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Bosentan is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Efavirenz is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Fosaprepitant is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Griseofulvin potentially decreases the efficacy of oral
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ HIV-protease inhibitors (ritonavir) are predicted to decrease the
efficacy of levonorgestrel. For FSRH guidance, see
Contraceptives, interactions p. 794.rTheoretical
▶ Lumacaftor is predicted to decrease the efficacy of
. Use additional contraceptive precautions.
▶ Modafinil is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Nevirapine is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Rifabutin is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Rifampicin is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ St John’s Wort is predicted to decrease the efficacy of
levonorgestrel. MHRA advises avoid. For FSRH guidance, see
Contraceptives, interactions p. 794.rTheoretical
▶ Sugammadex is predicted to decrease the exposure to
. Use additional contraceptive precautions.
▶ Ulipristal is predicted to decrease the efficacy of
levonorgestrel. Avoid.rTheoretical
Levothyroxine → see thyroid hormones
Lidocaine → see antiarrhythmics
Linagliptin → see TABLE 14 p. 1378 (antidiabetic drugs)
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Enzalutamide is predicted to decrease the exposure to
▶ Linagliptin is predicted to increase the exposure to lomitapide.
Separate administration by 12 hours.oTheoretical
is predicted to decrease the exposure to linagliptin.
is predicted to decrease the exposure to linagliptin.
Linezolid → see TABLE 15 p. 1378 (myelosuppression), TABLE 13 p. 1378
FOOD AND LIFESTYLE Patients taking linezolid should avoid
consuming large amounts of tyramine-rich foods (such as
mature cheese, salami, pickled herring, Bovril ®, Oxo ®,
Marmite ® or any similar meat or yeast extract or fermented
soya bean extract, and some beers, lagers or wines).
▶ Beta2 agonists are predicted to increase the risk of elevated
blood pressure when given with
▶ Bupropion is predicted to increase the risk of intraoperative
hypertension when given with linezolid.rAnecdotal → Also
▶ Buspirone is predicted to increase the risk of elevated blood
pressure when given with linezolid. Avoid.rTheoretical →
▶ Levodopa is predicted to increase the risk of elevated blood
pressure when given with linezolid. Avoid.rTheoretical
(clarithromycin) increase the exposure to linezolid.
▶ Methylphenidate is predicted to increase the risk of elevated
blood pressure when given with
▶ Moclobemide is predicted to increase the risk of side-effects
when given with linezolid. Avoid and for 14 days after
stopping moclobemide.rTheoretical → Also see TABLE 13
▶ Monoamine-oxidase A and B inhibitors, irreversible are
predicted to increase the risk of side-effects when given with
. Avoid and for 14 days after stopping the MAOI.
Theoretical → Also see TABLE 13 p. 1378
▶ Monoamine-oxidase B inhibitors (rasagiline, selegiline) are
predicted to increase the risk of side-effects when given with
. Avoid and for 14 days after stopping the MAOI.
Theoretical → Also see TABLE 13 p. 1378
▶ Monoamine-oxidase B inhibitors (safinamide) are predicted to
increase the risk of side-effects when given with linezolid.
Avoid and for 1 week after stopping
Theoretical → Also see TABLE 13 p. 1378
▶ Reboxetine is predicted to increase the risk of a hypertensive
crisis when given with linezolid. Avoid.rTheoretical
slightly decreases the exposure to linezolid.
▶ Sympathomimetics, inotropic are predicted to increase the risk
of elevated blood pressure when given with
▶ Sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
ephedrine, isometheptene, noradrenaline/norepinephrine,
phenylephrine) are predicted to increase the risk of elevated
blood pressure when given with
▶ Sympathomimetics, vasoconstrictor (pseudoephedrine) increase
the risk of elevated blood pressure when given with linezolid.
Liothyronine → see thyroid hormones
Liraglutide → see TABLE 14 p. 1378 (antidiabetic drugs)
Lisdexamfetamine → see amfetamines
Lisinopril → see ACE inhibitors
BNF 78 Levodopa — Lisinopril 1479
Lithium → see TABLE 13 p. 1378 (serotonin syndrome), TABLE 9 p. 1377
▶ ACE inhibitors are predicted to increase the concentration of
lithium. Monitor and adjust dose.rAnecdotal
alters the concentration of lithium.r
▶ Aldosterone antagonists (eplerenone) potentially increase the
concentration of lithium. Avoid.oTheoretical
▶ Aldosterone antagonists (spironolactone) potentially increase
the concentration of lithium.oStudy
▶ Aminophylline is predicted to decrease the concentration of
▶ Angiotensin-II receptor antagonists potentially increase the
concentration of lithium. Monitor concentration and adjust
▶ Antiepileptics (carbamazepine, oxcarbazepine) are predicted to
increase the risk of neurotoxicity when given with
▶ Calcitonin (salmon) decreases the concentration of lithium.
Monitor concentration and adjust dose.oStudy
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the risk of neurotoxicity when given with
▶ Loop diuretics increase the concentration of lithium. Monitor
▶ Methyldopa increases the risk of neurotoxicity when given
potentially affects the exposure to lithium. Avoid.
▶ NSAIDs increase the concentration of lithium. Monitor and
▶ Phenothiazines potentially increase the risk of neurotoxicity
when given with lithium.rAnecdotal → Also see TABLE 9
▶ Potassium-sparing diuretics (triamterene) potentially increase
the clearance of lithium.oStudy
▶ Quetiapine potentially increases the risk of neurotoxicity
when given with lithium.rAnecdotal
▶ Risperidone potentially increases the risk of neurotoxicity
when given with lithium.rAnecdotal → Also see TABLE 9
decreases the concentration of lithium.
▶ Sulpiride potentially increases the risk of neurotoxicity when
given with lithium.rAnecdotal → Also see TABLE 9 p. 1377
▶ Theophylline is predicted to decrease the concentration of
or adjust dose and monitor concentration.rStudy
▶ Tricyclic antidepressants potentially increase the risk of
neurotoxicity when given with lithium.rAnecdotal → Also
see TABLE 13 p. 1378 → Also see TABLE 9 p. 1377
▶ Zuclopenthixol potentially increases the risk of neurotoxicity
when given with lithium.rAnecdotal → Also see TABLE 9
Bacillus Calmette-Guérin vaccine .influenza vaccine (live) . measles,
mumps and rubella vaccine, live .rotavirus vaccine .typhoid
vaccine, oral .varicella-zoster vaccine .yellow fever vaccine, live.
GENERAL INFORMATION Oral typhoid vaccine is inactivated by
concurrent administration of antibacterials or
antimalarials: antibacterials should be avoided for 3 days
before and after oral typhoid vaccination; mefloquine should
be avoided for at least 12 hours before or after oral typhoid
vaccination; for other antimalarials oral typhoid vaccine
vaccination should be completed at least 3 days before the
first dose of the antimalarial (except proguanil hydrochloride
with atovaquone, which can be given concurrently).
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
abatacept. Public Health England advises avoid (refer to Green
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
alkylating agents. Public Health England advises avoid (refer
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
amsacrine. Public Health England advises avoid (refer to
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
anakinra. Public Health England advises avoid (refer to Green
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
anthracyclines. Public Health England advises avoid (refer to
▶ Live vaccines are predicted to increase the risk of generalised
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