p. 1376 → Also see TABLE 8 p. 1376
▶ Oral calcium channel blockers (verapamil) increase the risk of
cardiovascular side-effects when given with beta blockers,
non-selective.rStudy → Also see TABLE 6 p. 1376 → Also see
is predicted to increase the exposure to nadolol.
▶ Eliglustat is predicted to increase the exposure to propranolol.
▶ Beta blockers, non-selective are predicted to increase the risk
of peripheral vasoconstriction when given with
▶ Beta blockers, non-selective are predicted to increase the risk
of peripheral vasoconstriction when given with
▶ HIV-protease inhibitors (lopinavir, ritonavir, saquinavir) are
predicted to increase the exposure to nadolol.oStudy
▶ Beta blockers, non-selective are predicted to increase the risk
of bradycardia when given with lanreotide.oTheoretical
is predicted to increase the exposure to nadolol.
are predicted to increase the exposure to nadolol.
▶ Mexiletine potentially increases the risk of cardiovascular
side-effects when given with beta blockers, non-selective.
is predicted to increase the exposure to nadolol.
moderately decreases the exposure to carvedilol.
▶ Rifampicin decreases the exposure to propranolol. Monitor and
▶ Propranolol slightly to moderately increases the exposure to
rizatriptan. Adjust rizatriptan dose and separate
administration by at least 2 hours, p. 480.oStudy
▶ SSRIs (fluvoxamine) moderately increase the concentration of
▶ Beta blockers, non-selective increase the risk of hypertension
and bradycardia when given with sympathomimetics, inotropic
▶ Beta blockers, non-selective are predicted to increase the risk
of hypertension and bradycardia when given with
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).rStudy
▶ Beta blockers, non-selective are predicted to increase the risk
of bronchospasm when given with
is predicted to increase the exposure to nadolol.
Beta blockers, selective → see TABLE 6 p. 1376 (bradycardia), TABLE 8
acebutolol . atenolol . betaxolol . bisoprolol . celiprolol . esmolol . metoprolol . nebivolol.
1414 Bedaquiline — Beta blockers, selective BNF 78
▶ Since systemic absorption can follow topical application of
betaxolol, the possibility of interactions should be borne in
▶ Orange juice greatly decreases the exposure to celiprolol.
▶ Abiraterone is predicted to increase the exposure to
▶ Beta blockers, selective are predicted to increase the risk of
▶ Antiarrhythmics (amiodarone, disopyramide, dronedarone,
flecainide, lidocaine) are predicted to increase the risk of
cardiovascular side-effects when given with beta blockers,
selective. Use with caution or avoid.rStudy → Also see
▶ Antiarrhythmics (propafenone) are predicted to increase the
▶ Antiarrhythmics (propafenone) are predicted to increase the
exposure to nebivolol and nebivolol is predicted to increase the
risk of cardiodepression when given with antiarrhythmics
(propafenone). Avoid.rTheoretical
▶ Antiarrhythmics (propafenone) are predicted to increase the risk
of cardiovascular side-effects when given with beta blockers,
selective (acebutolol, atenolol, betaxolol, bisoprolol, celiprolol,
esmolol). Use with caution or avoid.rStudy
▶ Anticholinesterases, centrally acting are predicted to increase
the risk of bradycardia when given with beta blockers,
selective.oAnecdotal → Also see TABLE 6 p. 1376
▶ Antiepileptics (phenobarbital, primidone) are predicted to
decrease the exposure to beta blockers, selective (acebutolol,
bisoprolol, metoprolol, nebivolol).oStudy
▶ Antimalarials (mefloquine) are predicted to increase the risk of
▶ Bupropion is predicted to increase the exposure to beta
blockers, selective (metoprolol, nebivolol).oStudy
▶ Calcium channel blockers (diltiazem) are predicted to increase
the risk of cardiodepression when given with beta blockers,
selective.rStudy → Also see TABLE 6 p. 1376 → Also see
▶ Intravenous calcium channel blockers (verapamil) increase the
risk of cardiovascular side-effects when given with beta
blockers, selective. Avoid.rStudy → Also see TABLE 6
p. 1376 → Also see TABLE 8 p. 1376
▶ Oral calcium channel blockers (verapamil) increase the risk of
cardiovascular side-effects when given with beta blockers,
selective.rStudy → Also see TABLE 6 p. 1376 → Also see
▶ Cinacalcet is predicted to increase the exposure to beta
blockers, selective (metoprolol, nebivolol).oStudy
is predicted to increase the exposure to metoprolol.
▶ Eliglustat is predicted to increase the exposure to metoprolol.
▶ Beta blockers, selective are predicted to increase the risk of
peripheral vasoconstriction when given with
▶ Beta blockers, selective are predicted to increase the risk of
peripheral vasoconstriction when given with
greatly decreases the exposure to celiprolol.
▶ HIV-protease inhibitors (ritonavir) are predicted to increase the
▶ Beta blockers, selective are predicted to increase the risk of
bradycardia when given with lanreotide.oTheoretical
▶ Mexiletine potentially increases the risk of cardiovascular
side-effects when given with beta blockers, selective. Avoid or
▶ Mirabegron is predicted to increase the exposure to
▶ Panobinostat is predicted to increase the exposure to
metoprolol. Monitor and adjust dose.oTheoretical
▶ Panobinostat is predicted to increase the exposure to
nebivolol. Monitor and adjust dose.nTheoretical
▶ Rifampicin slightly decreases the exposure to beta blockers,
selective (bisoprolol, metoprolol).nStudy
moderately decreases the exposure to celiprolol.
▶ Rolapitant is predicted to moderately increase the exposure to
▶ SSRIs (fluoxetine, paroxetine) are predicted to increase the
beta blockers, selective (metoprolol, nebivolol).
▶ Beta blockers, selective increase the risk of hypertension and
bradycardia when given with sympathomimetics, inotropic
▶ Beta blockers, selective are predicted to increase the risk of
hypertension and bradycardia when given with
sympathomimetics, vasoconstrictor (adrenaline/epinephrine,
noradrenaline/norepinephrine).rStudy
▶ Terbinafine is predicted to increase the exposure to beta
blockers, selective (metoprolol, nebivolol).oStudy
▶ Beta blockers, selective are predicted to increase the risk of
Beta2 agonists → see TABLE 17 p. 1379 (reduced serum potassium)
predicted to increase the exposure to
▶ Apalutamide is predicted to decrease the exposure to
salmeterol. Avoid or monitor.oStudy
is predicted to increase the exposure to salmeterol.
▶ Atomoxetine is predicted to increase the risk of cardiovascular
▶ Cobicistat is predicted to increase the exposure to salmeterol.
▶ HIV-protease inhibitors are predicted to increase the exposure
▶ Idelalisib is predicted to increase the exposure to salmeterol.
▶ Beta2 agonists are predicted to increase the risk of glaucoma
when given with ipratropium.oAnecdotal
▶ Beta2 agonists are predicted to increase the risk of elevated
blood pressure when given with
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to salmeterol. Avoid.rStudy
▶ Monoamine-oxidase A and B inhibitors, irreversible are
predicted to increase the risk of cardiovascular side-effects
when given with beta2 agonists.oAnecdotal
▶ Monoamine-oxidase B inhibitors (rasagiline, selegiline) are
predicted to increase the risk of severe hypertension when
given with beta2 agonists. Avoid.rTheoretical
▶ Monoamine-oxidase B inhibitors (safinamide) are predicted to
increase the risk of severe hypertension when given with beta2
is predicted to increase the exposure to salmeterol.
▶ Antihistamines, non-sedating are predicted to decrease the
effects of betahistine.oTheoretical
▶ Antihistamines, sedating are predicted to decrease the effects
Betamethasone → see corticosteroids
Betaxolol → see beta blockers, selective
Bevacizumab → see monoclonal antibodies
▶ Bicalutamide is predicted to increase the exposure to
. Separate administration by 12 hours.o
▶ Antacids decrease the exposure to bictegravir. Separate
administration by at least 2 hours.oStudy
BNF 78 Beta blockers, selective — Bictegravir 1415
▶ Antiarrhythmics (amiodarone, dronedarone) are predicted to
increase the exposure to bictegravir. Use with caution or
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Antiepileptics (oxcarbazepine) are predicted to decrease the
exposure to bictegravir. Avoid.oTheoretical
▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to
increase the exposure to bictegravir. Use with caution or
▶ Antifungals, azoles (posaconazole) are predicted to increase the
exposure to bictegravir.oTheoretical
▶ Calcium channel blockers (verapamil) are predicted to increase
bictegravir. Use with caution or avoid.
▶ Ciclosporin is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Enzalutamide is predicted to decrease the exposure to
▶ HIV-protease inhibitors (atazanavir) moderately increase the
exposure to bictegravir. Avoid.rStudy
▶ HIV-protease inhibitors (lopinavir, ritonavir, saquinavir) are
predicted to increase the exposure to bictegravir. Use with
▶ Iron (oral) decrease the exposure to bictegravir. Bictegravir
should be taken 2 hours before iron (oral).oStudy
▶ Lapatinib is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
▶ Macrolides are predicted to increase the exposure to
bictegravir. Use with caution or avoid.oTheoretical
slightly increases the exposure to metformin.
▶ Mitotane is predicted to decrease the exposure to bictegravir.
▶ Bictegravir is predicted to increase the exposure to opioids
▶ Ranolazine is predicted to increase the exposure to bictegravir.
Use with caution or avoid.oTheoretical
slightly decreases the exposure to bictegravir. Avoid.
▶ Rifampicin is predicted to decrease the exposure to bictegravir.
▶ St John’s Wort is predicted to decrease the exposure to
bictegravir. Avoid.oTheoretical
▶ Sucralfate is predicted to decrease the exposure to bictegravir.
▶ Vemurafenib is predicted to increase the exposure to
bictegravir. Use with caution or avoid.oTheoretical
Bilastine → see antihistamines, non-sedating
Bisoprolol → see beta blockers, selective
Bisphosphonates → see TABLE 2 p. 1375 (nephrotoxicity)
given with bisphosphonates.oAnecdotal → Also see
▶ Antacids decrease the absorption of alendronic acid. Alendronic
should be taken at least 30 minutes before antacids.
▶ Antacids are predicted to decrease the absorption of
ibandronic acid. Avoid antacids for at least 6 hours before or
1 hour after ibandronic acid.oTheoretical
▶ Antacids decrease the absorption of risedronate. Separate
administration by at least 2 hours.oStudy
▶ Antacids decrease the absorption of sodium clodronate. Avoid
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