Study

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

predicted to markedly to very markedly increase the exposure

to darifenacin. Avoid.rStudy

▶ Apalutamide is predicted to decrease the exposure to

darifenacin. Avoid or monitor.oStudy

▶ Aprepitant is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Bupropion is predicted to slightly increase the exposure to

darifenacin.nStudy

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

slightly increase the exposure to darifenacin.oStudy

▶ Ciclosporin is predicted to increase the exposure to

darifenacin. Avoid.oTheoretical

▶ Cinacalcet is predicted to slightly increase the exposure to

darifenacin.nStudy

▶ Cobicistat is predicted to markedly to very markedly increase

the exposure to darifenacin. Avoid.rStudy

▶ Crizotinib is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Enzalutamide is predicted to decrease the exposure to

darifenacin.oTheoretical

▶ Grapefruit juice is predicted to increase the exposure to

darifenacin.oStudy

▶ HIV-protease inhibitors are predicted to markedly to very

markedly increase the exposure to

Study

darifenacin. Avoid.r

▶ Idelalisib is predicted to markedly to very markedly increase

the exposure to darifenacin. Avoid.rStudy

▶ Imatinib is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Macrolides (clarithromycin) are predicted to markedly to very

markedly increase the exposure to

Study

darifenacin. Avoid.r

▶ Macrolides (erythromycin) are predicted to slightly increase the

exposure to darifenacin.oStudy

▶ Mitotane

o

is predicted to decrease the exposure to darifenacin.

Theoretical

▶ Netupitant is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Nilotinib is predicted to slightly increase the exposure to

darifenacin.oStudy

▶ Rifampicin is predicted to decrease the exposure to

darifenacin.oTheoretical

▶ SSRIs (fluoxetine, paroxetine) are predicted to slightly increase

the exposure to darifenacin.nStudy

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

darifenacin.oTheoretical

▶ Terbinafine is predicted to slightly increase the exposure to

darifenacin.nStudy

▶ Darifenacin is predicted to increase the exposure to tricyclic

antidepressants.oTheoretical → Also see TABLE 10 p. 1377

Darunavir → see HIV-protease inhibitors

Dasabuvir

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to dasabuvir. Avoid.rTheoretical

▶ Clopidogrel is predicted to very markedly increase the

exposure to dasabuvir. Avoid.rStudy

1440 Dairy products — Dasabuvir BNF 78

Interactions | Appendix 1

A1

▶ Combined hormonal contraceptives (containing

ethinylestradiol) increase the risk of increased ALT

concentrations when given with dasabuvir. Avoid.rStudy

▶ Efavirenz increases the risk of increased ALT concentrations

when given with dasabuvir. Avoid.rStudy

▶ Enzalutamide is predicted to decrease the exposure to

dasabuvir. Avoid.rTheoretical

▶ Etravirine is predicted to decrease the exposure to dasabuvir.

Avoid.rTheoretical

▶ Fibrates (gemfibrozil) are predicted to very markedly increase

the exposure to dasabuvir. Avoid.rStudy

▶ Dasabuvir (with ombitasvir, paritaprevir, and ritonavir)

decreases the concentration of HIV-protease inhibitors

(darunavir). Avoid or adjust dose.oStudy

▶ Dasabuvir (with ombitasvir, paritaprevir, and ritonavir)

increases the concentration of loop diuretics (furosemide).

Adjust dose.oStudy

▶ Mitotane is predicted to decrease the exposure to dasabuvir.

Avoid.rTheoretical

▶ Nevirapine is predicted to decrease the exposure to dasabuvir.

Avoid.rTheoretical

▶ Rifampicin is predicted to decrease the exposure to dasabuvir.

Avoid.rTheoretical

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

dasabuvir. Avoid.rTheoretical

▶ Dasabuvir increases the exposure to statins (rosuvastatin).

Adjust rosuvastatin dose, p. 204.oStudy

Dasatinib → see TABLE 15 p. 1378 (myelosuppression), TABLE 9 p. 1377

(QT-interval prolongation), TABLE 4 p. 1375 (antiplatelet effects)

▶ Antacids decrease the absorption of dasatinib. Separate

administration by at least 2 hours.oStudy

▶ Antiarrhythmics (dronedarone) are predicted to increase the

exposure to dasatinib.rStudy → Also see TABLE 9 p. 1377

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to markedly decrease the

exposure to dasatinib. Avoid.rStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

Study → Also see TABLE 9 p. 1377

dasatinib.r

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

predicted to markedly increase the exposure to dasatinib.

Avoid or adjust dose

Study → Also see TABLE 9

—consult product literature.

p. 1377

r

▶ Apalutamide is predicted to decrease the exposure to

dasatinib. Avoid or monitor.oStudy → Also see TABLE 9

p. 1377

▶ Aprepitant

r

is predicted to increase the exposure to dasatinib.

Study

▶ Bosentan

r

is predicted to decrease the exposure to dasatinib.

Study

▶ Calcium channel blockers (diltiazem, verapamil) are predicted to

increase the exposure to dasatinib.rStudy

▶ Cobicistat is predicted to markedly increase the exposure to

dasatinib

r

. Avoid or adjust dose—consult product literature.

Study

▶ Dasatinib is predicted to increase the risk of bleeding events

when given with coumarins.rTheoretical

▶ Crizotinib

r

is predicted to increase the exposure to dasatinib.

Study → Also see TABLE 15 p. 1378 → Also see TABLE 9 p. 1377

▶ Efavirenz

r

is predicted to decrease the exposure to dasatinib.

Study → Also see TABLE 9 p. 1377

▶ Enzalutamide is predicted to markedly decrease the exposure

to dasatinib. Avoid.rStudy

▶ Grapefruit juice is predicted to increase the exposure to

dasatinib. Avoid.oTheoretical

▶ H2 receptor antagonists are predicted to decrease the exposure

to dasatinib. Avoid.oStudy

▶ HIV-protease inhibitors are predicted to markedly increase the

exposure to dasatinib. Avoid or adjust dose—consult product

literature.rStudy → Also see TABLE 9 p. 1377

▶ Idelalisib is predicted to markedly increase the exposure to

dasatinib

r

. Avoid or adjust dose—consult product literature.

Study → Also see TABLE 15 p. 1378

▶ Imatinib

r

is predicted to increase the exposure to dasatinib.

Study → Also see TABLE 15 p. 1378

▶ Macrolides (clarithromycin) are predicted to markedly increase

the exposure to dasatinib. Avoid or adjust dose—consult

product literature.rStudy → Also see TABLE 9 p. 1377

▶ Macrolides (erythromycin) are predicted to increase the

exposure to dasatinib.rStudy → Also see TABLE 9 p. 1377

▶ Mitotane is predicted to markedly decrease the exposure to

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

▶ Netupitant

r

is predicted to increase the exposure to dasatinib.

Study

▶ Nevirapine

r

is predicted to decrease the exposure to dasatinib.

Study

▶ Nilotinib

r

is predicted to increase the exposure to dasatinib.

Study → Also see TABLE 15 p. 1378 → Also see TABLE 9 p. 1377

▶ Dasatinib is predicted to increase the risk of bleeding events

when given with phenindione.rTheoretical

▶ Pitolisant is predicted to decrease the exposure to dasatinib.

Avoid.rTheoretical

▶ Proton pump inhibitors are predicted to slightly to moderately

decrease the exposure to dasatinib. Avoid.rStudy

▶ Rifampicin is predicted to markedly decrease the exposure to

dasatinib. Avoid.rStudy

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

dasatinib.rStudy

▶ Dasatinib is predicted to increase the exposure to statins

(simvastatin).oTheoretical

Daunorubicin → see anthracyclines

Decitabine → see TABLE 15 p. 1378 (myelosuppression)

Deferasirox → see iron chelators

Deferiprone → see TABLE 15 p. 1378 (myelosuppression)

▶ Antacids (aluminium hydroxide) are predicted to decrease the

absorption of deferiprone. Avoid.oTheoretical

▶ Ascorbic acid is predicted to increase the risk of cardiovascular

side-effects when given with deferiprone.rTheoretical

Deflazacort → see corticosteroids

Delamanid → see TABLE 9 p. 1377 (QT-interval prolongation)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to slightly decrease the

exposure to delamanid. Avoid.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole)

very slightly increase the exposure to

Study → Also see TABLE 9 p. 1377

delamanid.r

▶ Cobicistat

r

very slightly increases the exposure to delamanid.

Study

▶ Enzalutamide is predicted to slightly decrease the exposure to

delamanid. Avoid.oStudy

▶ HIV-protease inhibitors very slightly increase the exposure to

delamanid.rStudy → Also see TABLE 9 p. 1377

▶ Idelalisib

r

very slightly increases the exposure to delamanid.

Study

▶ Macrolides (clarithromycin) very slightly increase the exposure

to delamanid.rStudy → Also see TABLE 9 p. 1377

▶ Mitotane is predicted to slightly decrease the exposure to

delamanid. Avoid.oStudy

▶ Rifampicin is predicted to slightly decrease the exposure to

delamanid. Avoid.oStudy

Demeclocycline → see tetracyclines

Desferrioxamine → see iron chelators

Desflurane → see volatile halogenated anaesthetics

Desloratadine → see antihistamines, non-sedating

Desmopressin → see TABLE 18 p. 1379 (hyponatraemia)

▶ Antiepileptics (lamotrigine) are predicted to increase the risk of

hyponatraemia when given with

Theoretical

desmopressin.r

▶ Loperamide greatly increases the absorption of oral

desmopressin (and possibly sublingual).oStudy

▶ Phenothiazines (chlorpromazine) are predicted to increase the

risk of hyponatraemia when given with

Theoretical

desmopressin.r

Desogestrel

▶ Antiepileptics (carbamazepine, eslicarbazepine, fosphenytoin,

oxcarbazepine, perampanel, phenobarbital, phenytoin,

primidone, rufinamide, topiramate) are predicted to decrease

the efficacy of desogestrel. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

BNF 78 Dasabuvir — Desogestrel 1441

Interactions | Appendix 1

A1

Desogestrel (continued)

▶ Desogestrel is predicted to increase the exposure to

antiepileptics (lamotrigine).oStudy

▶ Aprepitant is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Bosentan is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Efavirenz is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

desogestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Griseofulvin potentially decreases the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Anecdotal

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

efficacy of desogestrel. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

▶ Modafinil is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Nevirapine is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Rifabutin is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Rifampicin is predicted to decrease the efficacy of desogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ St John’s Wort is predicted to decrease the efficacy of

desogestrel. MHRA advises avoid. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

▶ Sugammadex is predicted to decrease the exposure to

desogestrel. Refer to patient information leaflet for missed pill

advice.rTheoretical

▶ Ulipristal is predicted to decrease the efficacy of desogestrel.

Avoid.rTheoretical

Dexamethasone → see corticosteroids

Dexamfetamine → see amfetamines

Dexibuprofen → see NSAIDs

Dexketoprofen → see NSAIDs

Dexmedetomidine → see TABLE 11 p. 1377 (CNS depressant effects)

Dexrazoxane → see iron chelators

Diamorphine → see opioids

Diazepam → see TABLE 11 p. 1377 (CNS depressant effects)

▶ Diazepam potentially affects the concentration of antiepileptics

(fosphenytoin, phenytoin). Monitor concentration and adjust

dose.rStudy

▶ Antifungals, azoles (fluconazole, voriconazole) moderately

increase the exposure to

o

diazepam. Monitor and adjust dose.

Study

▶ Apalutamide is predicted to decrease the exposure to

diazepam. Avoid or monitor.nStudy

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

exposure to diazepam. Avoid.oTheoretical

▶ Monoclonal antibodies (tocilizumab) are predicted to decrease

the exposure to

Theoretical

diazepam. Monitor and adjust dose.o ▶ Rifampicin moderately decreases the exposure to diazepam.

Avoid.oStudy

▶ SSRIs (fluvoxamine) moderately increase the exposure to

diazepam.oStudy

Diazoxide → see TABLE 8 p. 1376 (hypotension)

▶ Diazoxide decreases the concentration of antiepileptics

(fosphenytoin, phenytoin) and antiepileptics (fosphenytoin,

phenytoin) are predicted to decrease the effects of diazoxide.

Monitor concentration and adjust dose.oAnecdotal

▶ Diazoxide increases the risk of severe hypotension when given

with hydralazine.rStudy → Also see TABLE 8 p. 1376

Diclofenac → see NSAIDs

Dicycloverine → see TABLE 10 p. 1377 (antimuscarinics)

Didanosine → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 12 p. 1378

(peripheral neuropathy)

ROUTE-SPECIFIC INFORMATION Antacids in tablet formulation

might affect absorption of other drugs—give at least 2 hours

apart.

▶ Allopurinol moderately increases the exposure to didanosine.

Avoid.rStudy

▶ Didanosine (buffered) decreases the exposure to antifungals,

azoles (itraconazole, ketoconazole). Separate administration by

2 hours.rStudy → Also see TABLE 1 p. 1375

▶ Febuxostat

r

is predicted to increase the exposure to didanosine.

Theoretical

▶ Ganciclovir

o

is predicted to increase the exposure to didanosine.

Study

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