▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly to very markedly increase the exposure
▶ Apalutamide is predicted to decrease the exposure to
darifenacin. Avoid or monitor.oStudy
▶ Aprepitant is predicted to slightly increase the exposure to
▶ Bupropion is predicted to slightly increase the exposure to
▶ 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
▶ Cobicistat is predicted to markedly to very markedly increase
the exposure to darifenacin. Avoid.rStudy
▶ Crizotinib is predicted to slightly increase the exposure to
▶ Enzalutamide is predicted to decrease the exposure to
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to markedly to very
markedly increase the exposure to
▶ Idelalisib is predicted to markedly to very markedly increase
the exposure to darifenacin. Avoid.rStudy
▶ Imatinib is predicted to slightly increase the exposure to
▶ Macrolides (clarithromycin) are predicted to markedly to very
markedly increase the exposure to
▶ Macrolides (erythromycin) are predicted to slightly increase the
exposure to darifenacin.oStudy
is predicted to decrease the exposure to darifenacin.
▶ Netupitant is predicted to slightly increase the exposure to
▶ Nilotinib is predicted to slightly increase the exposure to
▶ Rifampicin is predicted to decrease the exposure to
▶ SSRIs (fluoxetine, paroxetine) are predicted to slightly increase
the exposure to darifenacin.nStudy
▶ St John’s Wort is predicted to decrease the exposure to
▶ Terbinafine is predicted to slightly increase the exposure to
▶ Darifenacin is predicted to increase the exposure to tricyclic
antidepressants.oTheoretical → Also see TABLE 10 p. 1377
Darunavir → see HIV-protease inhibitors
▶ 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
▶ 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
▶ Etravirine is predicted to decrease the exposure to dasabuvir.
▶ 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).
▶ Mitotane is predicted to decrease the exposure to dasabuvir.
▶ Nevirapine is predicted to decrease the exposure to dasabuvir.
▶ Rifampicin is predicted to decrease the exposure to dasabuvir.
▶ St John’s Wort is predicted to decrease the exposure to
▶ 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
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to dasatinib.
▶ Apalutamide is predicted to decrease the exposure to
dasatinib. Avoid or monitor.oStudy → Also see TABLE 9
is predicted to increase the exposure to dasatinib.
is predicted to decrease the exposure to dasatinib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to dasatinib.rStudy
▶ Cobicistat is predicted to markedly increase the exposure to
. Avoid or adjust dose—consult product literature.
▶ Dasatinib is predicted to increase the risk of bleeding events
when given with coumarins.rTheoretical
is predicted to increase the exposure to dasatinib.
Study → Also see TABLE 15 p. 1378 → Also see TABLE 9 p. 1377
is predicted to decrease the exposure to dasatinib.
Study → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to markedly decrease the exposure
▶ Grapefruit juice is predicted to increase the exposure to
▶ H2 receptor antagonists are predicted to decrease the exposure
▶ 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
. Avoid or adjust dose—consult product literature.
Study → Also see TABLE 15 p. 1378
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
is predicted to increase the exposure to dasatinib.
is predicted to decrease the exposure to dasatinib.
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.
▶ 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
▶ St John’s Wort is predicted to decrease the exposure to
▶ Dasatinib is predicted to increase the exposure to statins
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
very slightly increases the exposure to delamanid.
▶ Enzalutamide is predicted to slightly decrease the exposure to
▶ HIV-protease inhibitors very slightly increase the exposure to
delamanid.rStudy → Also see TABLE 9 p. 1377
very slightly increases the exposure to delamanid.
▶ 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
▶ Rifampicin is predicted to slightly decrease the exposure to
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
▶ 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
▶ 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
▶ Desogestrel is predicted to increase the exposure to
antiepileptics (lamotrigine).oStudy
▶ Aprepitant is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ Bosentan is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ Efavirenz is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ 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.
Contraceptives, interactions p. 794.
▶ 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.
Contraceptives, interactions p. 794.
▶ Nevirapine is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ Rifabutin is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ Rifampicin is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ 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
▶ Ulipristal is predicted to decrease the efficacy of desogestrel.
Dexamethasone → see corticosteroids
Dexamfetamine → see amfetamines
Dexmedetomidine → see TABLE 11 p. 1377 (CNS depressant effects)
Dexrazoxane → see iron chelators
Diazepam → see TABLE 11 p. 1377 (CNS depressant effects)
▶ Diazepam potentially affects the concentration of antiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
▶ Antifungals, azoles (fluconazole, voriconazole) moderately
diazepam. Monitor and adjust dose.
▶ 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
diazepam. Monitor and adjust dose.o ▶ Rifampicin moderately decreases the exposure to diazepam.
▶ SSRIs (fluvoxamine) moderately increase the exposure to
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
Dicycloverine → see TABLE 10 p. 1377 (antimuscarinics)
Didanosine → see TABLE 1 p. 1375 (hepatotoxicity), TABLE 12 p. 1378
ROUTE-SPECIFIC INFORMATION Antacids in tablet formulation
might affect absorption of other drugs—give at least 2 hours
▶ Allopurinol moderately increases the exposure to didanosine.
▶ Didanosine (buffered) decreases the exposure to antifungals,
azoles (itraconazole, ketoconazole). Separate administration by
2 hours.rStudy → Also see TABLE 1 p. 1375
is predicted to increase the exposure to didanosine.
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