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Study

▶ Beta blockers, selective are predicted to increase the risk of

peripheral vasoconstriction when given with

r

ergometrine.

Study

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

increase the risk of ergotism when given with

r

ergometrine.

Theoretical

▶ Cobicistat is predicted to increase the risk of ergotism when

given with ergometrine. Avoid.rTheoretical

▶ Crizotinib is predicted to increase the risk of ergotism when

given with ergometrine.rTheoretical

▶ Ergometrine is predicted to increase the risk of ergotism when

given with dopamine receptor agonists (cabergoline, pergolide).

Avoid.oTheoretical

1452 Enzalutamide — Ergometrine BNF 78

Interactions | Appendix 1

A1

▶ Esketamine is predicted to increase the risk of elevated blood

pressure when given with

Theoretical

ergometrine. Avoid.r

▶ Grapefruit juice is predicted to increase the exposure to

ergometrine.rTheoretical

▶ HIV-protease inhibitors are predicted to increase the risk of

ergotism when given with

Theoretical

ergometrine. Avoid.r

▶ Idelalisib is predicted to increase the risk of ergotism when

given with ergometrine. Avoid.rTheoretical

▶ Imatinib is predicted to increase the risk of ergotism when

given with ergometrine.rTheoretical

▶ Ketamine is predicted to increase the risk of elevated blood

pressure when given with ergometrine.rTheoretical

▶ Letermovir is predicted to increase the concentration of

ergometrine. Avoid.rTheoretical

▶ Macrolides (clarithromycin) are predicted to increase the risk of

ergotism when given with

Theoretical

ergometrine. Avoid.r

▶ Macrolides (erythromycin) are predicted to increase the risk of

ergotism when given with ergometrine.rTheoretical

▶ Netupitant is predicted to increase the risk of ergotism when

given with ergometrine.rTheoretical

▶ Nilotinib is predicted to increase the risk of ergotism when

given with ergometrine.rTheoretical

▶ Ergometrine potentially increases the risk of peripheral

vasoconstriction when given with sympathomimetics, inotropic

(dopamine). Avoid.rAnecdotal

▶ Ergometrine is predicted to increase the risk of peripheral

vasoconstriction when given with sympathomimetics,

vasoconstrictor (noradrenaline/norepinephrine).rAnecdotal

Ergotamine

▶ Almotriptan is predicted to increase the risk of

vasoconstriction when given with ergotamine. Ergotamine

should be taken at least 24 hours before or 6 hours after

almotriptan.rTheoretical

▶ Antiarrhythmics (dronedarone) are predicted to increase the

risk of ergotism when given with ergotamine.rTheoretical

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the effects of

ergotamine.oTheoretical

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the risk of ergotism when given with

ergotamine.rTheoretical

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

predicted to increase the risk of ergotism when given with

ergotamine. Avoid.rTheoretical

▶ Antifungals, azoles (miconazole) are predicted to increase the

exposure to ergotamine. Avoid.oTheoretical

▶ Aprepitant is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Beta blockers, non-selective are predicted to increase the risk

r

of peripheral vasoconstriction when given with ergotamine.

Study

▶ Beta blockers, selective are predicted to increase the risk of

peripheral vasoconstriction when given with

r

ergotamine.

Study

▶ Bosentan

o

is predicted to decrease the effects of ergotamine.

Theoretical

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

increase the risk of ergotism when given with

r

ergotamine.

Theoretical

▶ Ceritinib is predicted to increase the exposure to ergotamine.

Avoid.rTheoretical

▶ Cobicistat is predicted to increase the risk of ergotism when

given with ergotamine. Avoid.rTheoretical

▶ Crizotinib is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Ergotamine is predicted to increase the risk of ergotism when

given with dopamine receptor agonists (bromocriptine,

cabergoline). Avoid.oTheoretical

▶ Ergotamine is predicted to increase the risk of ergotism when

Theoretical

given with dopamine receptor agonists (pergolide).o

▶ Efavirenz

o

is predicted to decrease the effects of ergotamine.

Theoretical

▶ Eletriptan increases the risk of vasoconstriction when given

with

Study

ergotamine. Separate administration by 24 hours.r

▶ Enzalutamide is predicted to decrease the effects of

ergotamine.oTheoretical

▶ Grapefruit juice is predicted to increase the exposure to

ergotamine.rTheoretical

▶ HIV-protease inhibitors are predicted to increase the risk of

ergotism when given with ergotamine. Avoid.rTheoretical

▶ Idelalisib is predicted to increase the risk of ergotism when

given with ergotamine. Avoid.rTheoretical

▶ Imatinib is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Letermovir is predicted to increase the concentration of

ergotamine. Avoid.rTheoretical

▶ Macrolides (clarithromycin) are predicted to increase the risk of

ergotism when given with ergotamine. Avoid.rTheoretical

▶ Macrolides (erythromycin) are predicted to increase the risk of

ergotism when given with ergotamine.rTheoretical

▶ Mitotane

o

is predicted to decrease the effects of ergotamine.

Theoretical

▶ Naratriptan is predicted to increase the risk of

vasoconstriction when given with ergotamine. Separate

administration by 24 hours.rTheoretical

▶ Netupitant is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Nevirapine

o

is predicted to decrease the effects of ergotamine.

Theoretical

▶ Nilotinib is predicted to increase the risk of ergotism when

given with ergotamine.rTheoretical

▶ Palbociclib is predicted to increase the exposure to

ergotamine. Adjust dose.oTheoretical

▶ Ribociclib (high-dose) is predicted to increase the exposure to

ergotamine. Avoid.oTheoretical

▶ Rifampicin

o

is predicted to decrease the effects of ergotamine.

Theoretical

▶ Rizatriptan is predicted to increase the risk of vasoconstriction

when given with ergotamine. Ergotamine should be taken at

least 24 hours before or 6 hours after

Theoretical

rizatriptan.r

▶ Rucaparib is predicted to increase the exposure to ergotamine.

Monitor and adjust dose.oStudy

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

ergotamine.oTheoretical

▶ Sumatriptan increases the risk of vasoconstriction when given

with ergotamine. Ergotamine should be taken at least 24 hours

before or 6 hours after sumatriptan.rStudy

▶ Ticagrelor is predicted to increase the exposure to ergotamine.

Avoid.rTheoretical

Eribulin → see TABLE 15 p. 1378 (myelosuppression), TABLE 12 p. 1378

(peripheral neuropathy), TABLE 9 p. 1377 (QT-interval prolongation)

Erlotinib

FOOD AND LIFESTYLE Dose adjustment may be necessary if

smoking started or stopped during treatment.

▶ Antacids are predicted to decrease the absorption of erlotinib.

Antacids should be taken 4 hours before or 2 hours after

erlotinib.oTheoretical

▶ Antiarrhythmics (amiodarone, dronedarone) are predicted to

increase the exposure to erlotinib.oTheoretical

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to erlotinib. Avoid or adjust erlotinib dose, p. 979.rStudy

▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)

are predicted to increase the exposure to

Theoretical

erlotinib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are

predicted to slightly increase the exposure to erlotinib. Use

with caution and adjust dose.oStudy

▶ Aprepitant

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Erlotinib is predicted to increase the risk of gastrointestinal

perforation when given with

Theoretical

aspirin (high-dose).r

BNF 78 Ergometrine — Erlotinib 1453

Interactions | Appendix 1

A1

Erlotinib (continued)

▶ Bosentan

r

is predicted to decrease the exposure to erlotinib.

Theoretical

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

increase the exposure to erlotinib.oTheoretical

▶ Ciclosporin

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Cobicistat is predicted to slightly increase the exposure to

erlotinib. Use with caution and adjust dose.oStudy

▶ Combined hormonal contraceptives slightly increase the

exposure to

o

erlotinib. Monitor side effects and adjust dose.

Study

▶ Corticosteroids increase the risk of gastrointestinal

perforation when given with erlotinib.rTheoretical

▶ Erlotinib

r

increases the anticoagulant effect of coumarins.

Anecdotal

▶ Crizotinib

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Efavirenz

r

is predicted to decrease the exposure to erlotinib.

Theoretical

▶ Enzalutamide is predicted to decrease the exposure to

erlotinib. Avoid or adjust erlotinib dose, p. 979.rStudy

▶ Grapefruit juice is predicted to increase the exposure to

erlotinib.oTheoretical

▶ H2 receptor antagonists are predicted to decrease the exposure

to erlotinib. Erlotinib should be taken 2 hours before or

10 hours after H2 receptor antagonists.oStudy

▶ HIV-protease inhibitors are predicted to slightly increase the

exposure to

o

erlotinib. Use with caution and adjust dose.

Study

▶ Idelalisib is predicted to slightly increase the exposure to

erlotinib. Use with caution and adjust dose.oStudy

▶ Imatinib

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Lapatinib

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Macrolides (azithromycin, erythromycin) are predicted to

increase the exposure to erlotinib.oTheoretical

▶ Macrolides (clarithromycin) are predicted to slightly increase

the exposure to

o

erlotinib. Use with caution and adjust dose.

Study

▶ Mexiletine slightly increases the exposure to erlotinib. Monitor

side effects and adjust dose.oStudy

▶ Mitotane is predicted to decrease the exposure to erlotinib.

Avoid or adjust erlotinib dose, p. 979.rStudy

▶ Netupitant

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Nevirapine

r

is predicted to decrease the exposure to erlotinib.

Theoretical

▶ Nilotinib

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Erlotinib is predicted to increase the risk of gastrointestinal

perforation when given with NSAIDs.rTheoretical

▶ Erlotinib is predicted to increase the risk of bleeding events

when given with phenindione.rTheoretical

▶ Proton pump inhibitors are predicted to slightly decrease the

exposure to erlotinib. Avoid.oStudy

▶ Quinolones (ciprofloxacin) slightly increase the exposure to

erlotinib. Monitor side effects and adjust dose.oStudy

▶ Ranolazine

o

is predicted to increase the exposure to erlotinib.

Theoretical

▶ Rifampicin is predicted to decrease the exposure to erlotinib.

Avoid or adjust erlotinib dose, p. 979.rStudy

▶ SSRIs (fluvoxamine) are predicted to increase the exposure to

erlotinib

Theoretical

. Monitor side effects and adjust dose.o ▶ St John’s Wort is predicted to decrease the exposure to

erlotinib.rTheoretical

▶ Vemurafenib

o

is predicted to increase the exposure to erlotinib.

Theoretical

Ertapenem → see carbapenems

Ertugliflozin → see TABLE 14 p. 1378 (antidiabetic drugs), TABLE 8

p. 1376 (hypotension)

Erythromycin → see macrolides

Escitalopram → see SSRIs

Esketamine → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS

depressant effects)

▶ Esketamine is predicted to increase the risk of seizures when

given with aminophylline. Avoid.rTheoretical

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to esketamine. Adjust dose.oTheoretical → Also see

TABLE 11 p. 1377

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

predicted to increase the exposure to

o

esketamine. Adjust dose.

Study

▶ Cobicistat is predicted to increase the exposure to esketamine.

Adjust dose.oStudy

▶ Enzalutamide is predicted to decrease the exposure to

esketamine. Adjust dose.oTheoretical

▶ Esketamine is predicted to increase the risk of elevated blood

pressure when given with

Theoretical

ergometrine. Avoid.r

▶ HIV-protease inhibitors are predicted to increase the exposure

to esketamine. Adjust dose.oStudy

▶ Idelalisib is predicted to increase the exposure to esketamine.

Adjust dose.oStudy

▶ Macrolides (clarithromycin) are predicted to increase the

exposure to esketamine. Adjust dose.oStudy

▶ Mitotane is predicted to decrease the exposure to esketamine.

Adjust dose.oTheoretical

▶ Rifampicin is predicted to decrease the exposure to

esketamine. Adjust dose.oTheoretical

▶ Esketamine is predicted to increase the risk of seizures when

given with theophylline. Avoid.rTheoretical

Eslicarbazepine → see antiepileptics

Esmolol → see beta blockers, selective

Esomeprazole → see proton pump inhibitors

Estramustine → see alkylating agents

Etanercept

▶ Anakinra is predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

etanercept. Avoid.rTheoretical

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

etanercept. Public Health England advises avoid (refer to

Green Book).rTheoretical

Etelcalcetide

▶ Cinacalcet increases the risk of hypocalcaemia when given

with etelcalcetide. Avoid.rTheoretical

Ethambutol

▶ Isoniazid increases the risk of optic neuropathy when given

with ethambutol.rAnecdotal

Ethosuximide → see antiepileptics

Etodolac → see NSAIDs

Etomidate → see TABLE 8 p. 1376 (hypotension), TABLE 11 p. 1377 (CNS

depressant effects)

Etonogestrel

▶ Antiepileptics (carbamazepine, eslicarbazepine, fosphenytoin,

oxcarbazepine, perampanel, phenobarbital, phenytoin,

primidone, rufinamide, topiramate) are predicted to decrease

the efficacy of etonogestrel. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

▶ Aprepitant is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Bosentan is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Efavirenz is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

etonogestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Griseofulvin decreases the efficacy of etonogestrel. For FSRH

guidance, see

Anecdotal

Contraceptives, interactions p. 794.r

1454 Erlotinib — Etonogestrel BNF 78

Interactions | Appendix 1

A1

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

efficacy of etonogestrel. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

▶ Modafinil is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Nevirapine is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Rifabutin is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

▶ Rifampicin is predicted to decrease the efficacy of etonogestrel.

For FSRH guidance, see

r

Contraceptives, interactions p. 794.

Theoretical

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

etonogestrel. MHRA advises avoid. For FSRH guidance, see

Contraceptives, interactions p. 794.rTheoretical

▶ Sugammadex is predicted to decrease the efficacy of

etonogestrel

Theoretical

. Use additional contraceptive precautions.r

▶ Ulipristal is predicted to decrease the efficacy of etonogestrel.

Avoid.rTheoretical

Etoposide → see TABLE 15 p. 1378 (myelosuppression)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the efficacy of

etoposide.oStudy

▶ Ciclosporin increases the exposure to etoposide. Monitor and

adjust dose.rStudy

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

etoposide. Public Health England advises avoid (refer to Green

Book).rTheoretical

▶ Netupitant

o

slightly increases the exposure to etoposide.

Study

Etoricoxib → see NSAIDs

Etravirine

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to etravirine. Avoid.rTheoretical

▶ Etravirine

o

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