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Study

. Avoid or adjust enzalutamide dose, p. 947.r

▶ Fibrates are predicted to increase the risk of gallstones when

given with ezetimibe.rTheoretical

▶ Fibrates are predicted to increase the risk of hypoglycaemia

when given with insulins.oTheoretical

▶ Gemfibrozil is predicted to increase the exposure to irinotecan.

Avoid.oTheoretical

▶ Gemfibrozil is predicted to increase the concentration of

letermovir.oStudy

▶ Gemfibrozil is predicted to moderately increase the exposure

to montelukast.oStudy

▶ Fibrates are predicted to increase the anticoagulant effect of

phenindione. Monitor INR and adjust dose.rStudy

▶ Gemfibrozil increases the exposure to pioglitazone. Monitor

blood glucose and adjust dose.rStudy

▶ Gemfibrozil

r

increases the exposure to repaglinide. Avoid.

Study

▶ Gemfibrozil is predicted to increase the exposure to retinoids

(alitretinoin)

Theoretical

. Adjust alitretinoin dose, p. 1262.o ▶ Gemfibrozil increases the concentration of retinoids

(bexarotene). Avoid.rStudy

▶ Gemfibrozil

Study

increases the exposure to selexipag. Avoid.r

▶ Ciprofibrate increases the risk of rhabdomyolysis when given

with statins (atorvastatin). Avoid or adjust dose.rStudy

▶ Bezafibrate increases the risk of rhabdomyolysis when given

with statins (atorvastatin, fluvastatin).rStudy

▶ Fenofibrate increases the risk of rhabdomyolysis when given

with statins (atorvastatin, simvastatin). Adjust fenofibrate dose,

p. 199.rAnecdotal

▶ Ciprofibrate increases the risk of rhabdomyolysis when given

with statins (fluvastatin).rStudy

▶ Fenofibrate is predicted to increase the risk of rhabdomyolysis

when given with statins (fluvastatin). Adjust fenofibrate dose,

p. 199.rTheoretical

▶ Fenofibrate is predicted to increase the risk of rhabdomyolysis

when given with statins (pravastatin). Avoid.rTheoretical

▶ Fibrates (bezafibrate, ciprofibrate) increase the risk of

rhabdomyolysis when given with

r

statins (pravastatin). Avoid.

Study

▶ Fenofibrate increases the risk of rhabdomyolysis when given

with statins (rosuvastatin). Adjust fenofibrate and rosuvastatin

doses, p. 199, p. 204.rAnecdotal

▶ Fibrates (bezafibrate, ciprofibrate) increase the risk of

rhabdomyolysis when given with statins (rosuvastatin). Adjust

rosuvastatin dose, p. 204.rStudy

▶ Fibrates (bezafibrate, ciprofibrate) increase the risk of

rhabdomyolysis when given with statins (simvastatin). Adjust

simvastatin dose, p. 205.rStudy

▶ Gemfibrozil increases the risk of rhabdomyolysis when given

with statins. Avoid.rAnecdotal

▶ Fibrates are predicted to increase the risk of hypoglycaemia

when given with sulfonylureas.oTheoretical

▶ Gemfibrozil is predicted to increase the concentration of

taxanes (paclitaxel).rAnecdotal

▶ Fibrates are predicted to decrease the efficacy of

ursodeoxycholic acid. Avoid.rTheoretical

Fidaxomicin

▶ Antiarrhythmics (amiodarone, dronedarone) are predicted to

increase the exposure to fidaxomicin. Avoid.oStudy

▶ Antifungals, azoles (itraconazole, ketoconazole) are predicted to

increase the exposure to fidaxomicin. Avoid.oStudy

▶ Calcium channel blockers (verapamil) are predicted to increase

the exposure to fidaxomicin. Avoid.oStudy

▶ Ciclosporin is predicted to increase the exposure to

fidaxomicin. Avoid.oStudy

▶ HIV-protease inhibitors (lopinavir, ritonavir, saquinavir) are

predicted to increase the exposure to

o

fidaxomicin. Avoid.

Study

▶ Lapatinib is predicted to increase the exposure to fidaxomicin.

Avoid.oStudy

▶ Macrolides are predicted to increase the exposure to

fidaxomicin. Avoid.oStudy

▶ Ranolazine is predicted to increase the exposure to

fidaxomicin. Avoid.oStudy

▶ Vemurafenib is predicted to increase the exposure to

fidaxomicin. Avoid.oStudy

Fingolimod → see TABLE 6 p. 1376 (bradycardia), TABLE 9 p. 1377 (QTinterval prolongation)

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to fingolimod.oStudy

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

increase the exposure to

Theoretical → Also see TABLE 6

fingolimod

p. 1376

. Avoid.o ▶ Enzalutamide is predicted to decrease the exposure to

fingolimod.oStudy

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

fingolimod. Public Health England advises avoid (refer to

Green Book).rTheoretical

▶ Mitotane

o

is predicted to decrease the exposure to fingolimod.

Study

▶ Rifampicin

o

is predicted to decrease the exposure to fingolimod.

Study

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

fingolimod. Avoid.oTheoretical

Flavoxate → see TABLE 10 p. 1377 (antimuscarinics)

Flecainide → see antiarrhythmics

Flucloxacillin → see penicillins

Fluconazole → see antifungals, azoles

Flucytosine

▶ Amphotericin increases the risk of toxicity when given with

flucytosine.rStudy

▶ Cytarabine

r

decreases the concentration of flucytosine. Avoid.

Study

▶ Zidovudine increases the risk of haematological toxicity when

given with

Theoretical

flucytosine. Monitor and adjust dose.r

Fludarabine → see TABLE 15 p. 1378 (myelosuppression)

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

fludarabine. Public Health England advises avoid (refer to

Green Book).rTheoretical

▶ Fludarabine increases the risk of pulmonary toxicity when

given with pentostatin. Avoid.rStudy → Also see TABLE 15

p. 1378

Fludrocortisone → see corticosteroids

Fluocinolone

ROUTE-SPECIFIC INFORMATION With intravitreal use in adults:

caution with concurrent administration of anticoagulant or

antiplatelet drugs (higher incidence of conjunctival

haemorrhage).

Interactions do not generally apply to corticosteroids used for

topical action unless specified.

BNF 78 Fexofenadine — Fluocinolone 1457

Interactions | Appendix 1

A1

Fluorouracil → see TABLE 15 p. 1378 (myelosuppression), TABLE 5

p. 1375 (thromboembolism)

ROUTE-SPECIFIC INFORMATION Since systemic absorption can

follow topical application, the possibility of interactions

should be borne in mind.

▶ Fluorouracil increases the concentration of antiepileptics

(fosphenytoin, phenytoin). Monitor concentration and adjust

dose.rAnecdotal

▶ Fluorouracil

r

increases the anticoagulant effect of coumarins.

Anecdotal

▶ Folates (folic acid) are predicted to increase the risk of toxicity

when given with fluorouracil. Avoid.rTheoretical

▶ Folates (folinic acid) are predicted to increase the risk of

toxicity when given with fluorouracil. Monitor and adjust

dose.rTheoretical

▶ H2 receptor antagonists (cimetidine) slightly increase the

exposure to fluorouracil.rStudy

▶ Live vaccines are predicted to increase the risk of generalised

infection (possibly life-threatening) when given with

fluorouracil. Public Health England advises avoid (refer to

Green Book).rTheoretical

▶ Methotrexate potentially increases the risk of severe skin

reaction when given with topical

Anecdotal → Also see TABLE 15 p. 1378

fluorouracil

→ Also see TABLE 5

.r

p. 1375

▶ Metronidazole increases the risk of toxicity when given with

fluorouracil.rStudy

Fluoxetine → see SSRIs

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

depressant effects)

▶ Flupentixol is predicted to decrease the effects of dopamine

receptor agonists. Avoid.oTheoretical → Also see TABLE 8

p. 1376

▶ Flupentixol decreases the effects of levodopa. Avoid or monitor

worsening parkinsonian symptoms.rTheoretical → Also

see TABLE 8 p. 1376

Fluphenazine → see phenothiazines

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

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

exposure to flurazepam. Avoid.oTheoretical

Flurbiprofen → see NSAIDs

Fluticasone → see corticosteroids

Fluvastatin → see statins

Fluvoxamine → see SSRIs

Folates

folic acid . folinic acid . levofolinic acid. ▶ Folates are predicted to decrease the concentration of

antiepileptics (fosphenytoin, phenobarbital, phenytoin,

primidone)

Study

. Monitor concentration and adjust dose.r

▶ Folates are predicted to increase the risk of toxicity when

given with capecitabine.rAnecdotal

▶ Folic acid is predicted to increase the risk of toxicity when

given with fluorouracil. Avoid.rTheoretical

▶ Folinic acid is predicted to increase the risk of toxicity when

given with

Theoretical

fluorouracil. Monitor and adjust dose.r

▶ Folates

o

are predicted to alter the effects of raltitrexed. Avoid.

Study

▶ Sulfasalazine

o

is predicted to decrease the absorption of folates.

Study

▶ Folates are predicted to increase the risk of toxicity when

given with tegafur.rTheoretical

Folic acid → see folates

Folinic acid → see folates

Fondaparinux → see TABLE 3 p. 1375 (anticoagulant effects)

Formoterol → see beta2 agonists

Fosamprenavir → see HIV-protease inhibitors

Fosaprepitant

▶ Fosaprepitant is predicted to increase the exposure to

alkylating agents (ifosfamide).rTheoretical

▶ Fosaprepitant is predicted to increase the exposure to

alprazolam.oStudy

▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,

phenytoin, primidone) are predicted to decrease the exposure

to fosaprepitant. Avoid.oTheoretical

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

predicted to increase the exposure to

Theoretical

fosaprepitant.o ▶ Antifungals, azoles (posaconazole) are predicted to increase the

exposure to fosaprepitant.oStudy

▶ Bosentan is predicted to decrease the exposure to

fosaprepitant.oTheoretical

▶ Fosaprepitant is predicted to increase the exposure to

bosutinib.rTheoretical

▶ Cobicistat is predicted to increase the exposure to

fosaprepitant.oTheoretical

▶ Fosaprepitant is predicted to decrease the efficacy of combined

hormonal contraceptives. For FSRH guidance, see

Contraceptives, interactions p. 794.rStudy

▶ Fosaprepitant is predicted to decrease the anticoagulant effect

of coumarins.oTheoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

desogestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Efavirenz is predicted to decrease the exposure to

fosaprepitant.oTheoretical

▶ Enzalutamide is predicted to decrease the exposure to

fosaprepitant. Avoid.oTheoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

etonogestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Fosaprepitant is predicted to increase the concentration of

guanfacine.oTheoretical

▶ HIV-protease inhibitors are predicted to increase the exposure

to fosaprepitant.oTheoretical

▶ Fosaprepitant is predicted to decrease the effects of hormone

replacement therapy.oAnecdotal

▶ Fosaprepitant is predicted to slightly increase the exposure to

ibrutinib.oTheoretical

▶ Idelalisib is predicted to increase the exposure to

fosaprepitant.oTheoretical

▶ Fosaprepitant is predicted to increase the exposure to

intravenous irinotecan.rTheoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

levonorgestrel. For FSRH guidance, see Contraceptives,

interactions p. 794.rTheoretical

▶ Fosaprepitant is predicted to increase the exposure to

lomitapide

Theoretical

. Separate administration by 12 hours.o ▶ Macrolides (clarithromycin) are predicted to increase the

exposure to fosaprepitant.oTheoretical

▶ Fosaprepitant

o

slightly increases the exposure to midazolam.

Study

▶ Mitotane is predicted to decrease the exposure to

fosaprepitant. Avoid.oTheoretical

▶ Nevirapine is predicted to decrease the exposure to

fosaprepitant.oTheoretical

▶ Fosaprepitant is predicted to decrease the efficacy of

norethisterone. For FSRH guidance, see Contraceptives,

interactions p. 794.rAnecdotal

▶ Fosaprepitant is predicted to increase the exposure to

pimozide. Avoid.rTheoretical

▶ Rifampicin is predicted to decrease the exposure to

fosaprepitant. Avoid.oTheoretical

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

fosaprepitant. Avoid.oTheoretical

▶ Fosaprepitant decreases the efficacy of ulipristal. For FSRH

guidance, see

Anecdotal

Contraceptives, interactions p. 794.r

▶ Fosaprepitant is predicted to increase the exposure to vinca

alkaloids.rTheoretical

Foscarnet → see TABLE 2 p. 1375 (nephrotoxicity)

▶ Foscarnet increases the risk of hypocalcaemia when given with

pentamidine.rAnecdotal → Also see TABLE 2 p. 1375

Fosinopril → see ACE inhibitors

Fosphenytoin → see antiepileptics

Frovatriptan → see TABLE 13 p. 1378 (serotonin syndrome)

1458 Fluorouracil — Frovatriptan BNF 78

Interactions | Appendix 1

A1

▶ SSRI

rs (fluvoxamine) increase the concentration of frovatriptan.

Study → Also see TABLE 13 p. 1378

Fulvestrant → see TABLE 5 p. 1375 (thromboembolism)

Furosemide → see loop diuretics

Fusidic acid

ROUTE-SPECIFIC INFORMATION Interactions do not generally

apply to topical use unless specified.

▶ Fusidic acid increases the risk of rhabdomyolysis when given

with statins. Avoid.rAnecdotal

Gabapentin → see antiepileptics

Galantamine → see anticholinesterases, centrally acting

Ganciclovir → see TABLE 15 p. 1378 (myelosuppression), TABLE 2 p. 1375

(nephrotoxicity)

ROUTE-SPECIFIC INFORMATION Since systemic absorption can

follow topical application, the possibility of interactions

should be borne in mind.

▶ Ganciclovir is predicted to increase the risk of seizures when

given with carbapenems (imipenem). Avoid.rAnecdotal

▶ Ganciclovir

o

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