▶ Oral hormone replacement therapy is predicted to decrease the
effects of thyroid hormones.oTheoretical
Hydralazine → see TABLE 8 p. 1376 (hypotension)
▶ Diazoxide increases the risk of severe hypotension when given
with hydralazine.rStudy → Also see TABLE 8 p. 1376
Hydrochlorothiazide → see thiazide diuretics
Hydrocortisone → see corticosteroids
Hydroflumethiazide → see thiazide diuretics
Hydroxycarbamide → see TABLE 15 p. 1378 (myelosuppression)
▶ Hydroxycarbamide increases the risk of toxicity when given
▶ Live vaccines are predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
hydroxycarbamide. Public Health England advises avoid (refer
▶ Hydroxycarbamide increases the risk of toxicity when given
▶ Hydroxychloroquine is predicted to decrease the effects of
▶ Antacids decrease the absorption of hydroxychloroquine.
Separate administration by at least 4 hours.oStudy
▶ Calcium salts (calcium carbonate) decrease the absorption of
hydroxychloroquine. Separate administration by at least
▶ Hydroxychloroquine is predicted to decrease the efficacy of
oral cholera vaccine.oTheoretical
▶ H2 receptor antagonists (cimetidine) are predicted to decrease
the clearance of hydroxychloroquine.oTheoretical
▶ Lanthanum is predicted to decrease the absorption of
hydroxychloroquine. Separate administration by at least
▶ Hydroxychloroquine is predicted to decrease the exposure to
. Avoid simultaneous administration.r
▶ Hydroxychloroquine is predicted to increase the risk of
haematological toxicity when given with
▶ Hydroxychloroquine is predicted to decrease efficacy rabies
Hydroxyzine → see antihistamines, sedating
Hyoscine → see TABLE 10 p. 1377 (antimuscarinics)
Ibandronic acid → see bisphosphonates
Ibrutinib → see TABLE 15 p. 1378 (myelosuppression), TABLE 4 p. 1375
FOOD AND LIFESTYLE Avoid food or drink containing bitter
(Seville) oranges as they are predicted to increase the
▶ Antiarrhythmics (amiodarone) are predicted to increase the
ibrutinib. Adjust ibrutinib dose, p. 983.r
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to ibrutinib. Adjust ibrutinib dose with moderate
inhibitors of CYP3A4, p. 983.rStudy
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to ibrutinib. Avoid or adjust ibrutinib dose, p. 983.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to ibrutinib. Adjust
1468 HIV-protease inhibitors — Ibrutinib BNF 78
dose with moderate inhibitors of CYP3A4, p. 983.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to very markedly increase the exposure to ibrutinib.
Avoid potent inhibitors of CYP3A4 or adjust ibrutinib dose,
▶ Aprepitant is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose with moderate inhibitors of CYP3A4,
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ibrutinib. Adjust ibrutinib dose with
moderate inhibitors of CYP3A4, p. 983.rStudy
▶ Cobicistat is predicted to very markedly increase the exposure
to ibrutinib. Avoid potent inhibitors of CYP3A4 or adjust
▶ Crizotinib is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose with moderate inhibitors of CYP3A4,
p. 983.rStudy → Also see TABLE 15 p. 1378
▶ Enzalutamide is predicted to decrease the exposure to
ibrutinib. Avoid or adjust ibrutinib dose, p. 983.rStudy
▶ Fosaprepitant is predicted to slightly increase the exposure to
▶ Grapefruit juice is predicted to increase the exposure to
▶ HIV-protease inhibitors are predicted to very markedly increase
the exposure to ibrutinib. Avoid potent inhibitors of CYP3A4
or adjust ibrutinib dose, p. 983.rStudy
▶ Idelalisib is predicted to very markedly increase the exposure
to ibrutinib. Avoid potent inhibitors of CYP3A4 or adjust
ibrutinib dose, p. 983.rStudy → Also see TABLE 15 p. 1378
▶ Imatinib is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose with moderate inhibitors of CYP3A4,
p. 983.rStudy → Also see TABLE 15 p. 1378
▶ Macrolides (clarithromycin) are predicted to very markedly
increase the exposure to ibrutinib. Avoid potent inhibitors of
CYP3A4 or adjust ibrutinib dose, p. 983.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ibrutinib. Adjust ibrutinib dose with moderate
inhibitors of CYP3A4, p. 983.rStudy
▶ Mitotane is predicted to decrease the exposure to ibrutinib.
Avoid or adjust ibrutinib dose, p. 983.rStudy → Also see
▶ Netupitant is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose with moderate inhibitors of CYP3A4,
▶ Nilotinib is predicted to increase the exposure to ibrutinib.
Adjust ibrutinib dose with moderate inhibitors of CYP3A4,
p. 983.rStudy → Also see TABLE 15 p. 1378
▶ Quinolones (ciprofloxacin) are predicted to increase the
ibrutinib. Adjust ibrutinib dose, p. 983.r
▶ Rifampicin is predicted to decrease the exposure to ibrutinib.
Avoid or adjust ibrutinib dose, p. 983.rStudy
▶ St John’s Wort is predicted to decrease the exposure to
▶ ACE inhibitors are predicted to decrease the efficacy of
icatibant and icatibant is predicted to decrease the efficacy of
ACE inhibitors. Avoid.oTheoretical
Idarubicin → see anthracyclines
Idelalisib → see TABLE 15 p. 1378 (myelosuppression)
▶ Idelalisib is predicted to increase the exposure to abemaciclib.
Avoid or adjust abemaciclib dose, p. 967.rStudy
▶ Idelalisib is predicted to markedly increase the exposure to
aldosterone antagonists (eplerenone). Avoid.rStudy
▶ Idelalisib increases the exposure to almotriptan.nStudy
▶ Idelalisib is predicted to moderately increase the exposure to
alpha blockers (alfuzosin, tamsulosin). Use with caution or
▶ Idelalisib is predicted to increase the exposure to alpha blockers
▶ Idelalisib moderately increases the exposure to alprazolam.
▶ Idelalisib is predicted to increase the exposure to
antiarrhythmics (amiodarone). Avoid.oTheoretical
▶ Idelalisib very markedly increases the exposure to
antiarrhythmics (dronedarone). Avoid.rStudy
▶ Idelalisib is predicted to increase the exposure to
antiarrhythmics (propafenone). Monitor and adjust dose.r
▶ Idelalisib is predicted to increase the exposure to
anticholinesterases, centrally acting (galantamine). Monitor and
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
▶ Idelalisib is predicted to very slightly increase the exposure to
antiepileptics (perampanel).nStudy
▶ Idelalisib is predicted to increase the exposure to antifungals,
azoles (isavuconazole). Avoid or monitor side effects.r
▶ Idelalisib is predicted to increase the exposure to
antihistamines, non-sedating (mizolastine). Avoid.rStudy
▶ Idelalisib is predicted to increase the exposure to
antihistamines, non-sedating (rupatadine). Avoid.oStudy
▶ Idelalisib is predicted to increase the concentration of
antimalarials (piperaquine).rTheoretical
▶ Idelalisib is predicted to increase the exposure to apalutamide.
▶ Idelalisib is predicted to markedly increase the exposure to
▶ Idelalisib is predicted to slightly increase the exposure to
aripiprazole. Adjust aripiprazole dose, p. 395.oStudy
▶ Idelalisib is predicted to increase the exposure to axitinib.
Avoid or adjust dose.oStudy → Also see TABLE 15 p. 1378
▶ Idelalisib is predicted to increase the exposure to bedaquiline.
▶ Idelalisib is predicted to increase the exposure to beta2 agonists
slightly increases the exposure to bortezomib.
Study → Also see TABLE 15 p. 1378
▶ Bosentan is predicted to decrease the exposure to idelalisib.
▶ Idelalisib is predicted to markedly increase the exposure to
bosutinib. Avoid or adjust dose.rStudy → Also see TABLE 15
▶ Idelalisib is predicted to increase the exposure to brigatinib.
Adjust brigatinib dose, p. 971.rStudy
▶ Idelalisib is predicted to increase the exposure to buspirone.
Adjust buspirone dose, p. 342.rStudy
slightly increases the exposure to cabozantinib.
Study → Also see TABLE 15 p. 1378
▶ Idelalisib is predicted to increase the exposure to calcium
channel blockers (amlodipine, felodipine, lacidipine, nicardipine,
. Monitor and adjust dose.o ▶ Idelalisib is predicted to increase the exposure to calcium
channel blockers (diltiazem, verapamil).rStudy
▶ Idelalisib is predicted to markedly increase the exposure to
calcium channel blockers (lercanidipine). Avoid.rStudy
▶ Idelalisib is predicted to increase the exposure to cannabis
extract. Use with caution and adjust dose.oTheoretical
▶ Idelalisib is predicted to moderately increase the exposure to
▶ Idelalisib is predicted to increase the exposure to ceritinib.
Avoid or adjust ceritinib dose, p. 973.rStudy → Also see
increases the concentration of ciclosporin.r
▶ Idelalisib is predicted to moderately increase the exposure to
cilostazol. Adjust cilostazol dose, p. 232.oStudy
▶ Idelalisib is predicted to moderately increase the exposure to
cinacalcet. Adjust dose.oStudy
▶ Idelalisib is predicted to markedly increase the exposure to
cobimetinib. Avoid or monitor for toxicity.rStudy
▶ Idelalisib is predicted to increase the exposure to colchicine.
Avoid potent inhibitors of CYP3A4 or adjust colchicine dose,
BNF 78 Ibrutinib — Idelalisib 1469
▶ Idelalisib is predicted to increase the exposure to
corticosteroids (beclometasone) (risk with beclometasone is
corticosteroids (betamethasone, budesonide, ciclesonide,
deflazacort, dexamethasone, fludrocortisone, fluticasone,
hydrocortisone, methylprednisolone, mometasone,
. Avoid or monitor side effects.
▶ Idelalisib is predicted to moderately increase the exposure to
crizotinib. Avoid.oStudy → Also see TABLE 15 p. 1378
▶ Idelalisib is predicted to increase the exposure to dabrafenib.
Use with caution or avoid.oStudy → Also see TABLE 15
▶ Idelalisib is predicted to markedly to very markedly increase
the exposure to darifenacin. Avoid.rStudy
▶ Idelalisib is predicted to markedly increase the exposure to
. Avoid or adjust dose—consult product literature.
Study → Also see TABLE 15 p. 1378
very slightly increases the exposure to delamanid.
▶ Idelalisib increases the risk of QT-prolongation when given
with domperidone. Avoid.rStudy
▶ Idelalisib increases the exposure to dopamine receptor agonists
▶ Idelalisib is predicted to increase the concentration of
dopamine receptor agonists (cabergoline).oAnecdotal
▶ Idelalisib is predicted to increase the exposure to doravirine.
▶ Idelalisib is predicted to increase the exposure to dutasteride.
Monitor side effects and adjust dose.oTheoretical
▶ Efavirenz is predicted to decrease the exposure to idelalisib.
▶ Idelalisib is predicted to markedly increase the exposure to
▶ Idelalisib is predicted to increase the exposure to eliglustat.
Avoid or adjust dose—consult product literature.rStudy
▶ Idelalisib is predicted to increase the exposure to encorafenib.
▶ Enzalutamide is predicted to decrease the exposure to
▶ Idelalisib is predicted to increase the risk of ergotism when
given with ergometrine. Avoid.rTheoretical
▶ Idelalisib is predicted to increase the risk of ergotism when
given with ergotamine. Avoid.rTheoretical
▶ Idelalisib is predicted to slightly increase the exposure to
erlotinib. Use with caution and adjust dose.oStudy
▶ Idelalisib is predicted to increase the exposure to esketamine.
▶ Idelalisib is predicted to increase the concentration of
everolimus. Avoid.rStudy → Also see TABLE 15 p. 1378
▶ Idelalisib is predicted to moderately increase the exposure to
fesoterodine. Adjust fesoterodine dose with potent inhibitors
of CYP3A4; avoid in hepatic and renal impairment,
▶ Idelalisib is predicted to increase the exposure to
is predicted to increase the exposure to gefitinib.
Study → Also see TABLE 15 p. 1378
▶ Idelalisib is predicted to moderately to markedly increase the
exposure to grazoprevir. Avoid.rStudy
▶ Idelalisib is predicted to increase the exposure to guanfacine.
Adjust guanfacine dose, p. 352.oStudy
▶ Idelalisib is predicted to very markedly increase the exposure
to ibrutinib. Avoid potent inhibitors of CYP3A4 or adjust
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