Page 1174 - Basic _ Clinical Pharmacology ( PDFDrive )

1160 SECTION X Special Topics

TABLE 66–1 Important drug interactions.

Drug or Properties Promoting
Drug Group Drug Interaction Clinically Documented Interactions
Azole Eplerenone: [P] Decreased metabolism of eplerenone.
antifungals
(cont.) Ergot alkaloids: [P] Decreased metabolism of ergot alkaloids.
HMG-CoA reductase inhibitors: [HP] Decreased metabolism of lovastatin, simvastatin,
and, to a lesser extent, atorvastatin.
Opioid analgesics: [P] Decreased elimination of alfentanil, fentanyl, methadone,
oxycodone, and sufentanil.
Quinidine: [P] Decreased metabolism of quinidine.
Phenytoin: [P] Decreased metabolism of phenytoin with fluconazole and probably
voriconazole.
Phosphodiesterase inhibitors: [P] Decreased metabolism of phosphodiesterase inhibitor.
Pimozide: [NE] Decreased pimozide metabolism.
Rifabutin: [P] Decreased rifabutin metabolism. Increased metabolism of itraconazole,
ketoconazole, and voriconazole.
Rifampin: [P] Increased metabolism of itraconazole, ketoconazole, and voriconazole.
Sirolimus: [P] Decreased elimination of sirolimus.
Tacrolimus: [P] Decreased elimination of tacrolimus.
See also Acid-Reducing Agents; Anticoagulants, oral.
Barbiturates Induction of hepatic microsomal Antivirals: Increased metabolism of antivirals amprenavir, atazanavir, boceprevir,
drug metabolizing enzymes and darunavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir,
P-glycoprotein. Additive central simeprevir, and telaprevir with barbiturates.
nervous system depression with
other central nervous system Beta-adrenoceptor blockers: [P] Increased β-blocker metabolism.
depressants. Calcium channel blockers: [P] Increased calcium channel blocker metabolism.
Central nervous system depressants: [HP] Additive central nervous system depression.
Corticosteroids: [P] Increased corticosteroid metabolism.
Cyclosporine: [NE] Increased cyclosporine metabolism.
Doxycycline: [P] Increased doxycycline metabolism.
Estrogens: [P] Increased estrogen metabolism.
Kinase inhibitors: [P] Increased metabolism of axitinib, bosutinib, ceritinib, cabozantinib,
cobimetinib, crizotinib, dabrafenib, dasatinib, erlotinib, gefitinib, ibrutinib, idelalisib, imatinib,
ixazomib, lapatinib, nilotinib, nintedanib, olaparib, osimertinib, palbociclib, pazopanib,
ponatinib, regorafenib, ruxolitinib, sunitinib, tofacitinib, vandetanib, vemurafenib.
Methadone: [NE] Increased methadone metabolism.
Opioid analgesics: [P] Increased elimination of alfentanil, fentanyl, methadone,
oxycodone, and sufentanil.
Phenothiazine: [P] Increased phenothiazine metabolism.
Phenytoin: [P] Increased phenytoin metabolism.
Quinidine: [P] Increased quinidine metabolism.
Sirolimus: [NE] Increased sirolimus metabolism.
Tacrolimus: [NE] Increased tacrolimus metabolism.
Theophylline: [NE] Increased theophylline metabolism.
Valproic acid: [P] Decreased phenobarbital metabolism.
See also Anticoagulants, oral; Antidepressants, tricyclic.
E, Expected; HP, Highly predictable. Interaction occurs in almost all patients receiving the interacting combination; P, Predictable. Interaction occurs in most patients receiving the
combination; NP, Not predictable. Interaction occurs only in some patients receiving the combination; NE, Not established. Insufficient data available on which to base estimate
of predictability.
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