Page 1177 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 66 Important Drug Interactions & Their Mechanisms 1163

TABLE 66–1 Important drug interactions.

Drug or Properties Promoting
Drug Group Drug Interaction Clinically Documented Interactions
Carbamazepine Haloperidol: [P] Increased haloperidol metabolism.
(cont.)
Isoniazid: [P] Decreased carbamazepine metabolism.
Kinase inhibitors: [P] Decreased metabolism of carbamazepine with ceritinib,
dasatinib, imatinib, idelalisib, and lapatinib. Increased metabolism of kinase inhibitors.
Macrolide antibiotics: [P] Clarithromycin and erythromycin inhibit the metabolism of
carbamazepine.
Nefazodone: [NE] Decreased carbamazepine metabolism.
Opioid analgesics: [P] Increased elimination of alfentanil, fentanyl, methadone,
oxycodone, and sufentanil.
Rifampin: [P] Increased carbamazepine metabolism.
Selective serotonin reuptake inhibitors (SSRIs): [NE] Fluoxetine and fluvoxamine
decrease carbamazepine metabolism.
Sirolimus: [P] Increased sirolimus metabolism.
St. John’s wort: [P] Increased carbamazepine metabolism.
Tacrolimus: [P] Increased tacrolimus metabolism.
Theophylline: [NE] Increased theophylline metabolism.
See also Anticoagulants, oral; Antidepressants, tricyclic; Azole antifungals; Calcium
channel blockers.
Cimetidine Inhibits hepatic microsomal drug- Antivirals: [P] Decreased metabolism of amprenavir, atazanavir, boceprevir, daclatasvir,
metabolizing enzymes. (Ranitidine, darunavir, delavirdine, etravirine, fosamprenavir, indinavir, lopinavir, maraviroc,
famotidine, and nizatidine do nelfinavir, rilpivirine, ritonavir, saquinavir, and tipranavir.
not.) May inhibit the renal tubular
secretion of weak bases. Benzodiazepines: [P] Decreased metabolism of alprazolam, chlordiazepoxide, diazepam,
halazepam, prazepam, and clorazepate but not oxazepam, lorazepam, or temazepam.
Carmustine: [NE] Increased bone marrow suppression.
Dofetilide: [NP] Decreased renal excretion of dofetilide.
Lidocaine: [P] Decreased metabolism of lidocaine.
Opioid analgesics: [P] Decreased elimination of alfentanil, fentanyl, methadone,
oxycodone, and sufentanil.
Phenytoin: [NE] Decreased phenytoin metabolism.
Procainamide: [P] Decreased renal excretion of procainamide.
Quinidine: [P] Decreased metabolism of quinidine.
Theophylline: [P] Decreased theophylline metabolism.
See also Anticoagulants, oral; Antidepressants, tricyclic; Azole antifungals;
β-Adrenoceptor blockers; Calcium channel blockers; Carbamazepine.
Cisapride Susceptible to induction and Amiodarone: [NP] Decreased cisapride metabolism. Expect similar interaction with
inhibition of metabolism by dronedarone.
CYP3A4 inhibitors. High cisapride
serum concentrations can result in Antivirals: [P] Amprenavir, atazanavir, boceprevir, darunavir, delavirdine, fosamprenavir,
ventricular arrhythmias. indinavir, nelfinavir, ritonavir, saquinavir, simeprevir, and telaprevir inhibit the metabolism
of cisapride.
Cobicistat: [P] Decreased metabolism of cisapride.
Conivaptan: [P] Decreased metabolism of cisapride.
Cyclosporine: [NE] Decreased metabolism of cisapride.
Kinase inhibitors: [P] Decreased metabolism of cisapride with ceritinib, dasatinib,
imatinib, idelalisib, and lapatinib.
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.
(continued )