Kinase inhibitors: [P] Decreased metabolism of eplerenone with ceritinib, dasatinib, imatinib, idelalisib, and lapatinib.
Potassium-sparing diuretics: [P] Additive hyperkalemic effect. Potassium supplements: [P] Additive hyperkalemic effect; especially a problem in presence of renal impairment.
See also Azole antifungals; Digitalis glycosides; Macrolides; Nonsteroidal anti-inflammatory drugs.
Clofibrate: [P] Reduced glucuronide conjugation of clofibric acid. Methotrexate: [P] Decreased renal methotrexate excretion; possible methotrexate toxicity.
Pralatrexate: [P] Decreased renal pralatrexate excretion; possible pralatrexate toxicity. Penicillin: [P] Decreased renal penicillin excretion. Salicylates: [P] Decreased uricosuric effect of probenecid (interaction unlikely with less than 1.5 g of salicylate daily). Acetazolamide: [P] Decreased renal quinidine excretion due to increased urinary pH; elevated serum quinidine. Amiodarone: [NP] Increased serum quinidine levels; additive prolongation of QTc interval. Antivirals: [P] Amprenavir, atazanavir, boceprevir, darunavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, simeprevir, and telaprevir inhibit the metabolism of quinidine. Boceprevir: [P] Decreased metabolism of quinidine. Cobicistat: [P] Decreased metabolism of quinidine. Conivaptan: [P] Decreased metabolism of quinidine. Kaolin-pectin: [NE] Decreased gastrointestinal absorption of quinidine. Kinase inhibitors: [P] Decreased metabolism of quinidine with ceritinib, dasatinib, imatinib, idelalisib, and lapatinib. Rifampin: [P] Increased quinidine metabolism. Thioridazine: [NE] Decreased thioridazine metabolism; additive prolongation of QTc interval.
See also Anticoagulants, oral; Antidepressants, tricyclic; Azole antifungals; Barbiturates; Cimetidine; Digitalis glycosides; Macrolides; Phenytoin. Caffeine: [P] Ciprofloxacin, enoxacin, and, to a lesser extent, norfloxacin inhibit caffeine metabolism.
Frovatriptan: [P] Ciprofloxacin, enoxacin, and, to a lesser extent, norfloxacin inhibit frovatriptan metabolism. Ropinirole: [P] Ciprofloxacin, enoxacin, and, to a lesser extent, norfloxacin inhibit ropinirole metabolism.
Sucralfate: [HP] Reduced gastrointestinal absorption of ciprofloxacin, norfloxacin, and probably other quinolones. Theophylline: [P] Ciprofloxacin, enoxacin, and, to a lesser extent, norfloxacin inhibit theophylline metabolism.
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.
TABLE 66–1 Important drug interactions.