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Interactions

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Managing specific interactions with smoking

31 October 2023When individuals taking certain medicines stop, start or re-start smoking, monitoring and dose changes may be needed.

Considering drug interactions with smoking

31 October 2023Tobacco smoke can induce liver enzymes, affecting drug metabolism. Some medicines may need dose adjustment or monitoring if a person stops or starts smoking.

Using nirmatrelvir and ritonavir (Paxlovid) in practice

30 June 2023Support for prescribing decisions in people on interacting medicines, those with swallowing difficulties, renal impairment, or who are pregnant or breastfeeding

Using clopidogrel with proton pump inhibitors (PPIs)

22 May 2023Avoid the combined use of clopidogrel with omeprazole or esomeprazole due to a significant interaction. Other PPIs are considered safe with clopidogrel.

Using bisphosphonates with proton pump inhibitors (PPIs)

4 April 2023Although no interaction between bisphosphonates and PPIs is documented, the increased risk of fractures when given together should be reviewed and managed

Identifying risk factors for developing a long QT interval

29 March 2023Some medicines (erythromycin, citalopram, ondansetron) can cause a long QT interval. Consider risk factors and follow MHRA recommendations for safe use.

Using contraception with enzyme-inducing medicines

13 February 2023Enzyme-inducing medicines reduce the effectiveness of certain contraceptives. Guidance on using contraception with these medicines is given.

Drug interactions: resources to support answering questions

19 January 2023Suggested resources to help primary care healthcare professionals find information to answer questions about drug interactions

Using warfarin with proton pump inhibitors (PPIs)

17 June 2022PPIs may enhance warfarin anticoagulation. Patients on warfarin require counselling when starting on a PPI and INR monitored appropriately.

Using miconazole oral gel with statins

30 November 2021Treatment of candidiasis with miconazole is complicated by concurrent HMG-CoA reductase inhibitor (statin) use because of potential for drug interactions.