Interactions

Managing interactions with direct oral anticoagulants (DOACs)

5 January 2024Interactions with apixaban, dabigatran, edoxaban or rivaroxaban can result in increased risks of a bleed or thrombosis. We advise on management options.

Understanding direct oral anticoagulant (DOAC) interactions

5 January 2024It is important to understand the risks, mechanisms of interactions and actions to take when prescribing medicines with DOACs.

Managing interactions with methotrexate

28 December 2023Guidance on frequently asked questions on medicine interactions with low dose methotrexate.

Managing interactions between macrolides and statins

24 November 2023The use of statins can be continued with azithromycin. However, the interaction risks need to be managed if clarithromycin or erythromycin are required.

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 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.