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All our advice relating to medicine interactions, with recommendations on management options.

Training resources

Drug interactions: resources to support clinical decisions

Suggested resources to help healthcare professionals find information on drug interactions

Understanding enzyme or transporter-based drug interactions

Many interactions are due to inhibition or induction of metabolising enzymes or drug transporters. Enzyme, transporter, and drug half-lives dictate duration.

Understanding drug interactions

This article discusses different mechanisms of drug interactions. We link to other SPS articles to help support decision making.

Managing specific drug interactions

Our advice on the management of a specific drug interaction.

Commonly used medicines associated with QT interval prolongation

Examples of medicines known to prolong the QT interval. Medicines are grouped by therapeutic class and are not an exhaustive list.

Managing medicines associated with QT interval prolongation

Guidance on patient assessment and management of medicines associated with QT interval prolongation.

Considerations and interactions with GLP-1 receptor agonists

Signposting key risks and interactions of GLP-1 receptor agonists in diabetes, obesity, and weight management.

Managing interactions between medicines and enteral feeds

Learn about the types of feed, some of the most common medicine and feed interactions and how to manage them.

Managing interactions with methotrexate

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

Managing interactions with direct oral anticoagulants (DOACs)

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

Considering interactions with local anaesthetics in dentistry

Interpreting significance of drug interactions with dental local anaesthetic (LA) cartridges and why most aren’t clinically relevant in general dental practice.

Managing interactions with local anaesthetics in dentistry

Most drug interactions with local anaesthetics (LA) cartridges are not clinically relevant in general dentistry. We advise on management options where needed.

Managing interactions between macrolides and statins

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

Using folic acid and phenytoin safely

Folic acid interacts with phenytoin and can reduce phenytoin blood levels. Concomitant use is possible with careful management of the interaction.

Understanding direct oral anticoagulant (DOAC) interactions

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

Considering drug interactions with smoking

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

Managing specific interactions with smoking

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

Using clopidogrel with proton pump inhibitors (PPIs)

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

Complementary medicine interactions

Managing complementary products and conventional medicines

Considerations when managing interactions with supplements and complementary, herbal and alternative products, including homeopathy, Chinese and Ayurvedic.

Complementary products: resources to support answering questions

Resources for reviewing interactions with supplements and complementary, herbal and alternative products, including homeopathy, Chinese and Ayurvedic.

Advising on complementary products and conventional medicines

Decision making when advising on interactions with supplements and complementary, herbal and alternative products, including homeopathy, Chinese and Ayurvedic.