Interactions with PBC Agents

www.hep-druginteractions.org

Interactions with PBC Agents

Charts created August 2019. Full information available at www.hep-druginteractions.org Page 1 of 4 Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister.

Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycholic Acid Acid Acid Acid Acid Acid Anaesthetics & Muscle Relaxants Antibacterials (continued) Antidepressants Bupivacaine   Dapsone   Agomelatine  Cisatracurium   Delamanid   Amitriptyline  Isoflurane   Ertapenem   Bupropion   Ketamine   Erythromycin   Citalopram   Nitrous oxide   Ethambutol   Clomipramine  Propofol   Flucloxacillin   Desipramine  Thiopental   Gentamicin   Desvenlafaxine  

Tizanidine  Imipenem   Dosulepin  Analgesics Isoniazid  Doxepin  Aceclofenac   Levofloxacin   Duloxetine   Alfentanil   Linezolid  Escitalopram   Aspirin   Lymecycline   Fluoxetine   Buprenorphine     Meropenem   Fluvoxamine Celecoxib   Imipramine  Methenamine   Codeine  distribution. for Lithium   Metronidazole   Dexketoprofen   Maprotiline  Moxifloxacin   Dextropropoxyphene  Mianserin   Nitrofurantoin   Diamorphine  Milnacipran     Diclofenac   Norfloxacin Mirtazapine  Diflunisal   Ofloxacin   Moclobemide   Dihydrocodeine  Penicillin V   Nefazodone   Etoricoxib  Piperacillin   Nortriptyline  Fentanyl   Pivmecillinam   Paroxetine   Flurbiprofen   Pyrazinamide   Sertraline   Hydrocodone  distribution. for Not only. use ersonal Rifabutin Tianeptine   Hydromorphone  Rifampicin Trazodone   Ibuprofen   Rifapentine  Trimipramine  Indometacin  Rifaximin  Venlafaxine   Ketoprofen   Spectinomycin   Vortioxetine   Mefenamic acid   Streptomycin   Meloxicam  Antidiabetics Sulfadiazine   Metamizole (Dipyrone)   Acarbose   Tazobactam   Methadone  Albiglutide     Morphine   Telithromycin Alogliptin   Naproxen   Temocillin   Canagliflozin  

Oxycodone  Tetracyclines   Not only. use For personal for distribution. Dapagliflozin   Paracetamol   Ticarcillin   Dulaglutide   Pethidine (Meperidine)  Trimethoprim/Sulfamethoxazole   Empagliflozin   Piroxicam   Troleandomycin   Exenatide   Tapentadol  Vancomycin   Glibenclamide (Glyburide)  Tramadol  Anticoagulant, Antiplatelet & Fibrinolytic Gliclazide   Anthelmintics Acenocoumarol Glimepiride  Albendazole   Anagrelide Glipizide  nal use only. Not for distribution. For p for distribution. Not only. use nal Ivermectin   Apixaban  Insulin   Oxamniquine   Clopidogrel  Linagliptin   Praziquantel  Dabigatran  Liraglutide   Pyrantel   r perso Dalteparin   Lixisenatide   Danaparoid   Antiarrhythmics Metformin   Dipyridamole   Amiodarone Nateglinide   Edoxaban  Bepridil  Pioglitazone  Eltrombopag   Digoxin   Repaglinide  Disopyramide   Enoxaparin   Rosiglitazone   Dofetilide  Fluindione Saxagliptin   Dronedarone Fondaparinux   Flecainide  Heparin   Sitagliptin   Lidocaine (Lignocaine)   Phenprocoumon  Tolbutamide  Mexiletine  Prasugrel   Vildagliptin   Propafenone  Rivaroxaban  Antifungals Quinidine  Streptokinase   Amphotericin B   Vernakalant   Ticagrelor   Anidulafungin   Antibacterials Ticlodipine   Caspofungin   Amikacin   Tinazaparin   Fluconazole   Amoxicillin   Warfarin  Flucytosine   Ampicillin   Anticonvulsants Griseofulvin   Azithromycin   Carbamazepine  Isavuconazole   Aztreonam   Clonazepam   Itraconazole  Bedaquiline   Eslicarbazepine   Ketoconazole  Benzylpenicillin   Ethosuximide   For personal use only. Not for distribution. Fo for distribution. Not only. use For personal For personal use only. Not for distribution. For personal use only. Not Not only. use For personal for distribution. Not only. use For personal Miconazole   Gabapentin   Capreomycin   Nystatin   Lacosamide   Cefaclor   Posaconazole  Cefadroxil   Lamotrigine   Terbinafine   Cefalexin   Levetiracetam   Voriconazole  Cefazolin   Oxcarbazepine   Cefixime   Perampanel   Cefotaxime   Phenobarbital  Cefradine   Phenytoin  Ceftaroline   Pregabalin   Ceftazidine   Primidone   Ceftriazone   Retigabine   Cefuroxime   Rufinamide   Chloramphenicol   Sultiame   Ciprofloxacin   Tiagabine   Clarithromycin   Topiramate   Clavulanic acid   Valproate (Divalproex)   Clindamycin  Vigabatrin   Cloxacillin   Zonisamide  

Key to symbols Notes  Further information is available at © Liverpool Drug Interactions Group,  These drugs should not be coadministered www.hep-druginteractions.org University of Liverpool, Pharmacology Research Labs, Potential clinically significant interaction that is likely to require additional  Predicted interactions are based on known 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF  monitoring, alteration of drug dosage or timing of administration metabolic pathways and routes of clearance. We aim to ensure that information is accurate and consistent with current knowledge Potential interaction likely to be of weak intensity. Additional  Caution is required in patients with hepatic and practice. However, the University of Liverpool and its servants or agents shall action/monitoring or dosage adjustment is unlikely to be required impairment as this may also increase drug levels not be responsible or in any way liable for the continued currency of information in and require dose modification. this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude  No clinically significant interaction expected  Where advice differs between countries, the liability for errors, omissions or inaccuracies to the fullest extent permitted by law.

charts reflect the more cautious option.

www.hep-druginteractions.org

Interactions with PBC Agents

Charts created August 2019. Full information available at www.hep-druginteractions.org Page 2 of 4 Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister.

Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycholic Acid Acid Acid Acid Acid Acid Antihistamines Antivirals Cancer Therapies Astemizole Aciclovir   Abiraterone   Bilastine   Amantadine   Acalabrutinib  Cetirizine   Brivudine   Anastrozole   Chlorphenamine  Cidofovir   Avelumab   Desloratadine   Foscarnet   Axitinib   Diphenhydramine   Oseltamivir   Bevacizumab   Doxylamine   Blinatumomab  

Rimantadine   Ebastine   Valaciclovir   Bortezomib   Fexofenadine   Zanamivir   Bosutinib   Hydroxyzine   Brentuximab vedotin   Anxiolytics/Hypnotics/Sedatives Levocetirizine   Capecitabine   Alprazolam   Loratadine   Carboplatin   Amobarbital  Promethazine   Cetuximab   Terfenadine  Bromazepam   for distribution. for Chlorambucil  Antimigraine Agents Bromperidol   Cisplatin   Almotriptan   Buspirone   Daratumumab   Dihydoergotamine   Clobazam   Dasatinib   Eletriptan   Clorazepate   Doxorubicin   Ergotamine  Clotiapine   Erlotinib  Frovatriptan   Diazepam   Estramustine  Methylergonovine  Estazolam   Etoposide   Naratriptan   Flurazepam   Everolimus  Pizotifen  

ersonal use only. Not for distribution. for Not only. use ersonal Lorazepam   Exemestane  Rizatriptan   Lormetazepam   Fludarabine   Sumatriptan   Midazolam (oral)  Gefitinib   Zolmiptriptan   Midazolam (parenteral)  Gemcitabine   Antiprotozoals Oxazepam   Idarubicin  Amodiaquine  Imatinib  Artemether   Quazepam   Ipilimumab   Artemisinin   Temazepam   Irinotecan   Artesunate   Triazolam   Ixazomib   Atovaquone  Zaleplon   Lapatinib   Chloroquine  Zolpidem  

Dihydroartemisinin   Zopiclone   Not only. use For personal for distribution. Letrozole   Mercaptopurine   Doxycycline   Beta Blockers Methotrexate   Halofantrine  Atenolol   Hydroxychloroquine   Bisoprolol   Mitoxantrone   Lumefantrine   Carvediol  Nilotinib   Mefloquine   Celiprolol  Niraparib   Pentamidine   Labetalol  Nivolumab   Primaquine  Obinutuzumab  

nal use only. Not for distribution. For p for distribution. Not only. use nal Metoprolol   Proguanil   Nebivolol  Ofatumumab   Pyrimethamine  Oxprenolol   Olaratumab   Quinine  Pindolol   Oxaliplatin   r perso Sodium stibogluconate   Propanolol  Paclitaxel  Sulfadoxine   Sotalol   Panitumumab   Antipsychotics/Neuroleptics Timolol  Pembrolizumab   Amisulpride   Bisphosphonates Rituximab   Aripiprazole   Alendronic acid   Sorafenib   Asenapine  Clodronate   Sunitinib Tamoxifen   Chlorpromazine   Ibandronic acid   Chlorprothixene  Temsirolimus   Pamidronate   Clozapine   Vinblastine   Risedronate   Flupentixol  Vincristine   Fluphenazine  Bronchodilators Vinorelbine   Haloperidol  Formoterol   Contraceptives and Hormone Replacements Indacaterol   Iloperidone Desogestrel   Ipatropium bromide   Levomepromazine   Dienogest    Montelukast   Olanzapine  Drospirenone   Paliperidone  Omalizumab   Estradiol   Perazine   Salbutamol   Ethinylestradiol   Periciazine   Salmeterol   Etonogestrel (implant)   Perphenazine   Theophylline   Etonogestrel (vaginal ring)   Pimozide  Tiotropium   For personal use only. Not for distribution. Fo for distribution. Not only. use For personal Pipotiazine   Not only. use For personal for distribution. Not only. use For personal Levonorgestrel (COC)   Calcium Channel Blockers Prochlorperazine   Levonorgestrel Amlodipine    Quetiapine   (Emergency Contraception)

Risperidone  Diltiazem  Levonorgestrel (HRT)   Sulpride   Felodipine Levonorgestrel (implant)   Thioridazine  Nicardipine  Levonorgestrel (IUD)   Tiapride   Nifedipine Levonorgestrel (POP)   Trifluoperazine   Nisoldipine Medroxyprogesterone (depot)   Ziprasidone   Nitrendipine  Medroxyprogesterone (oral)   Zuclopentixol  Verapamil  Norethisterone (norethindrone) 

Key to symbols Notes  Further information is available at © Liverpool Drug Interactions Group,  These drugs should not be coadministered www.hep-druginteractions.org University of Liverpool, Pharmacology Research Labs, Potential clinically significant interaction that is likely to require additional  Predicted interactions are based on known 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF  monitoring, alteration of drug dosage or timing of administration metabolic pathways and routes of clearance. We aim to ensure that information is accurate and consistent with current knowledge Potential interaction likely to be of weak intensity. Additional  Caution is required in patients with hepatic and practice. However, the University of Liverpool and its servants or agents shall action/monitoring or dosage adjustment is unlikely to be required impairment as this may also increase drug levels not be responsible or in any way liable for the continued currency of information in and require dose modification. this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude  No clinically significant interaction expected  Where advice differs between countries, the liability for errors, omissions or inaccuracies to the fullest extent permitted by law.

charts reflect the more cautious option.

www.hep-druginteractions.org

Interactions with PBC Agents

Charts created August 2019. Full information available at www.hep-druginteractions.org Page 3 of 4 Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister.

Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycho Obeticholic Ursodeoxycholic Acid Acid Acid lic Acid Acid Acid Erectile Dysfunction Agents Herbals/Supplements/Vitamins Hypertension/Heart Failure Agents Sildenafil   Aloe vera   Acebutolol   Tadalafil   Ascorbic acid (Vitamin C)   Aliskiren   Vardenafil   Black cohosh (A. racemosa)   Ambrisentan   Gastrointestinal Agents Cat’s claw (U. tomentosa)   Amiloride   Aluminium hydroxide   Colecalciferol (Vitamin D3)   Azilsartan     Alverine citrate   Cyanocobalamin (B12) Benazepril   Antacids   Diosmin  

Bendroflumethiazide     Echinacea   Aprepitant Bosentan  Bisacodyl   Eucalyptus globulus   Bumetanide   Cimetidine   Folic acid   Candesartan   Cisapride Garlic   Captopril   Cyclizine   Ginger (Z. officinale)   Dantron   Ginkgo biloba   Chlorothiazide     Ginseng   Chlortalidone   Domperidone distribution. for Droperidol   Goldenseal (H. canadensis)   Cilazapril   Esomeprazole   Grape seed extract   Clevidipine   Famotidine   Grapefruit juice   Clonidine   Granisetron   Green tea (C. sinensis)   Doxazosin  Hyoscine   Inula racemosa   Enalapril   Ispaghula husk   Iodine   Eplerenone   Lactulose   Iron supplements   Epoprostenol   Kava kava (P. methysticum)   Lansoprazole   Eprosartan   Milk thistle   Linaclotide   Fosinopril     distribution. for Not only. use ersonal Retinol (Vitamin A)   Loperamide Furosemide   Lubiprostone   Riboflavin (Vitamin B2)   Hydralazine   Macrogol   Serenoa repens   Hydrochlorothiazide   Mebeverine   St John’s wort   Mesalazine   Thiamine (Vitamin B1)   Iloprost   Methylcellulose   Turmeric (curcumin)   Indapamide   Metoclopramide   Valerian   Irbesartan   Naloxegol   Vitamin E   Isradipine Omeprazole   HIV Drugs Ivabradine   Ondansetron   Entry/Integrase Inhibitors Lacidipine 

Pantoprazole   Bictegravir/FTC/TAF   Not only. use For personal for distribution. Lercanidipine  Prucalopride   Dolutegravir   Lisinopril   Rabeprazole  Dolutegravir/rilpivirine   Losartan   Ranitidine   Elvitegravir/cobi /FTC/TAF   Macitentan   Senna   Elvitegravir/cobi/FTC/TDF   Methyldopa   Simeticone   Ibalizumab-uiyk   Metolazone   Sulfasalazine   Maraviroc   Moxonidine   Trimebutine   Raltegravir   nal use only. Not for distribution. For p for distribution. Not only. use nal Olmesartan   NNRTIs Hepatitis Drugs Perindopril   Adefovir  Doravirine   Prazosin   Daclatasvir   Doravirine/3TC/TDF   r perso Quinapril  Elbasvir/Grazoprevir   Efavirenz  Glecaprevir/Pibrentasvir   Etravirine   Ramipril   Entecavir   Nevirapine  Ranolazine Lamivudine   Rilpivirine   Rilmenidine   Ledipasvir/Sofosbuvir   Rilpivirine/dolutegravir   Riociguat   OBV/PTV/r   Rilpivirine/FTC/TAF   Selexipag  OBV/PTV/r + Dasabuvir   NRTIs Sildenafil   Peginterferon alfa-2a   Abacavir   Spironolactone   Peginterferon alfa-2b   Didanosine   Tadalafil   Ribavirin   Emtricitabine (FTC)   Telmisartan   Simeprevir   Emtricitabine + TAF   Torasemide   Emtricitabine + TDF   Sofosbuvir (SOF)   Trandolapril   Lamivudine   SOF/Velpatasvir   Treprostinil  SOF/Velpatasvir/Voxilaprevir   Stavudine   Valsartan   Telbivudine   Tenofovir-DF   Xipamide   Tenofovir alafenamide (TAF)   Zidovudine   Zofenopril   Tenofovir-DF   Protease Inhibitors Atazanavir alone   Atazanavir/cobicistat   Atazanavir + ritonavir   For personal use only. Not for distribution. Fo for distribution. Not only. use For personal Darunavir/cobicistat   Not only. use For personal for distribution. Not only. use For personal Darunavir/cobi/FTC/TAF   Darunavir + ritonavir   Fosamprenavir   Indinavir  Lopinavir  Ritonavir   Saquinavir  Tipranavir 

Key to symbols Notes  Further information is available at © Liverpool Drug Interactions Group,  These drugs should not be coadministered www.hep-druginteractions.org University of Liverpool, Pharmacology Research Labs, Potential clinically significant interaction that is likely to require additional  Predicted interactions are based on known 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF  monitoring, alteration of drug dosage or timing of administration metabolic pathways and routes of clearance. We aim to ensure that information is accurate and consistent with current knowledge Potential interaction likely to be of weak intensity. Additional  Caution is required in patients with hepatic and practice. However, the University of Liverpool and its servants or agents shall action/monitoring or dosage adjustment is unlikely to be required impairment as this may also increase drug levels not be responsible or in any way liable for the continued currency of information in and require dose modification. this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude  No clinically significant interaction expected  Where advice differs between countries, the liability for errors, omissions or inaccuracies to the fullest extent permitted by law.

charts reflect the more cautious option.

www.hep-druginteractions.org

Interactions with PBC Agents

Charts created August 2019. Full information available at www.hep-druginteractions.org Page 4 of 4 Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister.

Obeticholic Ursodeoxycholic Obeticholic Ursodeoxycholic Acid Acid Acid Acid Illicit/Recreational Other Drugs Amphetamine  Acamprosate   Cannabis   Acetazolamide   Cocaine   Acitretin  Ecstasy (MDMA)  Activated charcoal   GHB (Gamma-hydroxybutyrate)   Allopurinol   LSD (Lysergic acid diethylamide)  Atomoxetine   Mephedrone  Atropine  

Methamphetamine  Baclofen   Phencyclidine (PCP)  Benralizumab   Immunosuppressants Betahistine   Bimatoprost   Alemtuzumab   Biperiden  Azathioprine   Brinzolamide   Basiliximab   Bromocriptine   Brodalumab   distribution. for Calcitonin   Ciclosporin   Calcium carbimide   Eculizumab   Calcium resonium   Etanercept   Carbimazole   Fingolimod   Carisoprodol  Lenalidomide   Cilostazol   Mycophenolate  Clomifene   Pirfenidone   Colchicine   Sirolimus  Colestyramine 

Tacrolimus  distribution. for Not only. use ersonal Conivaptan   Lipid Lowering Agents Cyclobenzaprine  Atorvastatin   Cytisine   Bezafibrate   Darbepoetin   Ezetimibe  Deferiprone   Fenofibrate   Denosumab   Fish oils   Dexamfetamine  Fluvastatin  Dextromethorphan   Gemfibrozil   Disulfiram  Lovastatin   Donepezil 

Pitavastatin   Dorzolamide   Not only. use For personal for distribution. Pravastatin   Dupilumab   Rosuvastatin   Eliglustat   Simvastatin   Epoetin alfa   Oxytocics Etelcalcetide    Ergometrine (ergonovine)   Febuxostat Filgrastim   Mifepristone   Flibanserin 

Misoprostol  For p for distribution. Not only. use nal Gadopentetate (gadolinium)   Parkinsonism Agents Glycerol phenylbutyrate   Benztropine   Goserelin   Carbidopa   r perso Isosorbide mononitrate   Orphenadrine  Isotretinoin Pramipexole  Lanreotide   Rasagline  Levothyroxine   Ropinirole  Lofexidine   PBC Agents Lumacaftor/Ivacaftor   Obeticholic acid  Magnesium   Ursodeoxycholic acid  Melatonin   Steroids Memantine  Beclometasone   Methylphenidate   Betamethasone   Minoxidil   Budesonide  Modafinil   Ciclesonide   Naftidrofuryl   Clobetasol (topical)   Nalmefene   Clobetasone (topical)   Naloxone   Dexamethasone   Naltrexone   Fludrocortisone   Neostigmine   Flunisolide   Nicorandil   Fluticasone   Nusinersan   Ocrelizumab   Hydrocortisone (topical)   Orlistat For personal use only. Not for distribution. Fo for distribution. Not only. use For personal Methylprednisolone   Not only. use For personal for distribution. Not only. use For personal Penicillamine   Mometasone   Pentoxifylline   Prednicarbate   Phenylephrine   Prednisone   Pilocarpine   Triamcinolone   Piracetam   Urological Agents Potassium   Alfuzosin   Protamine sulphate   Desmopressin   Pseudoephedrine   Dutasteride  Pyridostigmine   Finasteride  Raloxifene   Mirabegron   Sevelamer   Silodosin   Strontium ranelate   Solifenacin   Thalidomide   Tamsulosin   Tranexamic acid   Tolterodine   Varenicline  

Key to symbols Notes  Further information is available at © Liverpool Drug Interactions Group,  These drugs should not be coadministered www.hep-druginteractions.org University of Liverpool, Pharmacology Research Labs, Potential clinically significant interaction that is likely to require additional  Predicted interactions are based on known 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF  monitoring, alteration of drug dosage or timing of administration metabolic pathways and routes of clearance. We aim to ensure that information is accurate and consistent with current knowledge Potential interaction likely to be of weak intensity. Additional  Caution is required in patients with hepatic and practice. However, the University of Liverpool and its servants or agents shall action/monitoring or dosage adjustment is unlikely to be required impairment as this may also increase drug levels not be responsible or in any way liable for the continued currency of information in and require dose modification. this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude  No clinically significant interaction expected  Where advice differs between countries, the liability for errors, omissions or inaccuracies to the fullest extent permitted by law.

charts reflect the more cautious option.