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Medications to Know - Pertinent Drug Interactions Part 1

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teaherbalist2's version from 2016-07-16 22:49

Section

Section

Question Answer
Chlorthalidone1) May ↑ risk of lithium toxicity
2) May ↓ effect of antidiabetic agents
3) NSAIDs ↓ antihypertensive effects
Hydrochlorothiazide1) May ↑ risk of lithium toxicity
2) May ↓ effect of antidiabetic agents
3) NSAIDs ↓ antihypertensive effects
Metolazone1) May ↑ risk of lithium toxicity
2) May ↓ effect of antidiabetic agents
3) NSAIDs ↓ antihypertensive effects
AtenololUse with other negative chronotropes (digoxin, non-DHPs, clonidine, ivabradine) may ↑ risk of bradycardia
MetoprololUse with other negative chronotropes (digoxin, non-DHPs, clonidine, ivabradine) may ↑ risk of bradycardia
NebivololUse with other negative chronotropes (digoxin, non-DHPs, clonidine, ivabradine) may ↑ risk of bradycardia
CarvedilolUse with other negative chronotropes (digoxin, non-DHPs, clonidine, ivabradine) may ↑ risk of bradycardia
PropranololUse with other negative chronotropes (digoxin, non-DHPs, clonidine, ivabradine) may ↑ risk of bradycardia
Benazepril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Enalapril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Fosinopril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Lisinopril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Quinapril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Ramipril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Trandolapril1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ARBs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Irbesartan1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ACEIs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Losartan1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ACEIs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Telmisartan1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ACEIs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Valsartan1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ACEIs or aliskiren may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use with aliskiren in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Aliskiren1) Use with K+ supplements, K+ sparing diuretics, ARAs, or NSAIDs may ↑ risk of hyperkalemia
2) Use with ACEIs or ARBs may ↑ risk of hyperkalemia and renal impairment (avoid concurrent use in DM and CrCl <60)
3) May ↑ risk of lithium toxicity
Amlodipine1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ effects
3) CYP3A4 inducers may ↓ effects
Felodipine1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ effects
3) CYP3A4 inducers may ↓ effects
Nifedipine1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ effects
3) CYP3A4 inducers may ↓ effects
Diltiazem1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ effects
3) CYP3A4 inducers may ↓ effects
4) Use with other negative chronotropes may ↑ risk of bradycardia
5) May ↑ effect/toxicity of CYP3A4 substrates
6) May ↑ risk of digoxin toxicity
Verapamil1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ effects
3) CYP3A4 inducers may ↓ effects
4) Use with other negative chronotropes may ↑ risk of bradycardia
5) May ↑ effect/toxicity of CYP3A4 substrates
6) May ↑ risk of digoxin toxicity
Doxazosin↑ Risk of hypotension with PDE-5 inhibitors (avoid concurrent use)
Terazosin↑ Risk of hypotension with PDE-5 inhibitors (avoid concurrent use)
ClonidineUse with other negative chronotropes may ↑ risk of bradycardia
ColesevelamBind to and ↓ absorption of many drugs (e.g. warfarin, digoxin, thiazides, levothyroxine, mycophenolate)
NiacinNone significant
Fenofibrate1) Avoid using fibrates (especially gemfibrozil) with statins due to ↑ risk of myopathy
2) ↑ effects of warfarin and sulfonylureas
3) ↓ cyclosporin levels
Gemfibrozil1) Avoid using fibrates (especially gemfibrozil) with statins due to ↑ risk of myopathy
2) ↑ effects of warfarin and sulfonylureas
3) ↓ cyclosporin levels
Atorvastatin1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ risk of side effects
3) May ↑ effects of warfarin
Lovastatin1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ risk of side effects
3) May ↑ effects of warfarin
PravastatinNot metabolized by CYP enzymes
Simvastatin1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ risk of side effects
3) May ↑ effects of warfarin
Rosuvastatin1) CYP3A4 substrate
2) CYP3A4 inhibitors may ↑ risk of side effects
3) May ↑ effects of warfarin
Ezetimibe1) Cyclosporine and fibrates may ↑ effects
2) ↑ cyclosporine levels
3) ↑ effects of warfarin
Furosemide1) May ↑ risk of lithium toxicity
2) May ↑ risk of ototoxicity with aminoglycosides
3) May ↓ effect of antidiabetic agents
4) NSAIDs ↓ effects
Digoxin1) P-gp substrate
2) Amiodarone, dronedarone, quinidine, verapamil, and clarithromycin may ↑ levels
3) Antacids may ↓ levels (separate by 1-2 hours)
4) Use with other negative chronotropes may ↑ risk of bradycardia
Isosorbide dinitrateNone significant
Amiodarone1) Inhibits CYP1A2, CYP2C9, CYP2D6, and CYP3A4
2) CYP3A4 substrate
3) ↑ risk of digoxin toxicity (↓ digoxin dose by 50%)
4) ↑ effects of warfarin (↓ warfarin dose by 30%)
5) Use with other negative chronotropes may ↑ risk of bradycardia
6) May ↑ cyclosporine or phenytoin levels
7) May ↑ risk of side effects of simvastatin and lovastatin
Penicillin VK1) Probenecid may ↑ effects (may be used for this purpose)
2) May ↓ effects of oral contraceptives
Amoxicillin1) Probenecid may ↑ effects (may be used for this purpose)
2) May ↓ effects of oral contraceptives
Amoxicillin-clavulanate1) Probenecid may ↑ effects (may be used for this purpose)
2) May ↓ effects of oral contraceptives
Cephalexin1) Probenecid may ↑ effects (may be used for this purpose)
2) May ↓ effects of oral contraceptives
Azithromycin1) Less affected by CYP3A4 than clarithromycin and erythromycin
2) ↑ risk of TdP with other QT prolonging drugs
3) May ↑ effects of warfarin
4) May ↑ risk of digoxin toxicity
Clarithromycin1) Major substrate and inhibitor of CYP3A4
2) CYP3A4 inhibitors may ↑ SE
3) CYP3A4 inducers may ↓ effects
4) May ↑ effect/toxicity of CYP3A4 substrates
5) ↑ risk of TdP with other QT prolonging drugs
6) May ↑ effects of warfarin
7) May ↑ risk of digoxin toxicity
Doxycycline1) Absorption ↓ with antacids, dairy products, and products with iron, magnesium, aluminum, calcium, or zinc (separate by 2 hr)
2) CYP3A4 inhibitors may ↑ risk of SE
3) CYP3A4 inducers may ↓ effects
4) May ↑ effect/toxicity of CYP3A4 substrates
5) May ↑ effects of warfarin
6) May ↓ effects of oral contraceptives
7) Isotretinoin may ↑ risk of intracranial hypertension
Minocycline1) Absorption ↓ with antacids, dairy products, and products with iron, magnesium, aluminum, calcium, or zinc (separate by 2 hr)
2) CYP3A4 inhibitors may ↑ risk of SE
3) CYP3A4 inducers may ↓ effects
4) May ↑ effect/toxicity of CYP3A4 substrates
5) May ↑ effects of warfarin
6) May ↓ effects of oral contraceptives
7) Isotretinoin may ↑ risk of intracranial hypertension
Linezolid1) Avoid taking with foods or beverages with high tyramine content (↑ risk of hypertensive crises)
2) Use with serotonergic agents may ↑ risk of serotonin syndrome (avoid concurrent use)
3) Use with adrenergic agents (e.g. dopamine, epinephrine) may ↑ risk of hypertensive crises
4) Use with tramadol may ↑ risk of seizures
5) Use with insulin or oral hypoglycemic agents may ↑ risk of hypoglycemia
Ciprofloxacin1) Absorption ↓ with antacids, dairy products, and products with iron, magnesium, aluminum, calcium, or zinc (separate by 2 hr)
2) Use with corticosteroids may ↑ risk of tendon rupture
3) Use with NSAIDs may ↑ risk of seizures
4) May ↑ effects of CYP1A2 substrates
5) May ↑ effects of warfarin
6) May ↑ effects of antidiabetic agents
7) ↑ risk of TdP with other QT prolonging drugs
Levofloxacin1) Absorption ↓ with antacids, dairy products, and products with iron, magnesium, aluminum, calcium, or zinc (separate by 2 hr)
2) Use with corticosteroids may ↑ risk of tendon rupture
3) Use with NSAIDs may ↑ risk of seizures
4) May ↑ effects of warfarin
5) May ↑ effects of antidiabetic agents
6) ↑ risk of TdP with other QT prolonging drugs
Moxifloxacin1) Absorption ↓ with antacids, dairy products, and products with iron, magnesium, aluminum, calcium, or zinc (separate by 2 hr)
2) Use with corticosteroids may ↑ risk of tendon rupture
3) Use with NSAIDs may ↑ risk of seizures
4) May ↑ effects of warfarin
5) May ↑ effects of antidiabetic agents
6) ↑ risk of TdP with other QT prolonging drugs
Trimethoprim/Sulfamethoxazole1) May ↑ effects/toxicity of methotrexate
2) May ↑ effects of warfarin
3) May ↑ effects of antidiabetic agents
ClindamycinNone significant
Metronidazole1) Disulfram-like reaction may occur with alcohol use
2) May ↑ effects of warfarin and lithium
3) Phenobarbital and phenytoin may ↓ effects
4) Cimetidine may ↑ effects
Fluconazole1) May ↑ effect/toxicity of CYP2C9, CYP2C19, and CYP3A4 substrates
2) Rifampin may ↓ effects
3) ↑ risk of TdP with other QT prolonging drugs
NystatinNone significant
Terbinafine1) May ↑ effect/toxicity of CYP2D6 substrates
2) May ↓ cyclosporine levels
AcyclovirNone significant
FamciclovirNone significant
ValacyclovirNone significant
Fluticasone furoateCobicistat and Ritonavir ↑ fluticasone levels and risk for Cushings and adrenal insufficiency
BudesonideCobicistat and Ritonavir ↑ ICS levels and risk for Cushings and adrenal insufficiency
BeclomethasoneCobicistat and Ritonavir ↑ ICS levels and risk for Cushings and adrenal insufficiency
MontelukastCYP2C9 substrate
TheophyllineInhibits CYP1A2 and CYP3A4
AlbuterolNon-selective beta blockers decrease effect
LevalbuterolNon-selective beta blockers decrease effect
IpratropiumCYP2D6 and CYP3A4 substrate
TiotropiumCYP2D6 and CYP3A4 substrate
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