-
P-Glycoprotein (P-gp) Inhibitors:
Partial list
- Itraconazole, Ketoconazole
- Indinovir, Lopinovir, Ritonavir
- Clarithromycin, Erythromycin
- Amiodarone
- Verapamil
- Quinidine
- Conivaptan
-
P-Glycoprotein (P-gp) Inducers:
Partial list
- Rifampin
- Avasimibe
- Carbamazepine
- Phenytoin
- St. John's Wort
- Tipranavir/Ritonavir
-
Notable P-gp substrates:
partial list
- Digoxin
- Dabigatran, Rivaroxaban
- Cyclosporine, Tacrolimus
- Colchicine
- Aliskiren
- Fexofenadine
- Posaconazole
- Ranolazine
- Saxagliptin
-
CYP 3A4 Inducers:
- Oxcarbazepine
- Carbamazepine
- Phenytoin
- Pheonbarbital
- Primidone,
- Rifabutin, Rifampin, Rifapentin,
- Smoking
- St. John's Wort
-
CYP 3A4 Inhibitors:
Partial list
- Amiodarone, Dronedarone,
- Diltiazem, verapamil
- Cimetidine
- Clarithromycin, Erythromycin, telithromycin
- Fluconazole, itraconazole, Ketoconazole, Posaconazole, Voriconazole
- Protease Inhibitors
- Grapefruit juice
- Sertraline, Fluvoxamine, Haloperidol,
- Isoniazid
-
Big CYP Inducers:
- PS PORCS:
- Phenytoin
- Smoking
- Phenobarbital
- Oxcarbazepine
- Rifampin (rifabutin, rifapentine)
- Carbamazepine
- St. John's Wort
-
Big CYP Inhibitors:
- G-PACMAN
- Grapefruit
- PIs Prtease inhibitors
- Azole antifungals
- Cyclosporine, Cimetidine
- Macrolides (not Azithromycin0
- Amiodarone and dronedarone
- Non-DHP CCB Diltiazem and Verapamil
-
Drugs that can cause Serotonin Syndrome if used concomitantly:
- MAOs
- SSRIs
- SNRIs
- TCAs
- Triptans
- tramadol, Mirtazapine, Cyclobenzaprine, bupropion, buspirone, linezolid, lithium, meperidine, St. John's Wort, Dextromethorphan, others
-
Drugs that increase bleeding risk if used concomitantly:
- Anticoagulants
- Antiplatelets
- NSAIDs
- SSRIs, SNRIs,
- Ginkgo Biloba, Vit E, Fish Oil, Garlic, Glucosamine, Grapefruit, Evening primrose oil, willow bark, wintergreen oil
-
Drugs that increase risk of Hyperkalemia:
- Aldosterone antagonists
- ACEIs, ARBs, aliskiren,
- amiloride,
- Calcineurin Inhibitors
- Trimethoprim (in Bactrim)w sulfamethoxazole
-
Drugs that cause CNS depression:
- Alcohol,
- Opioids
- Skeletal muscle relaxants,
- anticonvulsants
- Benzodiazepines,
- Barbiturates
- Hypnotics, mirtazapine, trazadone, propranolol, clonidine
-
Drugs that cause QT prolongation:
- AntiArrhythmics
- Quinolones
- Macrolides
- Azole antifungals
- PI protease inhibitors
- TCAs, SSRIs, SNRIs
- 5HT3 antagonists (setrons)
- Antipsychotics (thioridazines- chlorpromazine, haloperidol, ziprasidone, risperidone, patiperidone, iloperidone, quetiapine, clozapine,
- quinine, chloroquine,apomorphine, methadone, alfuzosin, ranolaxine, galantamine,
-
Drugs that cause Ototoxicity:
- Salicylates
- Aminoglycosides
- Vancomycin,
- Loop diuretics
- Cisplatin
- Mefloquine
-
Drugs that should not be used in Severe Renal Impairment (CrCl<30):
partial list
- Bisphosphonates
- NSAIDS
- Lithium
- Metformin
- Nitrofurantion
- K sparing diuretics
- Dabigatran, Fondaparinux, Rivaroxaban
- Glyburide
- Tramadol ER
- Voriconazole
- Meperidine
- Tadalafil, Tenofovir, Cidofovir,
-
Drugs to be flushed down toilet to avoid accidental use (FDA approved list):
- Oxycodone in most forms
- Buprenorphine, Methadone
- Hydromorphone, Morphine
- Methylphenidate
- Diazepam
- Fentanyl
- Meperidine, Tapentadol
-
Antibiotic suspensions NOT to refrigerate:
- Azithromycin, Clarithromycin
- Cefdinir, Cefixime
- Clindamycin
- Ciprofloxacin, Levofloxacin
- Doxycycline
- Linezolid
- Fluconazole, Voriconazole
-
Antibiotics that do NOT require renal dose adjustments:
- Azithromycin, Clindamycin, Erythromycin,
- Ceftriaxone
- Nafcillin, Oxacillin, Dicloxacillin
- Chloramphenicol
- Doxycycline, Minocycline, Tigecycline
- Fidaxomicin, Linezolid, Metronidazole
- Moxifloxacin, Rifaximin, Rifampin
- Quinupristin/dalfopristin
- Tinidazole
-
Drugs that cause alter BG- Hyperglycemia:
- Corticosteriods
- PIs
- Atypical antipsychotics (olanzapine, clozapine, quetiapine)
- Thiazide and loop diuretics
- Statins and niacin
- Fluoroquinolones
- Beta-Agonists
- Carvedilol, Propranolol (other BB possible)
- Cyclosporine, Tacrolimus
- Interferons
-
Drugs associated with Drug-Induced Lupus:
- Procainamide
- Hydralazine
- Isoniazid
- Quinidine
- Methyldopa
- Propylthiouracil
- Methimazole
- Terbinafine
- Anti-TNF agents
-
Drugs associated with Hypothyroidism:
- Amiodarone,
- interferons,
- lithium
- nitroprusside,
- Tyrosine Kinase Inhibitors (Sunitinib)
-
Drugs associated with osteoporosis risk:
- Steroid use long term
- Depot Medroxyprogesterone acetate
- Anticonvulsants
- Warfarin and Heparin
- Loop diuretics
- Aromatase inhibitors
- Nfarelin
- Adrogen blockers
- PPI
-
Drugs that increase risk of uric acid (Gout):
- Thiazide and loop diuretics
- Niacin
- Aspririn high dose
- Pyrazinamide
- Cyclosporine
- Tacrolimus
-
Drugs that can worsen HTN:
- ACTH
- Alcohol
- Amphetamines
- Appetite suppressants, Caffeine
- Calcineurin antagonists
- Corticosterioids
- Decongestants
- erythropoietin
- Estrogen
- NSAIDs
- Oncology drugs
- SNRIs
- Thyroid hormone
- Herbals: bitter orange, ephedra, ginseng, guarana, St. John's Wort
-
Drugs associated with Hyperlipidemia (LDL):
- Diuretics
- Cyclosporine, Tacrolimus
- Glucocorticoids
- Amiodarone
-
Drugs that can worsen Heart Failure:
- Some chemotherapeutic agents
- Amphetamines/sympathomimetics
- CCB in systemic HF
- Anti-Arrhythimics (low risk with amiodarone and dofetilide)
- Itraconazole
- Immunomodulators,(Interferons, TNF-I, rituximab others
- NSAIDS, especially COX-2-I
- Glucocorticoids
- Triptans
- Thiazolidinediones rosi, pioglitazone
- Excessive Alcohol
- Ergot derivatives
-
Drugs that can trigger an Asthma attack:
- Aspirin
- NSAIDs
- Sulfites
- Beta-Blockers (non-selective)
-
Drugs that can worsen depression:
- Beta-Blockers
- Clonidine
- Corticosteroids
- Cyclosporine
- Interferons,
- Oral contraceptives
- Statins,
- Varenicline
- Isotretinoin, indomethacin, procainamide, Reserpine
- Methadone, opioid use
- Methylphenidate other stimulants
-
Drugs that can cause Psychotic symptoms:
- Amphetamines (stimulants),
- Methamphetamine
- Cannabis
- Cocaine
- Dextromethorpan
- Anticholinergics
- Dopamine agonists
- Interferons
- Steroids
- Phencyclidine (PCP)
- Lysergic acid diethylamide (LSD)
-
Drugs that can worsen Dementia:
- anticholinergics
- Antihistamines
- Antipsychotics
- Barbiturates
- Benzodiazepines
- skeletal muscle relaxants
- other CNS depressants
-
Drugs that can worsen anxiety:
- Theophylline, Caffeine
- Levothyroxine
- Acetazolamide
- Albuterol
- stimulants
- Decongestants (pseudoephedrine)
- Steroids
- Bupropion, Fluoxetine, Paroxetine
- Cocaine, LSD, Methamphetamine others
-
Drugs that contribute to insomnia:
- Bupropion, Fluoxetine
- Stimulants
- Decongestants
- MAO-B inhibitors
- Caffeine
- Steroids
- Alcohol
- drugs that cause nocturia- diuretics
-
Drugs that lower Seizure Thresholds:
- antipsychotics (pheno-thiazines, clozapine)
- Bupropion,
- Penicillins
- Carbapenems
- cephalosporins
- Fluoroquinolones
- lindane, lithium, theophylline
- Mefloquine, Meperidine, Metoclopramide
- Evening primrose oil, ginko, melatonin
- Alcohol
- infection, fever
-
Drugs that cause Constipation:
- Opioids
- Anticholinergics
- Antihistamines,
- TCAs
- Non DHP CCB
- Clonidine
- Tramadole, tapentadol
- Colesevelam
- Iron, Aluminum, Bismuth
- Varenicline, aripiprazole, phentermine, topiramate
-
Drugs that cause Erectile Dysfunction:
- Beta-Blockers, Clonidine
- Antipsychotics
- SSRIs, SNRIs, TCAs(less)
- BPH drugs finasteride, dutasteride
- chemotherapy drugs
- Cimetidine
- Opioids, Methadone
- Nicotine
-
Drugs that worsen BPH:
- Decongestants
- Anticholinergics
- Antihistamines
- TCAs, SNRIs
- Caffeine
- Diurectics
- Testosterone
-
Drugs that increase Intraocular Pressure/Glaucoma:
- antihistamines
- Anticholinergics
- Corticosteroid chronic use
- Topiramate
-
Drugs that cause Photosensivity Reactions:
- Loop diuretics, HCTZ
- Tetracyclines, Fluoroquinolones, Sulfonamides
- NSAIDs
- Retinoids
- Sulfonylurias
- Statins
- Antifungals
- Amiodarone, quinine, Diltiazem,
- others
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