Critical Drug - Drug Interactions

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Last updated 11:37 PM on 4/11/26
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15 Terms

1
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Warfarin + Aspirin/NSAIDs

Major bleeding risk

2
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Sildenafil (Viagra) + Nitrates (nitroglycerin or isosorbide)

Severe hypotension (can be fatal)

3
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Opioids + Benzodiazepines

Respiratory depression / overdose

4
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MAO inhibitors + SSRIs/SNRIs

Serotonin syndrome (life-threatening)

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Statins + Gemfibrozil

Rhabdomyolysis (muscle breakdown)

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Warfarin + Antibiotics (fluconazole, aminodarone, TMP-SMX)

⬆INR ➡bleeding risk

7
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ACE inhibitors + ARBs or aliskiren

⬆potassium + kidney damage

8
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Digoxin + amiodarone or diuretics

Digoxin toxicity (especially low potassium)

9
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Methotrexate + NSAIDs

Methotrexate toxicity (kidney + bone marrow suppression)

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fluoroquinolones or tetracyclines + antacids/dairy

⬇antibiotic absorption (treatment failure)

11
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Clopidogrel (antiplatelet medication) + PPIs (omeprazole) treats GERD

⬇clopidogrel effectiveness

12
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St. John’s Wort + SSRIs

serotonin syndrome; also reduces effectiveness of many drugs (oral contraceptives, warfarin, HIV meds)

13
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Fish Oil/Vitamin E + Warfarin

Increased bleeding

14
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Ginkgo biloba + anticoagulant

Increased bleeding

15
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Grapefruit juice + Statins, CCBs, certain immunosuppressants

→ ↑ drug levels (CYP3A4 inhibitor)