KP Top Drugs

abiraterone

for prostate cancer;

• Take on an empty stomach: at least 1 hour before or 2 hours after food.

• Take once daily at the same time.

• Usually taken with prednisone; don’t stop prednisone abruptly

• Avoid grapefruit/grapefruit juice.

• Do not crush or chew tablets.

• Can cause hypertension, hypokalemia, fluid retention, and liver toxicity.

• Monitor BP, potassium, fluid status, and liver function.

• Report swelling, shortness of breath, yellowing of skin/eyes, or dark urine.

allopurinol

for gout

• Take after meals with plenty of water.

• Not for immediate relief of an acute gout attack.

• Gout attacks can temporarily increase when starting.

• Report rash immediately—can indicate severe hypersensitivity/Stevens-Johnson syndrome.

• Dose may need adjustment in kidney disease.

• Avoid excessive alcohol because it can increase uric acid.

• Important interaction with azathioprine/6-MP—major dose reduction required.

amlodipine

for hypertension/angina

• Take once daily, with or without food.

• May cause ankle/leg swelling, flushing, dizziness, or headache (Report severe swelling, fainting, or unusually fast/irregular heartbeat)

• Rise slowly if dizzy.

• Continue taking even if you feel well.

amoxicillin

for bacterial infections

• Take exactly as prescribed and finish the entire course.

• Can take with or without food; food may help stomach upset.

• Common effects: nausea, diarrhea, rash.

• Seek immediate help for difficulty breathing, facial swelling, or severe allergic reaction.

• Report severe/watery/bloody diarrhea.

anastrozole

for (hormone-sensitive) breast cancer

• Take once daily, with or without food.

• Can cause hot flashes, joint/muscle pain, and bone loss.

• May increase cholesterol.

• Maintain adequate calcium/vitamin D and weight-bearing exercise as recommended.

• Avoid pregnancy; may cause fetal harm.

atenolol

for hypertension, angina, arrhythmias

• Take at the same time every day.

• May cause slow heart rate, fatigue, dizziness.

• Use caution with other medications that lower heart rate.

• Do not stop abruptly—can cause rebound hypertension, angina, or other cardiac complications.

• May mask symptoms of hypoglycemia, especially rapid heartbeat.

atorvastatin

for high cholesterol/ CVD risk reduction

• can be taken with or without food.

• Report unexplained muscle pain, weakness, or dark urine.

• Avoid excessive alcohol.

• Avoid large amounts of grapefruit/grapefruit juice.

• Monitor cholesterol and liver function as directed.

• Contraindicated during pregnancy.

azathioprine

for autoimmune disease; transplant immunosuppression

• Take with food if it causes stomach upset

• Use sun protection

• Can suppress bone marrow and immune system.

• Report fever, sore throat, unusual bruising/bleeding, or signs of infection.

• Increased risk of infections and certain cancers.

• Requires CBC and liver monitoring.

• Major interaction with allopurinol/febuxostat.

• Avoid live vaccines unless specifically approved

azelastine

for allergic rhinitis

• Use as directed; prime spray if needed.

• Avoid getting in eyes.

• May cause bitter taste, nasal irritation, or drowsiness.

• Avoid driving until you know how it affects you.

• Alcohol and other sedatives may increase drowsiness.

• Aim spray slightly outward, away from nasal septum.

benzonatate

for cough

• Swallow capsule whole.

• Do NOT chew, suck, crush, or dissolve.

• Numbing of mouth/throat can occur if chewed → choking risk.

• Keep away from children; accidental ingestion can be fatal.

• May cause dizziness or drowsiness.

• Take only as prescribed.

bisoprolol fumurate

for hypertension, heart failure

• Take once daily, consistently.

• May cause fatigue, dizziness, slow heart rate.

• Monitor BP/HR if instructed.

• Do not abruptly discontinue.

• Can mask some symptoms of hypoglycemia.

• Rise slowly if dizzy.

bupropion hcl

for depression, smoking cessation

• Can cause insomnia → avoid taking close to bedtime.

• May cause dry mouth, nausea, headache.

• Can increase BP; monitor BP.

• Depending on formulation, do not crush/chew extended-release tablets.

• Dose-related seizure risk.

• Avoid excessive alcohol.

• Contraindicated in patients with seizure disorders and certain eating disorders.

• Do not take with an MAOI or within the required washout period.

capecitabine

for cancer, esp colon/breast

• Take within 30 minutes after a meal.

• Swallow whole with water; do not crush/chew.

• Important adverse effects: diarrhea, hand-foot syndrome, nausea/vomiting, mouth sores.

• Report severe diarrhea.

• For hand-foot syndrome: moisturize hands/feet and avoid excessive heat/friction.

• May cause low blood counts.

• Avoid pregnancy.

• Important interaction with warfarin.

• Report chest pain or severe toxicity.

carvedilol

for HF, hypertension

• Take with food to reduce orthostatic effects and improve absorption consistency.

• Can cause dizziness, fatigue, and slow heart rate.

• Monitor BP and pulse.

• Rise slowly.

• Do not stop abruptly.

• Can mask hypoglycemia symptoms.

• May worsen asthma/COPD in susceptible patients.

cephalexin

for bacterial infections

• Take at evenly spaced intervals.

• Finish the full course.

• Can take with or without food.

• Common: nausea, diarrhea.

• Report severe/watery/bloody diarrhea.

• Seek help for allergic reaction.

• Tell provider about significant penicillin/cephalosporin allergies.

clopidogrel

blood thinner (antiplatelet)

• Take once daily at the same time

• Do not stop without physician approval, especially after a stent.

• Increased bleeding/bruising.

• Report black/tarry stools, blood in urine, vomiting blood, or unusual bleeding.

• Tell dentists/surgeons before procedures.

• Avoid NSAIDs unless approved.

• Omeprazole and esomeprazole can reduce activation/effect of clopidogrel; alternatives such as pantoprazole may be preferred.

colchicine

for acute gout and gout prevention

• Used to prevent/treat gout and certain inflammatory conditions.

• Avoid grapefruit due to interaction potential.

• Toxicity can cause severe diarrhea/vomiting, muscle weakness, and bone marrow suppression.

• Dose adjustment may be necessary in kidney/liver disease.

• Important interactions with strong CYP3A4/P-gp inhibitors.

• Report severe muscle pain/weakness

cyclobenzaprine

muscle relaxant

• May cause dry mouth and constipation

• Causes drowsiness and dizziness.

• Avoid driving until effects are known.

• Avoid alcohol and other CNS depressants.

• Usually intended for short-term use.

• Can have anticholinergic effects.

• Avoid with MAOIs and use caution with serotonergic drugs because of serotonin syndrome risk.

dapagliflozin (farxiga)

for diabetes or kidney/heart protection

• may increase need to urinate more often

• may cause dizziness or lightheadedness from dehydration —> take plenty of water

• take dose in the morning

dexamethasone

steroid

• Take with food to reduce stomach irritation.

• Can cause increased blood glucose, appetite, insomnia, mood changes, and fluid retention.

• Take in the morning if once daily unless instructed otherwise (mimics body’s cortisol levels)

• Do not stop abruptly after prolonged therapy.

• Increased infection risk; report signs of infection.

• Long-term use can cause osteoporosis, cataracts, adrenal suppression, etc.

• May require glucose/BP monitoring.

doxycycline mono

for bacterial infections, acne, some STIs

• Take with a full glass of water.

• Remain upright for at least 30 minutes after taking.

  • Avoid taking immediately before bedtime.

• Can cause photosensitivity → use sunscreen/protective clothing.

• Separate from antacids, calcium, iron, magnesium, and zinc because they reduce absorption.

• Can cause nausea/esophagitis.

• Take with food if needed for stomach upset, but follow product-specific instructions.

• Finish course unless instructed otherwise.

duloxetine hcl

for depression, anxiety, neuropathic pain, fibromyalgia, chronic pain (SNRI)

• Take once daily, with or without food.

• Do not crush delayed-release capsules.

• May cause nausea, dry mouth, dizziness, or insomnia.

• Can increase BP.

• Do not abruptly stop—withdrawal symptoms can occur.

• Increased risk of serotonin syndrome with other serotonergic medications.

• Report worsening mood or suicidal thoughts.

• May cause sexual dysfunction.

• Avoid excessive alcohol due to liver injury risk.

eliquis

blood thinner (anticoagulant)

• Take twice daily at approximately the same times.

• Do not stop abruptly without medical advice → increased clot/stroke risk.

• Increased bleeding risk.

• Report unusual bleeding, black stools, blood in urine, severe headache, etc.

• Tell healthcare providers/dentists you take an anticoagulant.

• Avoid NSAIDs unless approved.

• If a dose is missed, take it when remembered the same day; do not double up.

• Avoid activities with high risk of trauma.

emtricitabine/tenofovir disoproxil fumurate (truvada)

HIV treatment; HIV PrEP (prophylaxis)

• Used for HIV treatment or PrEP depending on regimen.

• Take consistently every day.

• For HIV treatment, use with other appropriate antiretrovirals.

• Do not stop suddenly without medical guidance, particularly with hepatitis B.

• Monitor kidney function.

• Can affect bone mineral density.

• If used for PrEP, requires HIV testing and ongoing monitoring.

• Does not protect against all STIs; condoms may still be recommended.

escitalopram

SSRI for depression, generalized anxiety disorder

• Take once daily.

• May take several weeks for full benefit.

• Common: nausea, headache, sexual dysfunction, sleep changes.

• Do not stop abruptly.

• Increased risk of serotonin syndrome with other serotonergic medications.

• Monitor for worsening depression/suicidal thoughts, especially when starting or changing dose.

• Avoid excessive alcohol.

• May increase bleeding risk with NSAIDs/anticoagulants.

ezetimibe

for high cholesterol

• Take once daily, with or without food.

• Lowers LDL cholesterol.

• Can cause diarrhea or muscle pain.

• Report unexplained muscle pain/weakness.

• If taken with a bile acid sequestrant, separate doses.

• Continue diet/exercise recommendations.

• Liver monitoring may be needed when combined with statins.

famotidine

for GERD, heartburn, ulcers (decreases stomach acid production)

• Can be taken with or without food.

• May cause headache or dizziness.

• Seek evaluation for difficulty swallowing, vomiting blood, or black stools.

finasteride

for BPH or hair loss

• For BPH, improvement may take several months.

• Decreases PSA; tell healthcare providers you take finasteride when interpreting PSA.

• May cause decreased libido, erectile dysfunction, or decreased ejaculate volume.

• Pregnant women should not handle crushed/broken tablets.

• Do not donate blood while taking and for the recommended period after discontinuation.

• Continue even if symptoms improve unless instructed otherwise.

fluoxetine

for depression, anxiety, OCD, panic disorder, bulimia, PMDD

• May cause nausea, insomnia, headache, or sexual dysfunction.

• Can be activating → morning administration may help if it causes insomnia.

• Full effect may take several weeks.

• Long half-life means interactions/discontinuation effects can persist.

• Do not stop abruptly without medical advice.

• Risk of serotonin syndrome with serotonergic medications.

• Monitor for suicidal thoughts when initiating/changing therapy.

• Significant interaction potential.

furosemide

loop diuretic/ “water pill”

• Usually take in the morning; if twice daily, second dose in early afternoon.

• Causes increased urination.

• Can cause low potassium, low sodium, dehydration, dizziness.

• Monitor BP, electrolytes, renal function.

• Rise slowly.

• Report severe weakness, muscle cramps, dizziness, or dehydration.

• Protect hearing with very high/rapid IV doses; ototoxicity is possible.

gabapentin

nerve pain, seizures

• May cause drowsiness, dizziness, and impaired coordination.

• Avoid alcohol and other CNS depressants unless approved.

• Don't drive until you know effects.

• Dose adjustment needed with kidney impairment.

• Do not stop abruptly if used regularly; tapering may be needed.

• Can cause peripheral edema.

• Monitor for unusual mood changes/suicidal thoughts.

glipizide

type 2 DM

• Take before meals, generally about 30 minutes before breakfast for immediate-release.

• Main concern: hypoglycemia.

• Do not skip meals after taking.

• Know symptoms of low blood sugar: sweating, shaking, hunger, confusion, fast heartbeat.

• Alcohol can increase hypoglycemia risk.

• Monitor glucose.

• May cause weight gain.

• Use caution with kidney/liver impairment.

hydralazine

hypertension

• Take as prescribed, often multiple times daily.

• Can cause headache, dizziness, flushing, and fast heart rate.

• Rise slowly.

• Monitor BP.

• Long-term/high-dose therapy can cause drug-induced lupus.

• Report joint pain, fever, chest pain, or unusual symptoms.

• Often used with other medications to manage reflex tachycardia/fluid retention

hctz

“water pill” (htn, edema)

• take in the morning because it increases urination.

• Can cause low sodium/potassium, dehydration, dizziness.

• May increase blood glucose and uric acid.

• Can cause photosensitivity → sunscreen.

• Monitor BP and electrolytes.

• Rise slowly.

• Report muscle cramps, weakness, or severe dizziness.

ibuprofen

pain/inflammation/fever

• Take with food or milk if stomach upset occurs.

• NSAID → increased risk of GI bleeding, kidney injury, increased BP, and cardiovascular events.

• Avoid taking with other NSAIDs such as naproxen/meloxicam unless specifically instructed.

• Report black stools, vomiting blood, severe abdominal pain.

• Avoid prolonged use without medical guidance.

• Avoid/use caution with anticoagulants such as Eliquis.

• Avoid during pregnancy, especially later pregnancy.

insulin glargine

diabetes

• Usually administered once daily at the same time every day.

• Long-acting basal insulin; do not mix with other insulins.

• Do not use if solution is cloudy/contains particles.

• Rotate injection sites.

• Main risk: hypoglycemia.

• Know signs/treatment of low blood sugar.

• Do not skip basal insulin without medical guidance.

• Store unopened products refrigerated; follow specific product storage instructions after opening.

• Never share pens/needles.

ipratropium

COPD (bronchodilator)

• May cause dry mouth, throat irritation, or headache.

• Avoid spraying into eyes → may worsen glaucoma.

• Use regularly if prescribed for maintenance.

• Not generally the first choice for rapid relief of severe acute bronchospasm.

• Seek urgent care for severe breathing difficulty.

Jardiance (empagliflozin)

for type 2 dm, hf, CVD risk

• Take once daily, usually in the morning.

• Can increase urination.

• Maintain hydration.

• Can cause genital fungal infections and UTIs.

• Report burning urination, unusual genital discharge/itching.

• Can cause dehydration and low BP.

• Rarely causes euglycemic ketoacidosis—seek medical attention for nausea, vomiting, abdominal pain, or difficulty breathing.

• Temporarily stop around certain surgeries/fasting situations as directed.

• Monitor kidney function.

letrozole

for breast cancer in premenopausal women

• Take once daily, with or without food.

• Common: hot flashes, joint pain, fatigue.

• Can decrease bone mineral density.

• Calcium/vitamin D and weight-bearing exercise may be recommended.

• Monitor bone health.

• Avoid pregnancy.

• Report severe bone pain/fractures.

• May increase cholesterol.

levothyroxine

for hypothyroidism

• Take on an empty stomach, ideally 30–60 minutes before breakfast.

• Take consistently at the same time each day.

• Separate from calcium, iron, antacids by at least 4 hours.

• Many medications/supplements affect absorption.

• Full effect takes several weeks.

• Symptoms of excessive dose: palpitations, tremor, sweating, anxiety, weight loss.

• Monitor TSH.

lisinopril

blood pressure medication

• Can be taken with or without food.

• May cause cough, dizziness, increased potassium.

• Rare but serious: angioedema—swelling of face/lips/tongue → emergency.

• Monitor BP, kidney function, and potassium.

• Avoid potassium supplements/salt substitutes unless approved.

• Contraindicated in pregnancy

lisinopril/hctz

for high blood pressure

• Combines ACE inhibitor + thiazide diuretic.

• Take in morning.

• May cause dizziness and increased urination.

• Monitor BP, potassium, sodium, and kidney function.

• Lisinopril → cough/angioedema/hyperkalemia.

• HCTZ → electrolyte abnormalities, photosensitivity, increased uric acid/glucose.

• Avoid potassium supplements unless approved.

• Contraindicated in pregnancy.

losartan

htn

• Take once daily, with or without food.

• May cause dizziness.

• Monitor BP, kidney function, potassium.

• Avoid potassium supplements/salt substitutes unless instructed.

• Can cause hyperkalemia.

• Do not use during pregnancy.

• Less likely than ACE inhibitors to cause cough.

losartan/hctz

high blood pressure

• Take once daily, generally in the morning.

• Increases urination.

• Monitor BP, electrolytes, kidney function.

• Losartan → hyperkalemia.

• HCTZ → low sodium/potassium, dehydration, photosensitivity.

• Avoid potassium supplements unless instructed.

• Contraindicated in pregnancy.

meloxicam

pain/inflammation, arthritis

• Take once daily with food if stomach upset occurs.

• NSAID → risk of GI bleeding, kidney injury, increased BP, cardiovascular events.

• Avoid other NSAIDs unless instructed.

• Increased bleeding risk with Eliquis/clopidogrel.

• Report black stools, vomiting blood, severe abdominal pain.

• Avoid prolonged use unless monitored.

• Avoid during pregnancy, particularly later pregnancy.

metformin

for type 2 diabetes

• Take with meals to reduce GI upset.

• Common: diarrhea, nausea, stomach upset.

• Extended-release tablets should generally be swallowed whole.

• Long-term use can decrease vitamin B12.

• Rare but serious: lactic acidosis.

• Kidney function must be monitored.

• Avoid excessive alcohol.

• May need to be held around certain iodinated contrast procedures depending on kidney function/procedure.

• Usually does not cause hypoglycemia by itself.

methimazole

for hyperthyroidism

• Report fever or sore throat immediately → possible agranulocytosis.

• Report yellowing skin/eyes or dark urine → possible liver injury.

• Monitor thyroid function.

• Do not discontinue without medical advice.

• Can cause rash/GI upset.

• Pregnancy requires specific discussion because treatment considerations change.

methocarbamol

for muscle spasms

• Causes drowsiness and dizziness.

• Avoid alcohol and other CNS depressants.

• Don't drive until effects are known.

• Can cause blurred vision.

• Take as prescribed; generally used short-term for muscle spasms.

• May cause urine discoloration.

methotrexate

autoimmune disease (RA, psoriasis, etc); some cancers

usually once WEEKLY not daily

• Take on the same day every week.

• Often given with folic acid.

• Avoid pregnancy; significant fetal toxicity.

• Avoid excessive alcohol.

• Can cause liver toxicity, bone marrow suppression, mouth sores, GI effects, lung toxicity.

• Report fever, sore throat, unusual bruising, mouth sores, shortness of breath.

• Requires CBC, liver, and kidney monitoring.

• Avoid live vaccines unless specifically approved.

metoprolol

blood pressure

• Take consistently; formulation matters.

• Extended-release tablets should generally be swallowed whole.

• Can cause fatigue, dizziness, slow HR.

• Monitor BP/HR.

• Do not abruptly discontinue.

• May mask hypoglycemia.

• Take with food consistently if using immediate-release formulation.

• Avoid driving until effects are known.

minoxidil

severe/refractory htn (oral); hair loss (topical)

• Can cause fluid retention, increased heart rate, dizziness, and excessive hair growth.

• Monitor BP and heart rate.

• Often prescribed with a beta-blocker and diuretic for BP because of these effects.

• Rise slowly.

• Report swelling, rapid heartbeat, chest pain, or shortness of breath.

mirtazapine

for depression

• Usually taken at bedtime because it can cause sedation.

• Can increase appetite and cause weight gain.

• May cause dry mouth.

• Avoid alcohol/CNS depressants.

• Do not stop abruptly.

• Monitor mood and suicidal thoughts.

• Lower doses can sometimes be more sedating, though individual response varies.

montelukast

asthma

• Used for asthma/allergic rhinitis; not a rescue medication for acute asthma attacks.

• Take once daily.

• For asthma, often taken in the evening.

• Important FDA boxed warning for serious neuropsychiatric effects.

• Report mood changes, nightmares, aggression, depression, or suicidal thoughts.

• Continue rescue inhaler for acute symptoms as prescribed.

naproxen

for pain, inflammation, arthritis

• Take with food/milk if stomach upset.

• NSAID → GI bleeding, kidney injury, increased BP, cardiovascular risk.

• Avoid other NSAIDs.

• Increased bleeding risk with Eliquis/clopidogrel.

• Report black stools or vomiting blood.

• Use lowest effective dose for shortest duration.

• Avoid during pregnancy, especially later pregnancy.

omeprazole

blocks stomach acid production

• Take 30–60 minutes before a meal, usually before breakfast.

• Swallow delayed-release formulation whole.

• Not intended for immediate relief of heartburn.

• Long-term use may be associated with low magnesium, B12 deficiency, fractures, and C. difficile infection.

• Report persistent diarrhea.

• Important interaction with clopidogrel.

• Seek medical evaluation for alarm symptoms such as difficulty swallowing, unexplained weight loss, or GI bleeding.

ondansetron

for nausea/vomiting

• Used to prevent nausea/vomiting.

• May cause headache and constipation.

• Can prolong QT interval → caution in patients with arrhythmias or certain medications.

• Seek help for fainting or abnormal heartbeat.

• ODT: place on tongue and allow to dissolve; follow formulation-specific instructions.

• May cause serotonin syndrome when combined with serotonergic medications, though uncommon.

pantoprazole

lowers stomach acid

• Usually take 30–60 minutes before a meal.

• Swallow delayed-release tablets whole.

• May cause headache/diarrhea.

• Long-term use may be associated with low magnesium/B12 and fractures.

• Report persistent/severe diarrhea.

• Not immediate relief for acute heartburn.

pioglitazone

for type 2 diabetes

• with or without food.

• Can cause weight gain and fluid retention.

• May worsen or cause heart failure.

• Report shortness of breath, rapid weight gain, or swelling.

• Can increase fracture risk.

• Monitor blood glucose/A1C.

• May take several weeks to reach full effect.

• Avoid in symptomatic heart failure.

• Usually does not cause hypoglycemia by itself.

potassium chloride

prevention/to treat low potassium

• Take with food and a full glass of water to reduce GI irritation.

• Do not crush/chew extended-release tablets/capsules.

• Can cause GI irritation.

• Monitor potassium and kidney function.

• Avoid potassium supplements/salt substitutes unless instructed.

• Signs of high potassium can include muscle weakness or abnormal heartbeat.

• Never take extra doses to make up for missed doses unless instructed.

potassium citrate

kidney stone prevention; making urine less acidic

• Used to alkalinize urine/prevent certain kidney stones.

• Take with meals or immediately after meals and with plenty of water.

• Swallow extended-release tablets whole.

• Do not crush/chew.

• Monitor potassium and kidney function.

• Avoid potassium-containing salt substitutes unless instructed.

• GI upset can occur.

• Report severe abdominal pain, vomiting, or signs of high potassium.

prednisone

steroid medication

• Take with food.

• Usually take in the morning if once daily.

• Can increase blood glucose, appetite, BP, and infection risk.

• Can cause insomnia and mood changes.

• Do not abruptly stop after prolonged use.

• Avoid exposure to infections when possible.

• Long-term use can cause osteoporosis, cataracts, adrenal suppression, etc.

• May require tapering.

propranolol

htn, arrhythmias, angina, tremor, migraine prevention, etc

• Take consistently with regard to meals.

• Can cause fatigue, dizziness, and slow HR.

• Do not abruptly stop.

• Can mask hypoglycemia symptoms.

• May worsen bronchospasm in asthma/COPD.

• Monitor BP and heart rate.

• Avoid driving until you know how it affects you.

rosuvastatin

for high cholesterol/CVD risk reduction

• Take once daily, with or without food.

• Can be taken any time of day.

• Report unexplained muscle pain/weakness or dark urine.

• Monitor lipid panel.

• Avoid excessive alcohol.

• Contraindicated in pregnancy.

• Kidney function may affect dosing.

• Lower interaction potential with grapefruit than some other statins.

sertraline

mood (SSRI antidepressant)

• Take once daily.

• May take several weeks for full effect.

• Can cause nausea, diarrhea, insomnia, or sexual dysfunction.

• Do not stop abruptly.

• Risk of serotonin syndrome with other serotonergic drugs.

• Monitor for worsening depression/suicidal thoughts.

• May increase bleeding risk with NSAIDs/anticoagulants.

• Avoid excessive alcohol

sildenafil

for ED; pulmonary hypertension

• For erectile dysfunction: generally take 30–60 minutes before sexual activity.

• Do not take more than once daily for ED.

• Requires sexual stimulation to work.

• Common: headache, flushing, nasal congestion, indigestion.

• Can cause dizziness/low BP.

• NEVER use with nitrates → potentially dangerous hypotension.

• Seek emergency care for an erection lasting >4 hours.

• Seek immediate attention for sudden vision/hearing loss.

• Alpha-blockers can increase hypotension risk.

simvastatin

for high cholesterol; CVD risk reduction

• Usually take in the evening.

• Report muscle pain, weakness, or dark urine.

• Avoid excessive grapefruit/grapefruit juice.

• Important drug interactions due to CYP3A4 metabolism.

• Monitor cholesterol/liver function as directed.

• Avoid during pregnancy.

• Do not exceed prescribed dose.

spirinolactone

potassium-sparing diuretic

• Take with or without food, but consistently with regard to food.

• Can increase potassium → hyperkalemia.

• Avoid potassium supplements and potassium-containing salt substitutes unless instructed.

• Monitor potassium and kidney function.

• Can cause dizziness and increased urination.

• May cause breast tenderness/enlargement and menstrual changes.

• Report muscle weakness or abnormal heartbeat.

• Avoid NSAID overuse because NSAIDs can worsen kidney function and potassium elevation.

tacrolimus

for organ transplant rejection, eczema

• Take at the same time every day and consistently with or without food.

• Do not switch between formulations without medical guidance.

• Requires therapeutic drug-level monitoring.

• Major concerns: kidney toxicity, hypertension, hyperkalemia, tremor, infections.

• Avoid grapefruit/grapefruit juice.

• Avoid live vaccines unless specifically approved.

• Report fever/infection, decreased urination, severe tremor, or unusual neurologic symptoms.

• Many drug interactions.

tamoxifen

breast cancer

• Can cause hot flashes, sweating, and vaginal symptoms.

• Increased risk of blood clots and stroke.

• Report leg swelling/pain, chest pain, shortness of breath, or sudden neurologic symptoms.

• Report abnormal vaginal bleeding.

• May increase risk of endometrial cancer.

• Avoid pregnancy; fetal harm.

• Some antidepressants, particularly strong CYP2D6 inhibitors, can reduce activation of tamoxifen.

tamsulosin

BPH; helps make it easier to urinate

• Take 30 minutes after the same meal each day.

• Capsule should generally be swallowed whole.

• Can cause dizziness/orthostatic hypotension.

• Rise slowly.

• May cause abnormal ejaculation.

• Tell ophthalmologist before cataract surgery due to risk of intraoperative floppy iris syndrome.

• PDE-5 inhibitors such as sildenafil can increase hypotension.

terazosin

BPH and hypertension

• Take at bedtime initially because of first-dose syncope/orthostatic hypotension.

• Rise slowly.

• Can cause dizziness/fainting.

• If therapy is interrupted for several days, dose may need to be restarted low.

• May cause headache, weakness, nasal congestion.

• PDE-5 inhibitors can increase hypotension.

• Monitor BP.

topiramate

seizures; migraine prevention

• May cause cognitive slowing, difficulty finding words, tingling, weight loss.

• Stay well hydrated → reduces kidney stone risk.

• Can cause metabolic acidosis.

• May decrease sweating → risk of overheating.

• Can cause acute angle-closure glaucoma → sudden eye pain/vision changes requires urgent evaluation.

• Avoid abrupt discontinuation.

• Can increase risk of birth defects; discuss contraception/pregnancy.

• May interact with hormonal contraceptives depending on dose.

trazodone

depression; off-label insomnia

• Usually taken at bedtime due to sedation.

• Can cause dizziness and orthostatic hypotension.

• Avoid alcohol and other CNS depressants.

• Do not drive until effects are known.

• Can cause dry mouth.

• Rare: priapism → emergency if erection lasts >4 hours.

• Risk of serotonin syndrome with serotonergic medications.

• Do not stop abruptly without guidance.

trospium chloride

overactive bladder/urge incontinence

• Take on an empty stomach, usually at least 1 hour before meals or as directed.

• Swallow extended-release capsules whole.

• Can cause dry mouth, constipation, blurred vision.

• May cause urinary retention.

• Avoid overheating because sweating can decrease.

• Can cause dizziness/drowsiness.

• Separate from certain medications because trospium absorption can be affected.

• Use caution in glaucoma, urinary retention, and kidney impairment.