PTCB Drugs with side effects, interactions, and contraindications by classification

ACE inhibitors - Hypertension/Heart Failure

Benazepril (Lotensin)

Enalapril (Vasotec)

Lisinopril (Zestril)

Ramipril (Altace)

Side effects: Dry cough, increased potassium, hypotension, Angioedema

Interactions: Drugs that increase potassium levels (spironolactone, ARBs), any other antihypertensive drug in combination can cause dangerously low blood pressure

Contraindications: Pregnancy, prior angioedema

Angiotensin Receptor Blockers (ARBs) - Hypertension/Heart Failure

Losartan (Cozaar)

Olmesartan (Benicar)

Valsartan (Diovan)

Side effects: Increased potassium, hypotension

Interactions: Drugs that increase potassium levels (spironolactone, ACEi's), any other antihypertensive drug in combination can cause dangerously low blood pressure

Contraindications: Pregnancy

Beta Blockers - Hypertension/Heart Failure

Atenolol (Tenormin)

Carvedilol (Coreg)

Metoprolol (Lopressor, Toprol XL)

Nebivolol (Bystolic)

Propranolol (Inderal)

Side effects: Bradycardia, hypotension

Interactions: Drugs that lower heart rate (diltiazem, verapamil), drugs that cause hypoglycemia (insulin) may mask symptoms, any other antihypertensive drug in combination can cause dangerously low blood pressure

Contraindications: Asthma, heart block

Calcium Channel Blockers - Hypertension

Amlodipine (Norvasc)

Diltiazem (Cardizem)

Nifedipine (Procardia)

Verapamil (Calan, Verelan)

Side effects: hypotension, bradycardia (for diltiazem and verapamil)

Interactions: Drugs that lower heart rate (beta blockers), any other antihypertensive drug in combination can cause dangerously low blood pressure

Contraindications: Heart failure or heart block (for diltiazem and verapamil)

Alpha Agonists - Hypertension

Clonidine (Catapres)

Side effects: hypotension

Interactions: any other antihypertensive drug in combination can cause dangerously low blood pressure

Diuretics - Hypertension/Heart Failure

Chlorthalidone (Thalitone,Hygroton)

Furosemide (Lasix)

Hydrochlorothiazide (Microzide)

HCTZ/ Triamterene (Dyazide, Maxzide)

Spironolactone (Aldactone)

Side effects: hypotension, electrolyte abnormalities, dehydration

Interactions: aminoglycosides; can cause kidney damage, any other antihypertensive drug in combination can cause dangerously low blood pressure

Vasodilators - Heart Failure/Angina

Hydralazine (Apresoline)

Isosorbide Mononitrate (Imdur)

Nitroglycerin (Nitrostat)

Side effects: hypotension, headache

Interactions: any other antihypertensive drug in combination can cause dangerously low blood pressure

Cardiac Glycosides - Heart Failure/Atrial Fibrillation

Digoxin (Lanoxin) NTI

Side effects: bradycardia, digoxin toxicity (vision changes, nausea, vomiting, arrhythmias)

Interactions: loop diuretics and thiazide diuretics increase risk of digoxin toxicity

HMG-CoA Reductase Inhibitors - Lowers Cholesterol

Atorvastatin (Lipitor)

Lovastatin (Altoprev)

Pravastatin (Pravachol)

Rosuvastatin (Crestor)

Simvastatin (Zocor)

Side effects: muscle pains, rhabdomyolysis, liver failure

Interactions: grapefruit juice, fibrates increase risk of liver toxicity, macrolides increase risk of adverse effects

Contraindications: Pregnancy

Fibrates - Lowers Cholesterol

Fenofibrate (Tricor)

Gemfibrozil (Lopid)

Side effects: muscle pains, liver failure

Interactions: statins increase risk of liver toxicity

Cholesterol Absorption Inhibitors - Lowers Cholesterol

Ezetimibe (Zetia)

Fish Oils - Lowers Cholesterol

Omega-3 Fatty Acids (Lovaza)

Side effects: bad taste

Antiplatelets

Aspirin

Clopidogrel (Plavix)

Used to prevent heart attacks/strokes in at risk patients

Side effects: bleeding

Interactions: other drugs that increase risk of bleeding (anticoagulants, NSAIDs, WARFARIN), omeprazole with clopidogrel reduces effects

Contraindications: Aspirin can cause peptic/gastric ulcers, BLEEDING

Anticoagulants - Prevents Blood Clots, Heart Attacks/Stroke

Apixaban (Eliquis)

Rivaroxaban (Xarelto)

Warfarin (Coumadin) NTI

Side effects: bleeding

Interactions: other drugs that increase risk of bleeding (NSAIDS, anticoagulants), Warfarin is prone to interactions with many drugs because of its interference with metabolism; VITAMIN K, phenytoin reduces effects of warfarin

Contraindications: major bleeding

Anti-arrhythmics - Irregular Heart Beat

Amiodarone (Cordarone) NTI

Side effects: can actually cause arrhythmias, amiodarone can cause lung toxicity, hypothyroidism, and liver toxicity

Interactions: many because of interference with metabolism, drugs that prolong QT interval may increase risk of arrhythmias

Biguanides - Diabetes

Metformin (Glucophage)

Side effects: gastrointestinal upset, lactic acidosis (rare)

Contraindications: chronic kidney disease, advanced heart failure

Sulfonylureas - Diabetes

Glipizide (Glucotrol)

Glimepiride (Amaryl)

Glyburide (Glynase)

Side effects: hypoglycemia

Interactions: other drugs that can cause hypoglycemia (like insulin)

Thiazolidinediones - Diabetes

Pioglitazone (Actos)

Side effects: fluid retention (edema)

Contraindications: heart failure

DPP-4 Inhibitors - Diabetes

Linagliptin (Tradjenta)

Sitagliptin (Januvia)

Sitagliptin + Metformin (Janumet)

GLP-1 Receptor Agonists - Diabetes

Liraglutide (Victoza)

Contraindications: Medullary Thyroid Carcinoma (MTC)

SGLT-2 Inhibitors - Diabetes

Canagliflozin (Invokana)

Side effects: lower limb amputations (rare)

Insulins - Diabetes

Insulin aspart (Novolog)

Insulin detemir (Levemir)

Insulin glargine (Lantus, Toujeo)

Insulin lispro (HumaLOG)

Regular insulin (HumuLIN, NovoLIN)

Side effects: hypoglycemia, weight gain

Interactions: other drugs that cause hypoglycemia (sulfonylureas), beta blockers can mask the signs of hypoglycemia

Thyroid Analogues - Hypothyroidism

Levothyroxine (Synthroid, Levoxyl) NTI

Thyroid (Armour Thyroid)

Interactions: food; should be taken at the same time on an empty stomach

Oral Contraceptives

Ethynyl Estradiol/Desogestrel

Ethynyl Estradiol/Drospirenone

Ethynyl Estradiol/Etonogestrel

Ethynyl Estradiol/Levonorgestrel

Ethynyl Estradiol/Norethindrone

Ethynyl Estradiol/Norgestimate

Norethindrone

Side effects: increased risk of blood clots, breakthrough

bleeding

Interactions: some antibiotics, smoking causes increased risk of blood clots

Contraindications: history of major blood clots

Estrogens - Manages Hormones

Estradiol (numerous brands)

Side effects: increase risk of cardiovascular events and estrogen sensitive cancers

Interactions: phenytoin reduces effects

Contraindications: history of heart attacks, stroke, certain cancers

Androgens - Testosterone Deficiency

Testosterone (Androgel, Androderm, Testim, etc.) Clll

Contraindications: avoid exposure to children

Proton Pump Inhibitors (PPIs) - GERD

Esomeprazole (Nexium)

Lansoprazole (Prevacid)

Omeprazole (Prilosec)

Histamine-2 (H2) Receptor Blockers - GERD

Famotidine (Pepcid)

Ranitidine (Zantac)

5-HT3 Antagonists - Prevent Nausea

Ondansetron (Zofran)

Side effects: cardiac arrhythmias (rare)

Laxatives

Docusate (Colace)

Polyethylene Glycol (Miralax)

Side effects: diarrhea

Antidiarrheals

Loperamide (Imodium)

Side effects: constipation

Selective Serotonin Reuptake Inhibitors (SSRIs) - Depression

Citalopram (Celexa)

Escitalopram (Lexapro)

Fluoxetine (Prozac)

Paroxetine (Paxil)

Sertraline (Zoloft)

Interactions: use with other drugs that increase serotonin can cause "serotonin syndrome" (certain antidepressants, muscle relaxants, tramadol, St. Johns Wort), first generation antihistamines with SSRIs can cause increased sedation

Selective Norepinephrine Reuptake Inhibitors (SNRIs) - Depression

Duloxetine (Cymbalta)

Venlafaxine (Effexor)

Interactions: use with other drugs that increase serotonin can cause "serotonin syndrome" (certain antidepressants, muscle relaxants, tramadol, St. Johns Wort)

Monoamine Oxidase Inhibitors (MAOIs) - Antidepressant

Isocarboxazid (Marplan)

Tranylcypromine (Parnate)

Phenelzine (Nardil)

Interactions: taking foods with tyramine (fermented products) increases the risk of hypertensive crisis when taken with MAO inhibitor

*must wait 2 weeks before starting therapy after taking any other serotonin agent. MAOi's were the first antidepressant used and are not commonly administered anymore. these are really only in the set because of the interactions

Tricyclic Antidepressants (TCAs) - Depression

Amitriptyline (Elavil) NTI

Nortriptyline (Pamelor)

Side effects: overdose are particularly life threatening which has limited their use since safer drugs are available

Interactions: use with other drugs that increase serotonin can cause "serotonin syndrome" (certain antidepressants, muscle relaxants, tramadol, St. Johns Wort)

Miscellaneous Antidepressants

Bupropion (Wellbutrin)

Mirtazapine (Remeron)

Trazodone (Desyrel)

Antipsychotics - Schizophrenia

Aripiprazole (Abilify)

Quetiapine (Seroquel)

Risperidone (Risperdal) *note: not for older patients

Side effects: extrapyramidal symptoms, numerous other side effects that vary

Interactions: other drugs that prolong that QT interval (risk for life threatening arrhythmias), first generation antihistamines with antipsychotics can cause increased sedation

Bipolar Disorder Drugs

Lithium (Lithobid) NTI

Side effects: narrow therapeutic index drug (NTI) serum concentrating monitoring required

Antiepileptics

Carbamazepine (Tegretol) NTI

Gabapentin (Neurontin)

Lamotrigine (Lamictal)

Levetiracetam (Keppra)

Pregabalin (Lyrica)

Topiramate (Topamax)

Phenytoin (Dilantin, Phenytek) NTI

Side effects: NTI require serum concentration monitoring

Interactions: numerous

Opioid Analgesics - Pain

Acetaminophen + Hydrocodone (Hycet, Lorcet, Lortab, Norco, Vicodin) Cll

Hydrocodone Bitartrate (Zohydo)

Morphine (MS Contin, Roxanal)

Oxycodone (Oxycontin, Roxicodone) Cll

Tramadol (Ultram) ClV

Buprenorphine (Suboxone) Clll - for opiod dependence

Codeine+APAP (Tylenol 3) Clll

Side effects: respiratory depression, somnolence, constipation, psychological dependence

Interactions: other drugs that cause CNS or respiratory depression (alcohol, benzodiazepines, muscle relaxants, etc.)

Non-Opioid Analgesics - Pain/Fever

Acetaminophen (Tylenol)

Acetaminophen+Butalbital+Caffine (Fioricet)

Side effects: liver toxicity

Interactions: other drugs that cause liver toxicity (alcohol, etc.)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) - Pain/Inflammation

Celecoxib (Celebrex)

Diclofenac (Flector, Voltaren)

Ibuprofen (Advil, Motrin)

Meloxicam (Mobic)

Naproxen (Aleve, Naprosyn)

Side effects: increase incidence of cardiovascular events, bleeding, peptic ulcers, kidney failure

Interactions: other drugs that cause bleeding (WARFARIN)

Muscle Relaxants

Baclofen (Lioreasal)

Cyclobenzaprine (Flexeril)

Methocarbamol (Robaxin)

Tizanidine (Zanaflex)

Side effects: somnolence

Interactions: use with other drugs that cause CNS (opiates), some may interact with other drugs that increase serotonin levels (risk for serotonin syndrome) or drugs that lower seizure threshold

5-HT Antagonists - Migraine

Sumatriptan (Imitrex)

Antitussives - Cough

Benzonatate (Tessalon)

Dextromethorphan (Delsym)

Benzodiazepines - Anxiety

Alprazolam (Xanax) ClV

Clonazepam (Klonopin) ClV

Diazepam (Valium) ClV

Lorazepam (Ativan) ClV

Chlordiazepoxide (Librium)

Temazepam (Restoril) ClV

Side effects: sedation, risk for dependence and abuse

Interactions: other CNS depressants (alcohol, opiates, etc.)

Non-Benzodiazepine Hypnotics/Anxiolytics - Insomnia/Anxiety

Zolpidem (Ambien) ClV

Buspirone (Buspar)

Eszopiclone (Lunesta) ClV

Side effects: "sleep walking"

Stimulants - ADHD

Dexmethylphenidate (Focalin) Cll

Dextroamphetamine (Dexedrine) Cll

Lisdexamfetamine (Vyvanse) Cll

Methylphenidate (Concerta, Ritalin, Methylin, Metadate, Daytrana) Cll

Amphetamine/Dextroamphetamine Salts (Adderall) Cll

Side effects: tics

Non-Stimulants for ADHD

Atomoxetine (Strattera)

Guanfacine (Intuniv, Tenex)

Dopaminerics - Parkinson's

Levodopa+Carbidopa (Sinemet)

Side effects: dyskinesia

Dopamine Agonists - Parkinson's

Pramipexole (Mirapex)

Ropinirole (Requip)

Cholinesterase Inhibitors - Alzheimer's

Donepezil (Aricept)

NMDA Receptor Antagonists - Alzheimer's

Memantine (Namenda)

Penicillins - Bacterial Infections

Amoxicillin (Amoxil)

Amoxicillin+Clavulanate (Augmentin)

Side effects: diarrhea

Contraindications: allergies

Cephalosporins - Bacterial Infections

Cefdinir (Omnicef)

Cephalexin (Keflex)

Side effects: diarrhea

Contraindications: cross-reactivity with penicillin allergies

Macrolides - Bacterial Infections

Azithromycin (Zithromax, Z-pak)

Side effects: arrythmias (rare), upset stomach, take on empty stomach

Interactions: other drugs that prolong QT interval, intensifies effects of warfarin, digoxin, and cyclosporine.

Fluoroquinolones - Bacterial Infections

Ciprofloxacin (Cipro)

Levofloxacin (Levaquin)

Side effects: arrhythmias (rare) and tendon rupture (rare)- has blackbox warning for these reasons, nausea

Interactions: other drugs that prolong QT intervals. multivalent ions (calcium, magnesium, iron) reduce effectiveness

Tetracyclines - Bacterial Infections

Doxycycline (Monodox, Vibramycin etc.)

Tetracycline (Sumycin)

Side effects: upset stomach, should not eat dairy or take antacids within several hours before or after

Miscellaneous Antibiotics

Clindamycin (Cleocin)

Bacitracin, Neomycin, Polymixin B (Neosporin)

Metronidazole (Flagyl, Metrogel)

Nitrofurantoin (Macrobid)

Mupirocin (Bactroban)

Sulfamethoxazole, Trimethoprim (Bactrim)

Antiviral Drugs

Acyclovir (Zovirax) (for herpes)

Valacyclovir (Valtrex) (for herpes)

Oseltamivir (Tamiflu) (influenza)

Antifungal Drugs

Fluconazole (Diflucan)

Antimalarial Drugs - Malaria Treatment-Prevention

Hydroxychloroquine (Plaquenil)

can treat lupus too

Beta Agonists - Asthma/COPD

Albuterol (ProAir, Proventil, Ventolin) -short acting

Salmeterol (Serevent) -long acting

Side effects: tachycardia

Interactions: counteracted by beta blockers

Anticholinergics - Asthma/COPD

Ipratropium (Atrovent) -short acting

Tiotroprium (Spiriva) -long acting

Albuterol+Ipratropium (Combivent) -combo w/ beta agonists

Theophylline (Uniphyl, Elixophyllin) NTI

Side effects: tachycardia

Inhaled Corticosteroids - Asthma/COPD

Beclomethasone (QVAR)

Budesonide (Pulmicort)

Fluticasone (Flonase, Flovent, Arnuity)

Mometasone (Asmanex)

Combinations with bronchodilators:

Budesonide+Formoterol (Symbicort)

Fluticasone+Salmeterol (Advair)

Interactions: increase the risk of hypokalemia (low blood potassium levels) when taken with beta-2 agonists

Antihistamines - Allergies

Cetirizine (Zyrtec)

Hydroxyzine (Atarax, Vistaril) *note: not for older patients

Levocetirizine (Xyzal)

Loratadine (Claritin)

Meclizine (Antivert, Bonine)

Promethazine (Phenergan)

Side effects: "anticholinergic" side effects

Leukotriene Modifiers - Asthma/Allergies

Montelukast (Singulair)

Intranasal Corticosteroids - Allergies

Triamcinolone (Nasacort)

Interactions: increase the risk of hypokalemia (low blood potassium levels) when taken with beta-2 agonists

Topical Corticosteroids

Hydrocortisone (Coritzone)

Triamcinolone (Kenalog)

Oral Corticosteroids - Inflammatory Disorders

Methylprednisolone (Medrol)

Prednisolone (Orapred)

Prednisone (Deltasone)

Side effects: weight gain, hyperglycemia, "moon face"

Interactions: NSAIDS; increased risk of peptic ulceration, increase the risk of hypokalemia (low blood potassium levels) when taken with beta-2 agonists

Monoclonal Antibodies

Adalimumab (Humira)

for rheumatoid arthritis, ibs, etc.

Side effects: increase risk for infections and certain cancers

Alpha Antagonists

Doxazosin (Cardura)

Tamulosin (Flomax)

Terazosin (Hytrin)

mostly indicated for Benign Prostatic Hypertrophy

Side effects: orthostatic hypotension

Anticholinergics

Mirabegron (Mybetriq) -overactive bladder

Oxybutynin (Ditropan) -overactive bladder

Dicyclomine (Bentyl) - IBS

Anti-Gout

Colchicine (Colcrys) -acute gout attacks

Allopurinol (Zyloprim) -reduce risk of attacks

Side effects: liver toxicity (for allopurinol)

PDE5 Inhibitors - Vasodilator

Sildenafil (Viagra)

Tadalafil (Cialis)

Vardenafil (Levitra)

Avanafil (Stendra)

Side effects: headache, congestion, dyspepsia

Contraindications: nitrates may cause sever hypotension

Bisphosphonates - Osteoporosis

Alendronate (Fosamax)

Side effects: erosive esophagitis

Interactions: food and other drugs reduce absorption, should be taken 30-60 minutes before any other drugs or food

Chemotherapeutic Agents

Methotrexate ("MTX") NTI

Side effects: hazardous drug

Opthalmic drugs - Glaucoma

Latanoprost (Xalatan)

Timolol (Timoptic)

Brimonidine (Alphagan)

Vitamin D Supplement

Ergocalciferol (Deltalin)

Vitamin A

Retinol

fat soluble

vital for vision, skeletal growth, and regulation of mucous membranes of the oral cavity and eyes.

Vitamin D

Calciferol

fat soluble

vital for bone and teeth formation by assisting absorption of calcium and phosphorous

Vitamin E

Tocopherols

fat soluble

antioxidant properties

Vitamin K

Phytomenadione

fat soluble

vital for blood clotting

Vitamin C

Ascorbic acid

water soluble

assists with wound healing, immune system function and collagen synthesis

Vitamin B1

Thiamine

water soluble

promotes normal appetite, essential for nervous system function

Vitamin B2

Riboflavin

water soluble

vision/healthy skin

Vitamin B3

Niacin

water soluble

digestion, appetite, healthy skin

Vitamin B5

Panthothenic acid

water soluble

hormone formation and nutrient metabolism

Vitamin B6

Pyridoxine

water soluble

promotes formation of red blood cells, insulin, and hemoglobin

Vitamin B7

Biotin

water soluble

essential to metabolize proteins and carbohydrates

Vitamin B9

Folic Acid

water soluble

promotes red blood cells production, energy metabolism, and collagen synthesis

Vitamin B12

Cobalamins

water soluble

promotes red blood cell production, energy metabolism, and collagen synthesis

Fish Oil

cholesterol; blood pressure maintenance

Glucosamine

osteoarthritis; bone disorders

Kava Kava

stress and anxiety, sedative effects

Milk Thistle

liver disease

St. John's Wort

depression

Saw Palmetto

prostate disorders

Melatonin

sleep-inducing hormone

Valerian Root

anxiety