old GCI

Bivalirudin

active bleeding

Dabigatran

active bleeding

Apixaban

active bleeding

Rivaroxaban

active bleeding

Ticagrelor

active bleeding

Warfarin

active bleeding, pregnancy

Clopidogrel

active bleeding; avoid omeprazole and esomeprazole due to diminished antiplatelet effect

Enoxaparin

active bleeding; history of heparin induced thrombocytopenia

Heparin

active bleeding; history of heparin induced thrombocytopenia

Prasugrel

active bleeding; prior history of stroke

Niacin

Active liver disease, PUD, arterial hemorrhage

Fenofibrate

active liver disease, severe renal impairment, breastfeeding

Thyroid

Acute MI, nontoxic diffuse goiter or nodular thyroid disease, uncorrected adrenal insufficiency

Levothyroxine

Acute MI, nontoxic diffuse goiter or nodular thyroid disease, uncorrected adrenal insufficiency

Metformin

Acute or chronic metabolic acidosis, severe renal impairment (eGFR

Spironolactone

anuria, acute renal insufficiency, hyperkalemia

Bumetanide

anuria, severe electrolyte depletion

Furosemide

anuria, severe electrolyte depletion

Chlorthalidone

anuria; sulfonamide hypersensitivity

Hydrochlorothiazide (HCTZ)

anuria; sulfonamide hypersensitivity

Bisacodyl

Appendicitis; intestinal obstruction; gastroenteritis

Aspirin

asthma, rhinitis, and nasal polyps syndrome

Loperamide

"bloody/black stools, febrile, invasive gut bacterial infections and antibiotic-

associated diarrhea (C. difficile)"

Acyclovir

buccal tablet: hypersensitivity to milk protein concentrate

Pseudoephedrine

CAD; hypertension; MAOI use concurrently or within 14 days

Oxymetazoline

CI: do not use for more than 3 days

Repaglinide

Concomitant therapy with gemfibrozil

Tizanidine

"Concomitant therapy with potent CYP1A2 inhibitors (eg, ciprofloxacin, fluvoxamine).

"

Docusate

Concomitant use of mineral oil; intestinal obstruction; acute abdominal pain, nausea, or vomiting

Dolutegravir

concurrent use with dofetilide

"Bictegravir, emtricitabine,

and tenofovir alafenamide"

concurrent use with dofetilide and rifampin

Isosorbide mononitrate

concurrent use with phosphodiesterase-5 (PDE-5) inhibitors (i.e. sildenafil) or riociguat

Nitroglycerin

concurrent use with phosphodiesterase-5 (PDE-5) inhibitors (i.e. sildenafil) or riociguat

Celecoxib

"CYP2C9 Substrate

Hypersensitivity (eg, anaphylaxis, serious skin reactions) to celecoxib, sulfonamides, aspirin, other NSAIDs. Though Sulfa cross reactivity is questionable"

Canagliflozin

Dialysis

Dapagliflozin

Dialysis

Empagliflozin

Dialysis

"Emtricitabine and

Tenofovir Disoproxil Fumarate"

do not use to treat HIV; do not use as pre-exposure prophylaxis in patients with unknown HIV status

Hydroxyzine

Documented hypersensitivity or related product including cetirizine and levocetirizine and components of the formulation, QT prolongation

Acetaminophen

hepatic disease or impairment; hypersensitivity

Sacubitril/Valsartan

history of angioedema, pregnancy, concomitant ACEIs or aliskiren

Diclofenac

"History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs

Major substrate of CYP2C9"

Colesevelam

history of bowel obstruction and hypertriglyceridemia-induced pancreatitis; triglycerides \> 300 mg/dL

Calcium Carbonate

Hypercalcemia

Varenicline

hypersensitivity

Etodolac

Hypersensitivity (eg, anaphylaxis, serious skin reactions) to etodolac, aspirin, other NSAIDs.

Salicylic Acid

"hypersensitivity to aspirin, Children/teens – recovering from chickenpox/flu – r/o Reye syndrome

"

Azithromycin

Hypersensitivity to azithromycin or any macrolide or ketolide antibiotic; hepatic dysfunction with prior azithromycin therapy

Carisoprodol

Hypersensitivity to carbamates

Ciprofloxacin

Hypersensitivity to ciprofloxacin or other quinolones, concurrent administration of tizanidine

Clarithromcyin

Hypersensitivity to clarithromycin or any macrolide or ketolide antibiotic; concomitant use with cisapride, pimozide, colchicine (in renal or hepatic impairment), lomitapride, lovastatin, simvastatin, ergotamine, dihydroergotamine; history of cholestatic jaundice or hepatic dysfunction

Clindamycin

Hypersensitivity to clindamycin, lincomycin, or any component of the formulation

Doxycycline

Hypersensitivity to doxycycline, other tetracyclines, or any component of the fomulation

Fidaxomicin

Hypersensitivity to fidaxomicin or component in the formulation

Levofloxacin

Hypersensitivity to levofloxacin or other quinolones, concurrent administration of tizanidine

Lidocaine Topical Patch

hypersensitivity to lidocaine

Linezolid

Hypersensitivity to linezolid or any component of the formulation. Concurrent use or within 2 weeks of monoamine oxidase inhibitors (MAOI).

Meloxicam

Hypersensitivity to meloxicam; history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs

Methocarbamol

Hypersensitivity to methocarbamol or any component of the formulation; renal impairment

Metronidazole

Hypersensitivity to metronidazole

Minocycline

Hypersensitivity to minocycline, other tetracyclines, or any component of the fomulation

Moxifloxacin

Hypersensitivity to moxifloxacin or other quinolones, concurrent administration of tizanidine

Nabumetone

Hypersensitivity to nabumetone or any component of the formulation, urticaria, or allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs); use in the setting of coronary artery bypass graft surgery.

Nitrofurantoin

Hypersensitivity to nitrofurantoin, use in neonates or pregnant patients at term (38-42 wk) due to risk of hemolytic anemia, anuria or oliguria

Bismuth Subsalicylate

"hypersensitivity to salicylates,

ulcer/bleeding problems, children

years of age, children and teens

recovering from chicken-pox or flu-like

symptoms, breastfeeding, pregnant"

Trimethoprim/sulfamethoxazole

Hypersensitivity to sulfonamides, children

Tramadol

"Hypersensitivity to tramadol, opioids or any component of the formulation

Use in pediatric paitents less than 12 years old

Signficant respiratory dression

Concomitant use with 14 days of an MAOI"

Vancomycin

Hypersensitivity to vancomycin or any component of formulation

Lubiprostone

Hypersensitivity, bowel obstruction

Tamoxifen

hypersensitivity, do not administer with warfarin. In patients with a history of DVT/PE, tamoxifen is also CI if the indication for treatment is either reduction of breast cancer incidence in high-risk patients or risk reduction of invasive breast cancer after treatment of DCIS

Anastrazole

hypersensitivity, women of premenopausal endocrine status (Including pregnant women)

Diphenoxylate/Atropine

Hypersensitvity to drug or it components, objstructive jaundice, C diff diareha

Baclofen

Injecting IV, IM, SubQ, or epidural administration

Polyethylene glycol 3350

Known or suspected bowel obstruction

Polyethylene Glycol

known or suspected bowel obstruction

Nicotine

Lozenge MINT - soy allergy/hypersensitivity

Cyclobenzaprine

MAOi inhibitors, arrhythmias; heart block or conduction disturbances; acute recovery phase of MI, avoid iin patient's with heart failure

Dextromethorphan

MAOI use concurrently or within 14 days

Hydralazine

mitral valve rheumatic disease, coronary artery disease

Dulaglutide

Multiple endocrine neoplasia type 2, personal or family history of medullary thryoid carcinoma

Semaglutide

Multiple endocrine neoplasia type 2, personal or family history of medullary thryoid carcinoma

Liraglutide

Multiple endocrine neoplasia type 2, personal or family history of medullary thryoid carcinoma

Diphenhydramine

newborns/premature infants; nursing mothers

Ibuprofen

NSAID allergy or hypersensitivity; CABG surgery

Naproxen

NSAID allergy or hypersensitivity; CABG surgery