Contraindications and Warnings

Thyroid

Armour Thyroid, NP Thyroid

Black box - Not to be used for weight loss

Levothyroxine

Synthroid, Levoxyl

Black box - Not to be used for weight loss

Estradiol

Estrace

Black box - Risk of endometrial cancer

Ethinyl estradiol + Drospirenone

Yaz, Yasmin

Risk of thromboembolism and cancer

Black box - smoking and CV risk, especially 35+ yo

Ethinyl estradiol + Levonorgestrel

Lutera, Trivora

Risk of thromboembolism and cancer

Black box - smoking and CV risk, especially 35+ yo

Ethinyl estradiol + Norethindrone

Loestrin

Risk of thromboembolism and cancer

Black box - smoking and CV risk, especially 35+ yo

Ethinyl estradiol + Norgestimate

Estarylla, Ortho-Tri-Cyclen

Risk of thromboembolism and cancer

Black box - smoking and CV risk, especially 35+ yo

Ethinyl estradiol + Etonogestrel

NuvaRing

Risk of thromboembolism and cancer

Black box - smoking and CV risk, especially 35+ yo

Norethindrone

Ortho Micronor, Errin, Heather

Black box - Cigarette smoking increases risk of MI

Progesterone

Prometrium

Hypersensitivity to peanuts (oil in caps)

Testosterone

Depo-Testosterone, Androderm, Androgel Pump

Breast and prostate cancer, uncontrolled HTN

Black box - Secondary exposure to testosterone (topical formulations) - advise caution

Dorzolamide

Trusopt

None

Latanoprost

Xalatan

None

Timolol

Timoptic, Betimol

Caution in pt with asthma, COPD, heart disease

Dapagliflozin

Farxiga

Pregnancy, renal disease

Dulaglutide

Trulicity

Medullary thyroid cancer, multiple endocrine neoplasia syndrome, DMT1

Black box - Risk of thyroid cancer

Empagliflozin

Jardiance

Pregnancy, renal disease

Glimepiride

Amaryl

Hypoglycemia risk

Glipizide

Glucotrol

Hypoglycemia risk

Insulin Aspart

Novolog

Hypoglycemia risk

Insulin Degludec

Tresiba

Hypoglycemia risk, not to be used in insulin pump

Insulin Glargine

Lantus, Lantus SoloStar, Basaglar

Hypoglycemia risk, not to be used in insulin pump

Insulin Isophane

Humulin N, Novolin N

Hypoglycemia risk, not to be used in insulin pump

Insulin Lispro

Humalog

Hypoglycemia risk

Metformin

Glucophage

Hx of lactic acidosis, renal dysfunction, dehydration

Black box - lactic acidosis

Pioglitazone

Actos

CHF, DMT1, not for use in children

Semaglutide

Ozempic, Rybelsus

Medullary thyroid cancer, multiple endocrine neoplasia syndrome, DMT1

Black box - Risk of thyroid cancer

Sitagliptin

Januvia, Janumet

DMT1

Tirzepatide

Mounjaro, Zepbound

Medullary thyroid cancer, multiple endocrine neoplasia syndrome, DMT1

Black box - Risk of thyroid cancer

Alendronate

Fosamax

Caution in pt with esophageal issues (ensure tablet is swallowed)

Phentermine

Adipex-P, Fastin, Qsymia

Hx of CV disease, pregnancy, renal dysfunction, uncontrolled HTN

Methotrexate

Trexall, Rheumatrex

Pregnancy, pt with renal/hepatic/pulmonary dysfunction, myelosuppression

Black box - MANY boxed warnings including fetal/pulmonary/hepatic/GI toxicity, risk of lymphoma, and more

Anastrozole

Arimidex

Pregnancy, pre-menopausal pts