631 - Top Drug #2 - Class, Use, C/I, BBW

Acyclovir (Zovirax)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Anti-viral

• Herpes simplex infection

• Hypersensitivity

Nirmatrelvir and ritonavir (Paxlovid)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Anti-viral

• COVID-19

• Hypersensitivity (toxic epidermal necrolysis, Steven-Johnson syndrome); Avoid co-admin with CYP3A4 substrates

• BBW: Significant drug interactions (this drug is a strong CYP3A4 inhibitor)

Valacyclovir (Valtrex)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Nucleoside analogue

• Herpes zoster, herpes labialis

• Hypersensitivity (Anaphylaxis, severe cutaneous adverse reactions)

Carvedilol (Coreg)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Beta adrenergic blocker - non-cardioselective and alpha-1 adrenergic blocker

• For HF and HTN

• Bradycardia, Heart block, HF

Chlorthalidone (Thalitone)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Diuretic

• HTN

• Hypersensitivity, other sulfonamide-derived drugs, anuria

Clopidogrel (Plavix)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Platelet activation and aggregation inhibitor

• ACS, MI, Stroke prevention

• Bleeding risk

• Diminished anti-platelet effect in CYP2C19 poor metabolizers

Diltiazem (Cardizem, Tiazac)

• Class

• Use

• C/I, warnings, precautions

• BBW

• CCB

• Angina, HTN

• AV Block, systolic BP < 90, HF

Enalapril (Vasotec)

• Class

• Use

• C/I, warnings, precautions

• BBW

• ACE-i

• HTN, HF

• Pregnancy, Hx of angioedema

• Fetal toxicity

Doxazosin (Cardura)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Alpha adrenergic blocker

• HTN, BPH

• Hypersensitivity; CNS depression, Dec in WBC and neutrophil count

Furosemide (Lasix)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Loop diuretic

• Edema, HF

• Anuria, severe electrolyte imbalance

• Fluid and electrolyte depletion

Hydralazine (Apresoline)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Vasodilator

• HTN, HF

• Hypersensitivity; coronary artery disease; mitral valve rheumatic heart disease

Irbesartan (Avapro)

• Class

• Use

• C/I, warnings, precautions

• BBW

• ARB

• HTN

• Pregnancy

• Fetal toxicity

Isosorbide dinitrate (Isordil)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Nitrate

• Angina

• Hypersensitivity; PDE5-i and riociguat, Hypotension/bradycardia, Increased ICP

Isosorbide mononitrate (Ismo, Imdur)

• Class

• Use

• C/I, warnings, precautions

• BBW

• Nitrate

• Angina

• Hypersensitivity; PDE5-i and riociguat, CNS depression

Lisinopril (Zestril, Prinivil)

• Class

• Use

• C/I, warnings, precautions

• BBW

• ACE-i

• HTN, HF

• Pregnancy, Hx of angioedema

• Fetal toxicity

Lisinopril + Hydrochlorothiazide (Zestoretic)

• Class: ACE inhibitor + thiazide diuretic

• Use: Hypertension, Heart failure

• C/I / Warnings / Precautions: Pregnancy, history of angioedema

• BBW: Fetal toxicity

Losartan (Cozaar)

• Class: Angiotensin II receptor blocker (ARB)

• Use: Hypertension, Heart failure

• C/I / Warnings / Precautions: Pregnancy

• BBW: Fetal toxicity

Losartan + Hydrochlorothiazide (Hyzaar)

• Class: ARB + thiazide diuretic

  Use: Hypertension, Heart failure

  C/I / Warnings / Precautions: Pregnancy

  BBW: Fetal toxicity

Metoprolol Succinate (Toprol XL)

• Class: Beta adrenergic blocker

• Use: Angina, Hypertension

• C/I / Warnings / Precautions: Bradycardia, heart block, heart failure

Metoprolol Tartrate (Lopressor)

• Class: Beta adrenergic blocker

  Use: Myocardial infarction

  C/I / Warnings / Precautions: Bradycardia, heart block, heart failure

Nebivolol (Bystolic)

• Class: Beta-1 selective blocker

  Use: Hypertension

  C/I / Warnings / Precautions: Heart failure, AV block

Nifedipine (Procardia, Adalat CC)

• Class: Calcium channel blocker

  Use: Hypertension

Olmesartan (Benicar)

• Class: Angiotensin II receptor blocker (ARB)

  Use: Hypertension

  C/I / Warnings / Precautions: Pregnancy

  BBW: Fetal toxicity

Potassium Chloride (Micro-K, Klor-Con)

• Class: Essential mineral

  Use: Hypokalemia

Propranolol (Inderal)

• Class: Beta adrenergic blocker

  Use: Angina, Hypertension

  C/I / Warnings / Precautions: Bradycardia, heart block, heart failure

Rivaroxaban (Xarelto)

• Class: Factor Xa inhibitor anticoagulant

• Use: Stroke, Deep vein thrombosis

• C/I / Warnings / Precautions: Bleeding risk

• BBW: Increased thrombotic event and stroke risk when discontinued early; epidural/spinal hematoma risk

Sacubitril + Valsartan (Entresto)

• Class: Neprilysin inhibitor + ARB

  Use: CHF

  C/I / Warnings / Precautions: Pregnancy

  BBW: Fetal toxicity

Telmisartan (Micardis)

• Class: Angiotensin II receptor blocker (ARB)

  Use: Hypertension

  C/I / Warnings / Precautions: Pregnancy

  BBW: Fetal toxicity

Valsartan (Diovan)

• Class: Angiotensin II receptor blocker (ARB)

  Use: Hypertension, Heart failure

  C/I / Warnings / Precautions: Pregnancy

  BBW: Fetal toxicity

Verapamil (Calan, Verelan)

• Class: Calcium channel blocker

• Use: Hypertension

• C/I / Warnings / Precautions: AV block, systolic BP <90, heart failure

Warfarin (Coumadin)

• Class: Vitamin K antagonist anticoagulant

• Use: Venous thromboembolism, Pulmonary embolism

• C/I / Warnings / Precautions: Bleeding risk, pregnancy

• BBW: Major or fatal bleeding risk

Clobetasol (Clobex)

• Class: Corticosteroid

  Use: Inflammation, Pruritus

Tretinoin (Retin-A)

• Class: Retinoid

• Use: Acne

Calcium Carbonate (TUMS)

• Class: Antacid, Electrolyte supplement

• Use: Antacid, Electrolyte supplement

Folic Acid

• Class: Vitamin

• Use: Anemia, Dietary supplement

Magnesium Salts (Mag-Ox)

• Class: Antacid, Electrolyte supplement

  Use: Magnesium deficiency

Alendronate (Fosamax)

• Class: Bisphosphonate

• Use: Osteoporosis

• C/I / Warnings / Precautions: Caution in patients with esophageal issues (ensure tablet is swallowed)

Dulaglutide (Trulicity)

Class: Glucagon-like peptide-1 (GLP-1) receptor agonist

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: Medullary thyroid cancer, multiple endocrine neoplasia syndrome, type 1 DM

BBW: Risk of thyroid cancer

Estradiol (Estrace)

Class: Estrogen

Use: Menopause

BBW: Risk of endometrial cancer

Ethinyl Estradiol + Drospirenone (Yaz, Yasmin)

Class: Estrogen + Progestin

Use: Oral contraception

C/I / Warnings / Precautions: Risk of thromboembolism and cancer

BBW: Smoking & cardiovascular risk, especially in patients >35

Ethinyl Estradiol + Etonogestrel (NuvaRing)

Class: Progestin + Estrogen

Use: Oral contraception

C/I / Warnings / Precautions: Risk of thromboembolism and cancer

BBW: Smoking & cardiovascular risk, especially in patients >35

Ethinyl Estradiol + Levonorgestrel (Lutera, Trivora)

Class: Estrogen + Progestin

Use: Oral contraception

C/I / Warnings / Precautions: Risk of thromboembolism and cancer

BBW: Smoking & cardiovascular risk, especially in patients >35

Ethinyl Estradiol + Norethindrone (Loestrin)

Class: Estrogen + Progestin

Use: Oral contraception

C/I / Warnings / Precautions: Risk of thromboembolism and cancer

BBW: Smoking & cardiovascular risk, especially in patients >35

Ethinyl Estradiol + Norgestimate (Estarylla, Ortho-Tri-Cyclen)

Class: Estrogen + Progestin

Use: Oral contraception

C/I / Warnings / Precautions: Risk of thromboembolism and cancer

BBW: Smoking & cardiovascular risk, especially in patients >35

Glimepiride (Amaryl)

Class: Sulfonylurea

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: Hypoglycemia risk

Glipizide (Glucotrol)

Class: Sulfonylurea

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: Hypoglycemia risk

Insulin Aspart (Novolog)

Class: Insulin - rapid acting

Use: Diabetes mellitus

C/I / Warnings / Precautions: Hypoglycemia risk

Insulin Degludec (Tresiba)

Class: Insulin - long acting

Use: Diabetes mellitus

C/I / Warnings / Precautions: Hypoglycemia risk, not to be used in insulin pump

Insulin Glargine (Lantus, Lantus SoloStar, Basaglar)

Class: Insulin - long acting

Use: Diabetes mellitus

C/I / Warnings / Precautions: Hypoglycemia risk, not to be used in insulin pump

Insulin Isophane (Humulin N, Novolin N)

Class: Insulin - intermediate acting

Use: Diabetes mellitus

C/I / Warnings / Precautions: Hypoglycemia risk, not to be used in insulin pump

Insulin Lispro (Humalog)

Class: Insulin - rapid acting

Use: Diabetes mellitus

C/I / Warnings / Precautions: Hypoglycemia risk

Levothyroxine (Synthroid, Levoxyl)

Class: Thyroid hormone

Use: Hypothyroidism

BBW: Not to be used for weight loss

Metformin (Glucophage)

Class: Biguanide

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: History of lactic acidosis, renal dysfunction, dehydration

BBW: Lactic acidosis

Norethindrone (Ortho Micronor, Errin, Heather)

Class: Progestin-only contraception

Use: Oral contraception

BBW: Cigarette smoking increases risk of MI

Pioglitazone (Actos)

Class: Thiazolidinedione

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: CHF, type 1 diabetes, not for use in children

BBW: Congestive heart failure

Progesterone (Prometrium)

Class: Progestin

Use: Endometrial hyperplasia

C/I / Warnings / Precautions: Hypersensitivity to peanuts (oil in capsules)

Semaglutide (Ozempic, Rybelsus)

Class: Glucagon-like peptide-1 (GLP-1) receptor agonist

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: Medullary thyroid cancer, multiple endocrine neoplasia syndrome, type 1 DM

BBW: Risk of thyroid cancer

Sitagliptin (Januvia)

Class: Dipeptidyl peptidase-4 (DPP-4) inhibitor

Use: Diabetes mellitus type 2

C/I / Warnings / Precautions: Type 1 DM

Testosterone (Depo-Testosterone, Androderm, Androgel Pump)

Class: Androgen

Use: Male hypogonadism

C/I / Warnings / Precautions: Pregnancy, CAD, prostate cancer, uncontrolled HTN

BBW: Breast & prostate cancer, uncontrolled HTN; secondary exposure to testosterone (topical formulations) - advise caution

Thyroid (Armour Thyroid, NP Thyroid)

Class: Thyroid hormone

Use: Hypothyroidism

BBW: Not to be used for weight loss

Tirzepatide (Mounjaro, Zepbound)

Class: GIP + GLP-1 receptor agonist

Use: Diabetes mellitus type 2, Obesity/weight management/sleep apnea

C/I / Warnings / Precautions: Medullary thyroid cancer, multiple endocrine neoplasia syndrome, type 1 DM

BBW: Risk of thyroid cancer

Dapagliflozin (Farxiga)

Class: Sodium-glucose cotransporter 2 (SGLT2) inhibitor

Use: CKD, DM, HF

C/I / Warnings / Precautions: Pregnancy, renal disease

Empagliflozin (Jardiance)

Class: Sodium-glucose cotransporter 2 (SGLT2) inhibitor

Use: CKD, DM, HF

C/I / Warnings / Precautions: Pregnancy, renal disease

Dicyclomine (Bentyl)

Class: Anticholinergic, Antispasmodic

Use: Irritable bowel syndrome

Docusate (Colace)

Class: Stool softener

Use: Constipation

Linaclotide (Linzess)

Class: Guanylate cyclase-C agonist

Use: Constipation

C/I / Warnings / Precautions: Not for use in children <2 years old

BBW: Not for use in children <2 years old

Ondansetron (Zofran)

Class: Serotonin 5-HT3 receptor antagonist

Use: Nausea, Vomiting

C/I / Warnings / Precautions: May increase risk of QT prolongation

Polyethylene Glycol 3350 (Miralax, Glycolax)

Class: Osmotic laxative

Use: Constipation, Bowel evacuation

Ferrous Sulfate

Class: Essential mineral

Use: Anemia, Dietary supplement

Adalimumab (Humira)

Class: Antirheumatic, monoclonal antibody, TNF blocking agent

Use: Rheumatoid arthritis, Psoriasis, Crohn's disease, Ulcerative colitis

BBW: Serious risk of infection & malignancy

Budesonide (Uceris, Entocort EC)

Class: Corticosteroid

Use: Ulcerative colitis, Crohn's disease

Hydrocortisone (Cortizone 10, Solu-Cortef)

Class: Corticosteroid

Use: Rash, Inflammation

Hydroxychloroquine (Plaquenil)

Class: Anti-malarial, immune modulator

Use: Rheumatoid arthritis, Malaria

C/I / Warnings / Precautions: QT prolongation risk

Methotrexate (Trexall, Rheumatrex)

Class: Antimetabolite

Use: Rheumatoid arthritis, Psoriasis, Crohn's disease, Ulcerative colitis, Cancers

C/I / Warnings / Precautions: Pregnancy, patients with renal, hepatic, or pulmonary dysfunction, myelosuppression

BBW: Multiple boxed warnings, including: fetal toxicity, pulmonary toxicity, hepatotoxicity, GI toxicity, risk of lymphoma, and more

Methylprednisolone (Medrol, Solu-Medrol)

Class: Glucocorticoid

Use: Inflammation

Prednisolone

Class: Corticosteroid

Use: Allergies, Inflammation

Prednisone

Class: Corticosteroid

Use: Allergies, Inflammation

Triamcinolone (Aristocort, Kenalog)

Class: Corticosteroid

Use: Allergies, Inflammation, Asthma

Baclofen (Lioresal)

Class: Muscle relaxant (central)

Use: Muscle spasms

Cyclobenzaprine (Flexeril)

Class: Muscle relaxant (central)

Use: Muscle spasms

Methocarbamol (Robaxin)

Class: Muscle relaxant (central)

Use: Musculoskeletal discomfort

Tizanidine (Zanaflex)

Class: Alpha-2 adrenergic agonist

Use: Muscle spasms

C/I / Warnings / Precautions: QT prolongation risk

Melatonin

Class: Melatonin receptor agonist

Use: Insomnia

Phentermine (Adipex-P, Fastin)

Class: Sympathomimetic amine

Use: Obesity

C/I / Warnings / Precautions: History of cardiovascular disease, pregnancy, renal dysfunction, uncontrolled HTN

Sumatriptan (Imitrex)

Class: Selective 5-HT1B/1D serotonin receptor agonist

Use: Migraine

C/I / Warnings / Precautions: Uncontrolled HTN, arrhythmia, cerebrovascular disease

Anastrozole (Arimidex)

Class: Aromatase inhibitor

Use: Breast cancer

C/I / Warnings / Precautions: Pregnancy, pre-menopausal patients

Dorzolamide (Trusopt)

Class: Carbonic anhydrase inhibitor

Use: Glaucoma

Latanoprost (Xalatan)

Class: Prostaglandin analog

Use: Glaucoma

Timolol (Timoptic, Betimol)

Class: Beta adrenergic blocker

Use: Glaucoma

C/I / Warnings / Precautions: Caution in patients with asthma, COPD, or heart disease

Albuterol (Ventolin, Proventil, ProAir)

Class: Beta-2-adrenergic agonist

Use: Asthma

Albuterol + Ipratropium (Duoneb, Combivent Respimat)

Class: Beta-2-adrenergic agonist + muscarinic antagonist

Use: Asthma and COPD

Benzonatate (Tessalon Perles)

Class: Stretch receptor anesthetic

Use: Cough

Budesonide + Formoterol (Symbicort)

Class: Corticosteroid + long-acting beta-2 adrenergic agonist

Use: Asthma, Chronic obstructive pulmonary disease (COPD)

Fluticasone + Umeclidinium + Vilanterol (Trelegy Ellipta)

Class: Corticosteroid + long-acting muscarinic antagonist + long-acting beta-2 adrenergic agonist

Use: Asthma, Chronic obstructive pulmonary disease (COPD)

Fluticasone + Vilanterol (Breo Ellipta)

Class: Corticosteroid + long-acting beta-2 adrenergic agonist

Use: Asthma, Chronic obstructive pulmonary disease (COPD)

Tiotropium (Spiriva HandiHaler)

Class: Anticholinergic

Use: Chronic obstructive pulmonary disease (COPD)

Fluticasone (Flonase, Flonase HFA, Flovent)

Class: Corticosteroid

Use: Allergies

Fluticasone + Salmeterol (Advair Diskus)

Class: Corticosteroid + long-acting beta-2 adrenergic agonist

Use: Asthma, Chronic obstructive pulmonary disease (COPD)

Cholecalciferol (Vitamin D3)

Class: Stimulates bone mineralization

Use: Osteoporosis

Cyanocobalamin (Vitamin B12)

Class: Coenzyme for various metabolic functions

Use: Vitamin B12 deficiency