Top 200 Exam 3 contraindications

CRESTOR

rosuvastatin

Active liver failure, decompensated cirrhosis

LIPITOR

atorvastatin

Active liver failure, decompensated cirrhosis

PRAVACHOL

pravastatin

Active liver failure, decompensated cirrhosis

TRICOR

fenofibrate

Kidney impairment/ESRD, Acute liver disease, preexisting gallbladder disease

DEPAKOTE (ER)

divalproex (valproic acid)

Mitochondrial disorder (POLG mutations)/ Urea cycle disorders/ Prevent of migraines during pregnancy or in those of childbearing potential who aren’t on effective contraception

DILANTIN

phenytoin sodium

Injection: sinus bradycardia, sinoatrial block, second and third-degree heart block, Adams-Stokes syndrome

KEPPRA

levetiracetam

None

Phenobarbital

Phenobarbital

Hepatic impairment, Dyspnea or airway obstruction, Intra-arterial or SUBQ injections for patients with a history substance use disorder or nephritic patients

TEGRETOL

carbamazepine

use within 14 days of stopping an MAOi

TOPAMAX

topiramate

Alcohol use with 6 hours or 6 hours afterward, patients w/ metabolic acidosis who are taking concomitant metformin

BELSOMRA

suvorexant

Narcolepsy

LUNESTA

eszopiclone

Patients who have experienced complex sleep behaviors after taking eszopiclone

CYMBALTA

duloxetine

MOAIs, IV methylene blue, Close angle gluacoma (notes)

DESYREL

trazodone

Use of MAOIs or within 14 days of discontinuing trazodone or MAOI; initiations of trazodone in pt receiving IV methylene blue

EFFEXOR (XR)

venlafaxine

Use of MAOIs (concurrently or within 14 days of discontinuing MAOI); initiation of MAOI wihtin 7 days of discontinuing venlafaxine; initiation in pts receiving IV methylene blue

ELAVIL

amitriptyline

Actively suicidal pts, hx of significant suicide attempts, elderly, significant cardiac comorbidity; coadministration with or withiin 14 days of MAOIs; coadministration with cisapride; acute recovery phase following MI

LEXAPRO

escitalopram

Do not use in pts < 7 years old; use of MAOIs (concurrently or within 14 days of discontinuing either escitalopram or MAOI); initiation of escitalopram in pts receiving IV methylene blue; concurrent use of pimozide

PAXIL

paroxetine

Concurrent use with or within 14 days of MAOIs (including linezolid and IV methylene blue); concomitant use with pimozide or thioridazine (risk of QT prolongation); Pregnancy (septal defects)

PROZAC

fluoxetine

Use of MAOI intended to tx psychiatric disorders (concurrently within 5 weeks of discontinuing prozac or within 2 weeks of discontinuing MAOI; initiation of fluoxetine when pt receiving IV methylene blue; use with pimozide or thioridazine (thioridazine should not be initiated until 5 weeks after fluoxetine is discontinued)

REMERON

mirtazapine

Use of MAOIs, including IV methylene blue (concurrently or within 14 days of stopping an MAOI)

WELLBUTRIN (SR, XL)

bupropion

Seizure disorder, current or hx of anorexia nervosa/bulimia, pts undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiseizure drugs, MAOIs (concurrently or within 14 days of discontinuing either bupropion or MAOI); initiation of bupropion in pt receiving linezolid or IV methylene blue);

ER-24 hour tablet: severe head injury, severe stroke, CNS tumor, CNS infection, arteriovenous malformation

ZOLOFT

sertraline

Use of MAOIs including methylene blue (concurrently or within 14 days of stopping an MAOI or sertraline); concurrent use with pimozide; concurrent use with disulifiram (oral solution only)

CLOZARIL

clozapine

Serious hypersensitivity to Clozapine (e.g. photosensitivity, SJS)

LITHONATE, LITHOTABS

lithium carbonate

Severe cardiovascular or renal disease, Severe debilitation, Dehydration, Sodium Depletion, Diuretics

RISPERDAL

risperidone

Hypersensitivity to risperidone or paliperidone

SEROQUEL

quetiapine

None

ADDERALL (XR)

amphetamine and dextroamphetamine salts

MOAIs (during or within 14 days), Hyperthyroidism, Glaucoma, Agitation, Hx of substance abuse, Cardiovascular disease

CONCERTA, RITALIN

methylphenidate

Use during or within 14 days following MAOI therapy, Cardiovascular disease, Thyrotoxicosis (excess thyroid hormone), Marked anxiety, Tension and Agitation, Family hx or dx of Tourette syndrome or other tic disorder

STRATTERA

atomoxetine

Use within 14 days of an MAOI, severe cardiovascular disease, history of pheochromocytoma (rare benign tumor that develops in the medulla); narrow-angle glaucoma

VYVANSE

lisdexamfetamine

concurrent use of MAOi (including linezolid or IV methylene blue), or within 14 days of the last MAOi dose

ATIVAN

lorazepam

acute narrow-angle glaucoma

BUSPAR

buspirone

Concomitant use of MAOIs or within 14 days of discontinuing MAOIs; concomitant use of MAOIs within 14 days of discontinuing buspirone

VALIUM

diazepam

Injection: untreated open-angle glaucoma;

Oral: untreated open-angle glaucoma; use in infants < 6 months, myasthenia gravis, severe respiratory impairment, severe hepatic impairment, sleep apnea syndrome

XANAX

alprazolam

Concurrent therapy with strong CYP3A4 inhibitors (itraconazole, ketoconazole), except ritonavir; acute narrow angle glaucoma