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Two SSRIs: sertraline + fluoxetine
risk of serotonin syndrome
Two NSAIDs: ibuprofen + naproxen
increased GI bleed risk
Two statins: atorvastatin + simvastatin
increased myopathy risk
Two PPIs: omeprazole + pantoprazole
no added benefit, just extra cost/risk
Two anticoagulants: warfarin + apixaban
major bleeding risk
Two benzodiazepines: alprazolam + lorazepam
over-sedation, respiratory depression
Two ACE inhibitors: lisinopril + enalapril
hypotension, kidney injury
Two beta blockers: metoprolol + atenolol
bradycardia risk
When can drug duplication be clinically acceptable?
When two similar-appearing drugs are used intentionally for different mechanisms or different therapeutic goals.
Why might a statin and fibrate be prescribed together, and what is the risk?
They target different lipids (LDL vs triglycerides), but increase risk of myopathy, so monitoring is required.
Why might a statin and fibrate be prescribed together, and what is the risk?
They target different lipids (LDL vs triglycerides), but increase risk of myopathy, so monitoring is required.