top drugs contraindications

amlodipine

cardiogenic shock, STEMI, CYP3A4/5 inducers

nifedipine

cardiogenic shock, STEMI, CYP3A4/5 inducers

benazepril

history of angioedema, sacubitril, aliskiren (diabetics), anuria

lisinopril

history of angioedema, sacubitril, aliskiren (diabetics)

chlorthalidone

sulfa drugs, anuria

hydrochlorothiazine

sulfa drugs, anuria

irbesartan

aliskiren (for diabetics), pregnancy

losartan

aliskien (for diabetics), pregnancy

olmesartan

aliskien (for diabetics), pregnancy

valsartan

aliskien (for diabetics), pregnancy

hydrochlorothiazide, losartan

sulfa drugs, anuria, aliskiren (for diabetics), pregnancy

hydrochlorothiazide, lisinopril

sulfa drugs, anuria, history of angioedema

amlodipine, benazepril

history of angioedema, anuria

triamterene, hydrochlorothiazide

sulfa drugs, anuria, hyperkalemia, potassium supplements

prazosin

hypertension

carvedilol

asthma, severe sinus bradycardia, AV block, sick sinus syndrome, overt heart failure, cardiogenic shock, severe hepatic impairment

furosemide

anuria

metoprolol

severe bradycardia, AV block, sick sinus syndrome, cardiogenic shock

atenolol

severe bradycardia, AV block, sick sinus syndrome, cardiogenic shock

propranolol

asthma, sinus bradycardia, AV block, sick sinus syndrome

spironolactone

hyperkalemia, anuria, acute real insufficiency

hydralazine

CAD, rheumatic/mitral valve heart disease, dissecting aortic aneurysm, heart failure

clonidine

remove patch for MRI

atorvastatin

breastfeeding, active liver disease, unexplained persistent elevations of serum transaminases

lovastatin

breastfeeding, active liver disease, concomitant use with strong CYP3A4/5 inhibitors, unexplained persistent elevation of liver enzymes

pravastatin

breastfeeding, active liver disease

rosuvastatin

breastfeeding, active liver disease

simvastatin

breastfeeding, active liver disease

insulin aspart

hypoglycemic episode

insulin lispro

hypoglycemic episode

insulin human (isophane human)

hypoglycemic episode

insulin degludec

hypoglycemic episode

insulin glargine

hypoglycemic episode

dulaglutide

history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome

liraglutide

history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome

semaglutide

history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome

fenofibrate

gallbadder disease, severe renal/hepatic dysfunction, nursing mothers

gemfibrozil

gallbladder disease, severe renal/hepatic dysfunction, concurrent use with repaglinide or simvastatin

dapagliflozin

severe renal impairment

empagliflozin

severe renal impairment, end stage renal disease, dialysis

glimepiride

diabetic ketoacidosis

glipizide

diabetic ketoacidosis, T1DM

ezetimibe

gallbladder diseases, severe hepatic dysfunction, concurrent use with statin in pregnant/nursing mother

pioglitazone

NYHA III/IV heart failure

metformin

contrast media, chronic kidney disease, metabolic acidosis

sitagliptin

none

metformin, sitagliptin

renal dysfunction, metabolic acidosis

calcium phosphate; cholecalciferol

none

cholecalciferol

hypersensitivity to cholecalciferol, ergocalciferol, or vitamin D metabolites (eg, calcitriol, calcifediol, alfacalcidol, calcipotriol)
hypercalcemia (exacerbation with enhanced toxicity)
hypervitaminosis D (worsening of condition; pretherapy 25-hydroxycholecalciferol levels should be considered in selected patients)

cyanocobalamin

hypersensitivity to cyanocobalamin or cobalt

desogestrel; ethinyl estradiol

blood pressure 160 mm Hg or greater systolic, or 100 mm Hg or greater diastolic, persistent
carcinoma of the breast, known or suspected, or personal history
carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
cerebral vascular or coronary artery disease, current or history
cholestatic jaundice of pregnancy or jaundice with prior hormonal contraceptive use
concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
deep vein thrombophlebitis or thromboembolic disorders, past history
diabetes with vascular involvement
genital bleeding, undiagnosed abnormal
headaches with focal neurological symptoms
heavy cigarette smoking (15 cigarettes or more per day) and over age 35; increased risk of serious cardiovascular side effects
hepatic adenomas or carcinomas or active liver disease
hepatocellular disease (acute or chronic) with abnormal liver function
hypersensitivity to any component of these products
hypertension, severe
major surgery with prolonged immobilization
pregnancy, known or suspected
thrombophlebitis, thromboembolic disorders, or known thrombophilic conditions
valvular heart disease with complications (ie thrombogenic complications)
inherited or acquired hypercoagulopathies

drospirenone; ethinyl estradiol

adrenal insufficiency
diagnosis or history of breast cancer (hormone sensitive or other estrogen or progestin-sensitive cancer)
cerebrovascular disease
concomitant use with hepatitis C drug combinations containing ombitasvir, paritaprevir/ritonavir, with or without dasabuvir
coronary artery disease
deep vein thrombosis or pulmonary embolism (current or past history)
diabetes mellitus with vascular disease
headaches with focal neurological symptoms or migraine headaches with or without aura if over age 35 years
hepatic dysfunction
hepatic tumors, benign or malignant
hypercoalgulopathies, inherited or acquired
hypertension, uncontrolled
pregnancy
renal insufficiency
smoking and over age 35 years
thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, subacute bacterial endocarditis with valvular disease or atrial fibrillation)
uterine bleeding, undiagnosed, abnormal

ergocalciferol

hypercalcemia; malabsorption syndrome; abnormal sensitivity to the toxic effects of vitamin D; hypervitaminosis D

estradiol (oral/transdermal patch)

hypersensitivity to estradiol; history of thromboembolic disorders, breast cancer, any estrogen-dependent neoplasm, known or suspected pregnancy

ethinyl estradiol; etonogestrel

hypersensitivity to ethinyl estradiol or progestin component; history of thromboembolic disorders, endometrial cancer, uncontrolled HTN, pregnancy; smoking more than 15 cigarettes per day and over 35 years of age

ethinyl estradiol; levonorgestrel

acute viral hepatitis, or severe (decompensated) cirrhosis
BMI greater than or equal to 30 kg/m(2)
known or suspected carcinoma of the breast or personal history of breast cancer
current or past history of cerebrovascular or coronary artery disease
cholestatic jaundice of pregnancy or jaundice with prior pill use
concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
a history of deep vein thrombophlebitis or thromboembolic disorders
diabetes with vascular involvement
diabetes mellitus and are over age 35, diabetes mellitus with hypertension or other end-organ damage, or diabetes mellitus of greater than 20 years duration
headaches with focal neurological symptoms
hepatic adenomas or carcinomas or other liver tumors, benign or malignant
hypersensitivity to any of the product components
active liver disease
migraines with aura
migraines in women who are 35 years or older
pregnancy
smoking and older than 35 years
thrombogenic rhythm disorders
hereditary or acquired thrombophilias
thrombophlebitis or thromboembolic disorders
uncontrolled hypertension or hypertension with vascular disease
undiagnosed abnormal vaginal bleeding
valvular heart disease with thrombogenic complications
known or suspected estrogen or progesterone sensitive malignancy
prolonged immobilization (especially with major surgery)

ethinyl estradiol; norethindrone

blood pressure 160 mmHg or greater systolic or 100 mgHg or greater, persistent
carcinoma of the breast, known or suspected, or personal history of breast cancer
carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia
cerebral vascular or coronary artery disease, current or history
cholestatic jaundice of pregnancy or jaundice with prior pill use
concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
deep vein thrombophlebitis or thromboembolic disorders, past history
diabetes with vascular involvement
genital bleeding, undiagnosed abnormal
headaches with focal neurological symptoms
hepatic adenomas or carcinomas
hepatocellular disease with abnormal liver function, acute or chronic
hypersensitivity to any component of the product
hypertension, uncontrolled
major surgery with prolonged immobilization
pregnancy, known or suspected
thrombophlebitis, thromboembolic disorders, or known thrombophilic conditions
valvular heart disease with complications

ethinyl estradiol; norgestimate

female patient known to have high risk of arterial or venous thrombotic diseases
current diagnosis of, or history of, breast cancer, which may be hormone-sensitive
current or history of deep vein thrombosis or pulmonary embolism
cerebrovascular disease
concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir
coronary artery disease
diabetes mellitus with vascular disease
headaches with focal neurological symptoms
inherited or acquired hypercoagulopathies
uncontrolled hypertension
female patient known to have liver disease or liver tumors, benign or malignant
migraine headaches in patients older than 35 years
migraine headaches with aura
female patient over age 35 years that smoke
thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, atrial fibrillation or subacute bacterial endocarditis with valvular disease)
undiagnosed abnormal uterine bleeding

ferrous sulfate

hypersensitivity to iron salts; hemochromatosis, hemolytic anemia

folic acid

hypersensitivity

levothyroxine

hypersensitivity, nontoxic diffuse goiter or nodular thyroid disease, thyrotoxicosis, AMI, treatment of obesity or weight loss, uncorrected adrenal insufficiency; may precipitate acute adrenal crisis

liothyronine

concomitant use with artificial warming of patients (injection)
hypersensitivity to liothyronine or any extraneous constituents of the preparation
uncorrected adrenal cortical insufficiency
untreated thyrotoxicosis

norethindrone

abnormal and undiagnosed genital bleeding; acute liver disease; benign or malignant liver tumors; carcinoma of the breast; hypersensitivity to any component of the product; pregnancy

potassium chloride

hypersensitivity to potassium, acute renal failure, structural, pathologic, or pharmacologic causes that delay tablet passage through the GI tract, hyperkalemia, Addison disease, acute dehydration

progesterone

abnormal vaginal bleeding, history of estrogen- or progesterone-dependent neoplasia, active or history of DVT or PE, known or suspected pregnancy

testosterone

hypersensitivity to testosterone; men with breast or prostate cancer; women who are pregnant, who may become pregnant, or who are breast-feeding

thyroid

hypersensitivity to thyroid, nontoxic diffuse goiter or nodular thyroid disease, thyrotoxicosis, AMI, treatment of obesity or weight loss, uncorrected adrenal insufficiency; may precipitate acute adrenal crisis

acyclovir

hypersensitivity

amiodarone

severe bradycardia, severe sinus node dysfunction, 2nd- or 3rd-degree AV block, and cardiogenic shock

amoxicillin

hypersensitivity

amoxicillin/clavulanate

extended release products are contraindicated in patients on dialysis of severe renal dysfunction; history of cholestatic jaundice or hepatic dysfunction with amoxicillin/clavulanate therapy

apixaban

active bleeding

aspirin

hypersensitivity, asthma, rhinitis, nasal polyps, inherited or acquired bleeding disorders, children <18y with viral infections

azithromycin

hypersensitivity to azitromycin, erythromycin, or any macrolide or ketolide antibiotic

cefdinir

hypersensitivity

cephalexin

hypersensitivity to cephalosporins

ciprofloxacin (PO, otic)

hypersensitivity

clindamycin (PO, topical)

hypersensitivity

clopidogrel

hypersensitivity

dapagliflozin

severe renal impairment

diltiazem

hypotension, 2nd/3rd degree AV block, sinus syndrome

doxycycline

hypersensitivity

fluconazole

concurrent ergot alkaloids; CYP3A4/5 substrates that prolong QTc

isosorbide mononitrate

hypersensitivity to nitrates, concurrent use with PDEIs, and riociguat

ketoconazole (topical)

hypersensitivity

metronidazole

hypersensitivity, 1st trimester of pregnancy

nitrofuantoin

use in neonates or pregnant patients at term 38-42 weeks due to risk of hemolytic anemia, anuria, or oliguria

nitroglycerin

hypersensitivity; concurrent use with PDEIs, symptomatic hypotension, marked bradycardia or tachycardia, severe anemia, or increase intracranial pressure

oseltamivir phosphate

hypersensitivity

rivaroxaban

active bleeding

sacubitril/valsartan

hypersensitivity, history of angioedema, pregnancy, concomitant ACEis, aliskiren

torsemide

hypersensitivity to torsemide or sulfonylureas; anuria; hepatic coma

trimethoprim/sulfamethoxazole

children < 2 months; pregnant patients at term, megaloblastic anemia due to folate deficiency, history of drug-induced thrombocytopenia with the use of sulfonamides or trimethoprim, marked hepatic damage or severe renal disease, concomitant administration with dofetilide

valcyclovir

hypersensitivity

verapamil

hypersensitivity; symptomatic hypotension; 2nd or 3rd degree AV block, sick sinus syndrome; severe left ventricular dysfunction, atrial fibrillation/flutter associated with accessory bypass tract

warfarin

hypersensitivity, bleeding tendencies recent or potential surgery, uncontrolled HTN; pericarditis or pericardial effusion; bacterial endocarditis; noncompliant patients, eclampsia/preeclampsia, threatened abortion, pregnancy

albuterol

hypersensitivity

azelastine

hypersensitivity

budesonide

hypersensitivity; hypersensitivity to milk proteins (flexhaler); primary treatment of status asthmaticus or other acute episodes of asthma

budesonide/formoterol

hypersensitivity to budesonide or formoterol; primary treatment of status asthmaticus or acute episodes of asthma or COPD