Top 200 Advanced

Levothyroxine (Levoxyl, Synthroid, Levothroid)

Synthetic thyroid hormone

Hypothyroidism, Myxedema coma

Synthetic T4 hormone which is converted to T3 hormone to exert metabolic effects by supplementing endogenous T3

Tachycardia, palpations, insomnia, weight loss, diarrhea (primarily in overdosage)

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Take consistently at the same time each day, take on an empty stomach and 30 minutes before other medications, monitor for signs and symptoms of overdose.

Desiccated thyroid (Armour thyroid)

Thyroid hormone

Hypothyroidism, Myxedema coma

Naturally derived T3 and T4 that exert metabolic effects by supplementing endogenous T3

Tachycardia, palpations, insomnia, weight loss, diarrhea (primarily in overdose)

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Take consistently at the same time each day, take on an empty stomach and 30 minutes before other medications, monitor for signs and symptoms of overdose.

Bimatoprost (Lumigan)

Prostaglandin analog

Open-angle glaucoma, ocular hypertension

Mimics natural prostaglandin to increase the outflow of aqueous humor

Conjunctival hyperemia, foreign body sensation, eye pruritis

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Administer by creating a small pocket with the lower eye lid and putting drops into the pocket, close eye for ~1 min and apply firm pressure to the inner corner, remove contact lenses before administration and wait 15 min before re-inserting.

Latanoprost (Xalatan)

Prostaglandin analog

Open-angle glaucoma, ocular hypertension

Mimics natural prostaglandin to increase the outflow of aqueous humor

Conjunctival hyperemia, foreign body sensation, eye pruritis

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Administer by creating a small with the lower eye-lid and place eye drops into the pocket, close eye for ~1min and apply pressure to inner corner of eye, remove contact lenses before administration and wait 15 minutes before re-inserting.

Timolol (Timoptic)

Beta-blocker (non-selective)

Open-angle glaucoma, elevated intraocular pressure

Blocks beta-1 and beta-2 receptors to reduce intra-ocular pressure by decreasing aqueous humor production and increasing outflow of aqueous humor.

Eye irritation, headache, signs of systemic absorption

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Administer by creating a small with the lower eye-lid and place eye drops into the pocket, close eye for ~1min and apply pressure to inner corner of eye, remove contact lenses before administration and wait 15 minutes before re-inserting.

Brimonidine (Alphagan P)

Alpha adrenergic agonist

Open-angle glaucoma, Ocular hypertension, Elevated intra-ocular pressure

Alpha-2 agonist that reduces aqueous humor formation and increases uveoscleral outflow

Allergic conjunctivitis, conjunctival hyperemia, itching, drowsiness in children

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: Administer by creating a small with the lower eye-lid and place eye drops into the pocket, close eye for ~1min and apply pressure to inner corner of eye, remove contact lenses before administration and wait 15 minutes before re-inserting.

Triamcinolone (Kenalog - topical, Nasacort - nasal)

Corticosteroid

Inflammation (topical), Allergic rhinitis (nasal)

Decreases chemical mediators of inflammation by inducing phospholipase A2 (PLA2) inhibitory proteins and inhibiting arachidonic acid release resulting in anti-inflammatory, antipruritic, and vasoconstrictive effects

Local burning, itching, skin atrophy, secondary infection

Renal dose adjust: No

Hepatic dos adjust: No

Counseling points: Potential to cause or worsen skin or other infections, will increase blood sugar (use in caution with diabetes), increases susceptibility to infections.

Hydrocortisone (Anusol-HC, Proctosol-HC)

Corticosteroid

Pruritis, Contact dermatitis, Hemorrhoids, Ulcerative colitis

Decreases chemical mediators of inflammation by inducing phospholipase A2 (PLA2) inhibitory proteins and inhibiting arachidonic acid release resulting in anti-inflammatory, antipruritic, and vasoconstrictive effects

Local burning, itching, skin atrophy, secondary infection

Renal dose adjust: No

Hepatic dos adjust: No

Counseling points: Potential to cause or worsen skin or other infections, will increase blood sugar (use in caution with diabetes), increases susceptibility to infections.

Clobetasol (Temovate, Impoyz)

Corticosteroid

Psoriasis, Dermatoses

Decreases chemical mediators of inflammation by inducing phospholipase A2 (PLA2) inhibitory proteins and inhibiting arachidonic acid release resulting in anti-inflammatory, antipruritic, and vasoconstrictive effects

Local burning, itching, skin atrophy, secondary infection

Renal dose adjust: No

Hepatic dos adjust: No

Counseling points: Potential to cause or worsen skin or other infections, will increase blood sugar (use in caution with diabetes), increases susceptibility to infections.

Sitagliptin (Januvia)

Dipeptidyl peptidase (DPP-4) inhibitors

Types 2 diabetes

Inhibits dipeptidyl peptidase 4 enzyme which prolongs active incretin hormone levels to regulate glucose homeostasis

Usually well tolerated, rare arthralgia, rare pancreatitis

Renal dose adjust: Yes

Hepatic dose adjust: No

Counseling points: Take at the same time everyday (with or without food), watch for signs and symptoms of pancreatitis (severe abdominal pain that may radiate to the back, vomiting), may cause severe joint pain, watch for signs of hypoglycemia

Metformin/sitagliptin (Janumet, Janumet XR)

Biguanide/DPP-4 inhibitor

Type 2 diabetes

Decreases hepatic glucose production, decreases intestinal absorption of glucose and improves insulin sensitivity / Inhibits dipeptidyl peptidase 4 enzyme which prolongs active incretin hormone levels to regulate glucose homeostasis

GI (N/V/D, flatulence, bloating), decreased vitamin b12 absorption, rare lactic acidosis; rare arthralgia or pancreatitis

Renal dose adjust: Yes

Hepatic dose adjust: Yes

Counseling points: Take with food to avoid stomach upset, don’t break tablets if XR form, watch for signs of rare but serious lactic acidosis (fatigue, unusual muscle pain, trouble breathing), signs of pancreatitis (abdominal pain radiating to back, vomiting), signs of hypoglycemia

Empagliflozin (Jardiance)

Sodium-glucose cotransporter 2 (SGLT-2) inhibitor

Type 2 diabetes, chronic kidney disease, heart failure

Inhibits SGLT-2 in the proximal renal tubules which reduces reabsorption of filtered glucose and lowers the renal threshold for glucose, which increases renal glucose excretion

Genital mycotic infections, UTIs, increased urination, rare hypotension

Renal dose adjust: Yes

Hepatic dose adjust: No

Counseling points: Will cause increased urination, drink plenty of fluids to avoid dehydration, watch for signs and symptoms of UTI and yeast infections (pain while urinating and blood in the urine), practice good hygiene and wear breathable fabrics

Metformin (Glucophage, Glumetza, Riomet)

Biguanide

Type 2 diabetes

Decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity

GI (N/V/D, flatulence, bloating), decreased vitamin b12 absorption, rare lactic acidosis

Renal dose adjust: Yes

Hepatic dose adjust: Yes

Counseling points: Take with food to avoid stomach upset, GI symptoms are the most common, watch for signs and symptoms of rare lactic acidosis (fatigue, unusual muscle pain, difficulty breathing, severe abdominal pain), do not cut, crush, or chew XR tablets), avoid excessive alcohol intake

Glipizide (Glucotrol, Glucotrol XL)

Sulfonylurea

Type 2 diabetes

Stimulates insulin release from the pancreas, reduces glucose output from the liver, and increases peripheral insulin sensitivity which decreases glucose levels

Hypoglycemia

Renal dose adjust: Yes

Hepatic dose adjust: Yes

Counseling points: IR (take 30 minutes before meal), XR (take with first meal of the day), Do NOT take on an empty stomach, watch for signs and symptoms of hypoglycemia (dizziness, shaking, sweating, weakness, confusion), potential to increase sensitivity to sunlight, potential weight gain

Glimepiride (Amaryl)

Sulfonylurea

Type 2 diabetes

Stimulates insulin release from the pancreas, reduces glucose output from the liver, and increases peripheral insulin sensitivity which decreases glucose levels

Hypoglycemia

Renal dose adjust: Yes

Hepatic dose adjust: No

Counseling points: Take with food to avoid hypoglycemia, watch for signs and symptoms of hypoglycemia (dizziness, shaking, sweating, weakness, confusion), avoid excessive alcohol consumption, can increase sensitivity to sunlight, potential weight gain)

Pioglitazone (Actos)

Thiazolidinedione

Type 2 diabetes

Binds to peroxisome proliferator-activated receptor-gamma (PPAR) which regulates insulin responsive genes, ultimately decreasing insulin resistance by improving target cell response to insulin

Hypoglycemia, edema, increased bladder cancer risk (dose/time dependent)

Renal dose adjust: No

Hepatic dose adjust: Yes

Counseling points: Contraindicated in severe heart failure, increased risk of bladder cancer, increased risk of bone fractures, increased risk of eye problems, increased risk of ovulation in pre menopausal women, watch for signs and symptoms of liver problems (severe stomach pain, discolored urine, yellowing of skin and/or eyes)

Insulin glargine (Basaglar, Lantas, Toujeo)

Long acting insulin

Type 1 diabetes, type 2 diabetes

Promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins; ultimately regulates glucose levels

Hypoglycemia, injection site reactions/pain, weight gain

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: This is a long-acting insulin that is usually intended to control blood sugar over a 24 hour period, educate on proper injection sites and how to rotate injection sites to avoid site reactions, educate on signs and symptoms of hypoglycemia and encourage them to carry a fast source of glucose, refrigerate insulin before use, can be left in room temp after starting for 28 days

Insulin aspart (Novolog)

Rapid acting insulin

Type 1 diabetes, Type 2 diabetes

Promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins; ultimately regulates glucose levels

Hypoglycemia, injection site reactions/pain, weight gain

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: This is a rapid-acting insulin that is generally used to correct glucose levels following meals, educate on proper injection sites and how to rotate injection sites to avoid site reactions, educate on signs and symptoms of hypoglycemia and encourage them to carry a fast source of glucose, refrigerate insulin before use, can be left in room temp after starting for 28 days

Insulin lispro (Humalog)

Rapid-acting insulin

Type 1 diabetes, Type 2 diabetes

Promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins; ultimately regulates glucose levels

Hypoglycemia, injection site reactions/pain, weight gain

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: This is a rapid-acting insulin that is generally used to correct glucose levels following meals, educate on proper injection sites and how to rotate injection sites to avoid site reactions, educate on signs and symptoms of hypoglycemia and encourage them to carry a fast source of glucose, refrigerate insulin before use, can be left in room temp after starting for 28 days

Insulin degludec (Tresiba)

Long-acting insulin

Type 1 diabetes, Type 2 diabetes

Promotes cellular uptake of glucose, fatty acids, and amino acids, and their conversion to glycogen, triglycerides, and proteins; ultimately regulates glucose levels

Hypoglycemia, injection site reactions/pain, weight gain

Renal dose adjust: No

Hepatic dose adjust: No

Counseling points: This is a long-acting insulin that is usually intended to control blood sugar over a 24 hour period, educate on proper injection sites and how to rotate injection sites to avoid site reactions, educate on signs and symptoms of hypoglycemia and encourage them to carry a fast source of glucose, refrigerate insulin before use, can be left in room temp after starting for 28 days

Hydrochlorothiazide (Microzide)

Thiazide diuretic

Edema, Hypertension

Inhibits sodium reabsorption in the distal tubule causing increased excretion of sodium and hydrogen ions

Hypotension, electrolyte disturbances (hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia), hyperurecemia/gout

Renal dose adjust: Yes

Hepatic dose adjust: No

Counseling points: Take consistently, will make you pee more often, avoid nighttime dosing, can potentially cause some sensitivity to sunlight.

Chlorthalidone (Hygroton)

Thiazide diuretic

Edema, hypertension

Inhibits sodium reabsorption in the distal tubule causing increased excretion of sodium and hydrogen ions

Hypotension, electrolyte disturbances (hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia), hyperurecemia/gout

Renal dose adjust: Yes

Hepatic dose adjust: No

Counseling points: Take consistently, will make you pee more often, avoid nighttime dosing, can potentially cause some sensitivity to sunlight.

Triamterene/HCTZ (Dyazide, Maxzide)

Potassium sparing diuretic/thiazide diuretic

Edema, hypertension

Blocks epithelial sodium channels which inhibits sodium reabsorption, decreases the function of Na/K ATPase, causing potassium retention and decreased Ca, Mg, and H excretion/inhibits sodium reabsorption in the distal tubule causing increased excretion of sodium and hydrogen ions

Hypotension, electrolyte disturbances (hyperkalemia or hypokalemia, hypomagnesemia, hyponatremia, hypercalcemia) hyperuricemia/gout

RDA: Yes

HDA: No

Patient counseling points: Used for hypertension and fluid retention, this medication will make you urinate more often, avoid taking before bedtime, this is a maintenance medication.

Furosemide (Lasix)

Edema, hypertension, acute pulmonary edema

Inhibits sodium and chloride reabsorption in the loop of Henle and interferes with chloride-binding cotransport system

Fluid/electrolyte loss, increased urination, nephrotoxicity, ototoxicity

RDA: Yes

HDA: No

Counseling points: This medication will cause you to urinate more frequently, take in the morning (2nd dose before 4 pm if applicable) to avoid night time urination, can be taken with or without food, if you miss a dose take it as soon as you remember unless getting too close to next dose then skip and only take next dose, can cause sensitivity to sunlight.

Spironolactone (Aldactone)

Potassium sparing diuretic

Edema, hypertension, hypokalemia, primary hyperaldosteronism

Competes with aldosterone in distal convoluted tubule which increases sodium chloride and water excretion while conserving potassium and hydrogen ions

Hyperkalemia, gynecomastia, menstrual irregularities

RDA: Yes

HDA: No

Counseling points: This medication can be used for multiple purposes, it will lead to increased urination, avoid eating a potassium rich diet (bananas, spinach, avocados, lentils, etc.), avoid drinking excessive amounts of alcohol, may cause dizziness.

Amlodipine (Norvasc)

Dihydropyridine calcium channel blocker

Hypertension, angina

Calcium channel blocker that inhibits the influx of calcium across cell membranes in vascular smooth muscle causing vasodilation

Peripheral edema, flushing, headache

RDA: No

HDA: Yes

Counseling points: This is a maintenance medication that is important to keep taking daily, take this medication with or without food, alcohol and excessive amounts of grapefruit juice can increase the blood pressure lowering effects of this medication.

Nifedipine (Procardia, Nifedical XL, Adalat CC)

Dihydropyridine calcium channel blocker

Hypertension, angina

Calcium channel blocker that inhibits the influx of calcium across cell membranes in vascular smooth muscle causing vasodilation

Peripheral edema, flushing, headache

RDA: No

HDA: No

Counseling points: this is a maintenance medication and is important to take every day, avoid taking this medication with grapefruit or grapefruit juice, protect the medication from sunlight, may experience dizziness or light headedness.

Diltiazem (Cardizem, Cartia, Dilacor, Dilt-XR, Tiazac)

Non-dihydropyridine calcium channel blocker

Angina (IR only), hypertension (SR only), arrhythmia control/conversion to sinus rhythm (injection only)

Inhibits the influx of calcium across cell membranes in vascular smooth muscle causing slowing of the SA and AV node conduction

Peripheral edema, bradycardia

RDA: No

HDA: No

Counseling points: Take at approximately the same time each day, can be taken with or without food (be consistent), Monitor for dizziness, light headedness, fainting.

Verapamil (Isoptin, Calan, Verelan)

Non-dihydropyridine calcium channel blocker

Angina, hypertension, supraventricular tachyarrhythmias

Calcium channel blocker that inhibits the influx of calcium across cell membranes in vascular smooth muscle causing slowing of the SA and AV node conduction

Peripheral edema, bradycardia

RDA: No

HDA: Yes

Counseling points: Take at approximately the same time each day, can be taken with or without food (be consistent), Monitor for dizziness, light headedness, fainting.

Amlodipine/benazepril (Lotrel)

Dihydropyridine calcium channel blocker/ACEi

Hypertension

Calcium channel blocker that inhibits the influx of calcium across cell membranes in vascular smooth muscle causing vasodilation/inhibits angiotensin-converting enzyme thus preventing conversion of angiotensin I to angiotensin II, ultimately reducing aldosterone secretion and increasing plasma renin activity.

Peripheral edema, flushing, headache/cough, angioedema

RDA: Yes

HDA: Yes

Counseling points: Take consistently at the same time each day, avoid use of NSAIDs as it may cause kidney damage, avoid potassium supplements or salt alternatives containing potassium, do not stop abruptly

Atorvastatin (Lipitor)

HMG-CoA reductase inhibitor

Dyslipidemia, heart failure

Competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis which causes a reduction in total cholesterol, LDL, triglycerides, and increases HDL

Constipation, dyspepsia, myalgia

RDA: No

HDAL Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), Avoid excessive grapefruit juice and alcohol intake, helps reduce risk of future stroke and MI, take at bedtime

Simvastatin (Zocor)

HMG-CoA reductase inhibitor

Dyslipidemia

Competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis which causes a reduction in total cholesterol, LDL, triglycerides, and increases HDL

Constipation, dyspepsia, myalgia

RDA: No

HDAL Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), Avoid excessive grapefruit juice and alcohol intake, helps reduce risk of future stroke and MI, take at bedtime

Rosuvastatin (Crestor)

HMG-CoA reductase inhibitor

Dyslipidemia

Competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis which causes a reduction in total cholesterol, LDL, triglycerides, and increases HDL

Constipation, dyspepsia, myalgia

RDA: Yes

HDAL Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), Avoid excessive grapefruit juice and alcohol intake, helps reduce risk of future stroke and MI, take at bedtime

Pravastatin (Pravachol)

HMG-CoA reductase inhibitor

Dyslipidemia

Competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis which causes a reduction in total cholesterol, LDL, triglycerides, and increases HDL

Constipation, dyspepsia, myalgia

RDA: Yes

HDAL Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), Avoid excessive grapefruit juice and alcohol intake, helps reduce risk of future stroke and MI, take at bedtime

Lovastatin (Mevacor)

HMG-CoA reductase inhibitor

Dyslipidemia

Competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis which causes a reduction in total cholesterol, LDL, triglycerides, and increases HDL

Constipation, dyspepsia, myalgia

RDA: Yes

HDAL Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), Avoid excessive grapefruit juice and alcohol intake, helps reduce risk of future stroke and MI, take at bedtime

Ezetimibe (Zetia)

A2-Azetidinone

Dyslipidemia

Inhibits cholesterol absorption in the small intestine which decreases LDL, total cholesterol, and triglycerides and increases HDL

Myalgia, elevated liver transaminases, arthralgia, abdominal pain,

RDA: No

HDA: Yes

Counseling points: Monitor for signs of severe liver impairment (dark urine, yellow skin and eyes, severe stomach ache, persistent nausea), helps reduce risk of future stroke and MI, avoid taking with bile acid sequestrants like cholestyramine for at least 2 hours before or 4 hours after.

Omega 3 ethyl esters (Lovaza)

Omega 3 fatty acid

Hypertriglyceridemia

Not completely understood, causes reduction in hepatic production of triglyceride-rich VLDL, mainly lowering triglycerides

Belching, dyspepsia, bad taste

RDA: No

HDA: No

Counseling points: