Top 200 Drug Interactions/Contraindications (1-200)

Metformin

Interactions: Furosemide, Cimetidine, Nifedipine, Alcohol

Contraindications: Impaired renal function (male>1.5, female>1.4)

Levothyroxine

Interactions: Oral anticoagulants

Contraindications: Uncorrected adrenal cortical insufficiency, uncorrected thyrotoxicosis, acute MI

Potassium Chloride

Interactions: K-sparing diuretics, K-containing medications/salt substitutes

Contraindications: Hyperkalemia

Albuterol

Interactions: MAO inhibitors

Contraindications: Hypersensitivity

Omeprazole

No major interactions or contraindications

Lisinopril

Interactions: K supplements

Contraindications: History of angioedema from ACE inhibitor treatment

Amlodipine

Interactions: Simvastatin

Metoprolol Tartrate

Interactions: Verapamil

Contraindications: Sinus bradycardia, heart block>1st degree, cardiogenic shock, CHF, cardiac failure, HR<45 bpm, SBP<100 mmHg

Cautions: Diabetes

Metoprolol Succinate

Interactions: Verapamil

Contraindications: Sinus bradycardia, heart block>1st degree, cardiogenic shock, HF, sick sinus syndrome

Cautions: Diabetes

Simvastatin

Interactions: CYP3A4 Inhibitors, grapefruit

Contraindications: Hypersensitivity, pregnancy/lactation, liver disease, strong CYP3A4 agents, excessive alcohol

PREGNANCY CATEGORY X

Atorvastatin

Interactions: Grapefruit

Contraindications: Pregnancy/lactation, liver disease, excessive alcohol

PREGNANCY CATEGORY X

Furosemide

Interactions: Aminoglycosides, electrolyte disturbances (digitalis)

Contraindications: Anuria, severe electrolyte depletion

Hydrochlorothiazide

Interactions: Electrolyte disturbances (digitalis)

Contraindications: Anuria, sulfonamide hypersensitivity

Warfarin

Contraindications: Alcohol, allopurinol, amiodarone, adrenocortical steroids, methyltetrazolethiol, cephalosporins, chloral hydrate, cimetidine, clofibrate, dextrothyroxine, disulfiram, erthromycin, glucagon, metronidazole, phenylbutazones, quinidine, salicylates, sulfamethoxazole/trimethoprim, sulfinpyrazone, thyroid

Contraindications: Hemorrhagic tendancies, blood dyscrasias, surgery, bleeding, eclampsia, spinal puncture, lumbar block, malignant hypertension

PREGNANCY CATEGORY X

Amoxicillin

Contraindications: Penicillin or cephalosporin allergy

Azithromycin

Interactions: Antacids, food

Contraindications: Macrolide or ketolide allergy, prolonged QT-interval

Gabapentin

Interactions: Antacids

Contraindications: Abrupt discontinuation

Zolpidem, CIV

Interactions: CNS depressants

Contraindications: Hypersensitivity, hypnotic agents

Citalopram

Interactions: MAO inhibitors

Contraindications: May increase suicidal thoughts in children, teenagers, w/in 14 days of MAO inhibitors

Sertraline

Interactions: MAO inhibitors, pimozide

Contraindications: May increase suicidal thoughts in children, teenagers, w/in 14 days of MAO inhibitors, tasks requiring alertness

Alprazolam, CIV

Interactions: CNS depressants

Contraindications: Hypersensitivity to benzodiazepines, narrow-angle glaucoma

Hydrocodone with Acetaminophen, CII

Interactions: Alcohol, CNS depressants

Tramadol, CIV

Interactions: CNS depressants

Contraindications: alcohol, hypnotics, opioids, psychotropic drugs & dependence

Prednisone

Contraindications: Systemic fungal infections, immunization w/ live vaccines

Meloxicam

Interactions: Aspirin

Contraindications: NSAID/Aspirin hypersensitivity, renal disease, ulcer disease GI bleeding

Insulin Glargine

Interactions: Everything

Cautions: Small changes in dose

Fluticasone Propionate

Interactions: Systemic Corticosteroids

Cautions: Pregnant/lactating women, multiple infections

Montelukast

Interactions: Phenobarbital

Pantoprazole

Interactions: No major interactions

Contraindications: Hypersensitivity to components

Ranitidine

Interactions: WARFARIN, lidocaine

Caution: Renal or hepatic impairment

Carvedilol

Interactions: Rifampin, cimetidine, CYP2C9 inhibitors

Contraindications: Cardiac failure, asthma, AV block, sick sinus syndrome, cardiogenic shock, bradycardia

Caution: Hepatic dysfunction, diabetics

Losartan

Interactions: No major interactions

Lisinopril w/ Hydrochlorothiazide

Interactions: Indomethacin, allopurinol, potassium supplements

Contraindications: Angioedema, sulfonamide hypersensitivity

Atenolol

Interactions: CLONIDINE, VERAPAMIL, lidocaine

Contraindicaitons: Sinus bradycardia, heart block, cardiogenic shock, cardiac failure

Pravastatin

Interactions: Gemfibrozil, erythromycin, immunosuppressive agents

Contraindications: Pregnancy/lactation, acute liver disease

PREGNANCY CATEGORY X

Rosuvastatin

Interactions: CYCLOSPORINE, warfarin, gemfibrozil, ANTACIDS

Contraindications: active liver disease, pregnancy/lactation

PREGNANCY CATEGORY X

Clopidogrel

Interactions: NSAIDS, CYP2C9 metabolites, OMEPRAZOLE, esomeprazole

Contraindications: Bleeding

Sulfamethoxazole w/ Trimethoprim

Interactions: Cyclosporine, anticoagulants

Contraindictions: Infants < 2 months, pregnancy/nursing, sulfa allergies, megaloblastic anemia

Cephalexin

Interactions: Oral contraceptives, probenecid

Contraindications: Penicillin/cephalosporin allergy

Ciprofloxacin

Interactions: ANTACIDS, IRON SALTS, THEOPHYLLINE,

Contraindications: Quinolone sensitivity, children, adolescents, or pregnant women

Clonazepam CIV

Interactions: ALCOHOL, CNS depressants

Contraindications: Benzodiazepine sensitivity, liver disease, <6 months old, glaucoma

Cyclobenzaprine

Interactions: ALCOHOL, CNS depressants, guanethidine

Contraindications: congestive heart failure, hyperthyroidism, cardiac arrhythmia, conductive disturbances, MI

Trazodone

Interactions: ALCOHOL, CNS depressants, phenytoin, grapefruit juice, CYP3A4 inhibitors

Duloxetine

Interactions: MAOI, CYP1A2 & CYP2D6 inhibitors, antidepressants

Contraindications: MAOI, narrow-angle glaucoma

Fluoxetine

Interactions: MAOI, THIORIDAZINE, tryptophan, sumatriptan, aspirin, NSAIDS

Contraindications: MAOI, thioridazine

Venlafaxine

Interactions: MAOI, antihistamines, aspirin, NSAIDS

Lorazepam CIV

Interactions: CNS depressants, probenecid, valproate

Contraindicated: benzodiazepine hypersensitivity, narrow-angle glaucoma

Oxycodone w/ Acetaminophen CII

Interactions: CNS depressants, ALCOHOL, hydantoins, sulfinpyrazone

Oxycodone CII

Interactions: Phenothiazines, anesthetics, hypnotics, sedatives, alcohol, muscle relaxants

Contraindications: Respiratory depression, bronchial asthma, paralytic ileus

Tamsulosin

Interactions: Alpha blockers, cimetidine

Contraindications: Prostate carcinoma screening

Glimepiride

Interactions: None; CYP450 2C9

Contraindications: Diabetic ketoacidosis w/ or w/o coma, aware of hypoglycemia

Glipizide

Interactions: Chloramphenicol, alcohol, MAOIs, phenylbutazones, salicylates, sulfonamides, thiazide diuretics

Contraindications: Juvenile, unstable or complicated diabetes mellitus, allergy to sulfa drugs, diabetic ketoacidosis w or w/o coma

Norgestimate & Ethinyl Estradiol

Interactions: Broad spectrum antibiotics (ampicillin, amoxicillin, metronidazole, tetracycline)

Contraindicated: Thromboembolic disorders, breast carcinoma, estrogen dependent neoplasia, pregnancy, benign/malignant liver tumors, abnormal genital bleeding, cerebral or cardiovascular disease

PREGNANCY CATEGORY X

Fluticasone w/ Salmeterol

Interactions: Systemic corticosteroids, sympathomimetics, tricyclic antidepressants, MAOIs, B-blockers

Contraindications: Primary treatment of status asthmaticus, LONG-ACTING BETA-2 AGONISTS

Ipratropium w/ Albuterol

Interactions: Sympathomimetics, tricyclic antidepressants, MAOIs, non-potassium sparing diuretics

Contraindications: Combivent-soybean or peanut sensitivity

Esomeprazole

Interactions: Diazepam, ketoconazole, digoxin, cyanocobalamin, ampicillin, iron salts

Isosorbide

Interactions: Alcohol, vasodilators, Ca2+ channel blockers

Contraindications: Nitrate hypersensitivity, hypotension

Diltiazem

Interactions: Cyclosporine, cimetidine, carbamazepine

Contraindications: Sick sinus syndrome, second/third-degree AV block

Clonidine

Interactions: Tricyclic antidepressants, beta-adrenergic blockers

Spironolactone

Interactions: Captopril, K+ sparing medications, K+ supplements, DIGITALIS

Contraindications: Anuria, acute renal insufficiency, renal impairment, hyperkalemia, sulfonamide/spironolactone sensitivity

Amoxicillin w/ Clavulanate

Interactions: Oral contraceptives, bacteriostatic antibiotics, prebenecid

Contraindications: Penicillin/cephalosporin sensitivity

Topiramate

Interactions: Alcohol, CNS depressants, estrogens, metformin, phenytoin, carbamazepine, hydrochlorothiazide, valproic acid

Lamotrigene

Interactions: Phenytoin, carbamazepine, phenobarbital, rifampin, valproic acid, ORAL CONTRACEPTIVES

Methylphenidate CII

Interactions: MAOIs, phenytoin, phenobarbital, warfarin, SSRIs, clonidine

Contraindications: Anxiety, tension, agitation, glaucoma, motor tics, family history of Tourette's syndrome, 14 days of MAOIs

Amphet w/ Dextroamphet CII

Interactions: MAOIs, furazolidone, sodium bicarbonate, antihypertensives

Contraindications: Advanced arteriosclerosis, cardiovascular disease, moderate hypertension, hyperthyroidism, agitated states, glaucoma, 14 days of MAOIs

Bupropion

Interactions: MAOIs, L-dopa, alcohol, tricyclic antidepressants, paroxetine, fluoxetine, sertraline, haloperidol, risperidone, thioridazine, metoprolol (CYP2D6)

Contraindications: Seizure disorder, history of bulimia or anorexia nervosa, 14 days of MAOIs

Amitriptyline

Interactions: Dicumarol, clonidine, guanethidine, fluoxetine, symmpathomimetics, MAOIs, alcohol, CNS depressants, cimetidine

Contraindications: 14 days of MAOIs

Escitalopram

Interactions: MAOIs, CYP3A4 inhibitors, cimetidine, aspirin, NSAIDs

Contraindications: 14 days of MAOIs

Paroxetine

Interactions: MAOIs, phenytoin, phenobarbital, cimetidine, WARFARIN, procyclidine, aspirin, NSAIDs

Contraindications: Pregnancy, 14 days of MAOIs

Quetiapine

Interactions: CNS depressants, phenytoin, thioridazine

Contraindications: DEMENTIA-RELATED PSYCHOSIS

Buspirone

Interactions: MAOIs, grapefruit juice

Morphine CII

Interactions: Phenothiazines, anesthetics, sedatives, hypnotics, alchol, muscle relaxants, analgesics

Contraindications: Respiratory depression, acute/sevre bronchial asthma, paralytic ileus

Methylprednisolone

Interactions: Anticholinesterases, barbituates, rifampin, hydantoins, estrogens, ketoconazole

Contraindications: Systemic fungal infections

Allopurinol

Interactions: Ampicillin-induced skin rash, thiopurines, chlorpropamide

Ibuprofen

Interactions: Aspirin, probenecid, lithium, beta-blockers, loop diuretics

Contraindications: NSAID hypersensitivity

Tiotropium

Interactions: CYP2D6/3A4 inhibitors

Contraindications: Atropine sensitivity

Digoxin

Interactions: DIURETICS, AMIODARONE, QUINIDINE, PROPAFENONE, ERYTHROMYCIN, CYCLOSPORINE, TETRACYCLINES, VERAPAMIL

Contraindications: V. fibb

Nifedipine

Interactions: Cimetidine, grapefruit juice, quinidine

Contraindications: Surgery w/ fentanyl

Propranolol

Interactions: Theophyllines, clonidine, rifampin, NSAIDS, VERAPAMIL, epinephrine, prazosin

Contraindications: Cardiogenic shock, bronchial asthma, sinus bradycardia, >1st degree heart block, CHF

Losartan w/ HCTZ

Interactions: Cimetidine, phenobarbital, DIGITALIS, diazoxide, NSAIDS, alcohol, barbituates, narcotics, cholestyramine

Contraindications: Volume-depleted, pregnant, anuria, sulfonamide sensitivity, pregnancy

Valsartan

Interactions: NSAIDS

Contraindications: Pregnancy

Fenofibrate

Interactions: WARFARIN, HMG-CoA reductase inhibitors, cholestyramine

Contraindications: Hepatic or renal dysfunction, primary biliary cirrhosis, preexisting gallbladder disease

Lovastatin

Interactions: GEMFIBROZIL, grapefruit juice

Contraindications: Pregnancy/lactation, active liver disease, elevated serum transaminases

PREGNANCY CATEGORY X

Triamterene w/ HCTZ

Interactions: Glycosides, diazoxide, lithium, potassium-sparing diuretics, potassium supplements, ACEI

Contraindications: Anuria, hyperkalemia, sulfonamide sensitivity, potassium-sparing diuretics

Levofloxacin

Interactions: Antacids, sucralfate, iron, QUINIDINE, PROCAINAMIDE, AMIODARONE, SOTALOL, NSAIDS

Contraindications: Quinolone sensitivity

Fluconazole

Interactions: Warfarin, phenytoin, midazolam, VORICONAZOLE, cyclosporine, antidiabetic meds, rifampin

Divalproex

Interactions: Aspirin, carbamazepine, dicumarol, phenobarbital, phenytoin, clonazepam

Contraindications: Hepatic disease

Temazepam CIV

Interactions: CNS depressants

Contraindications: Pregnancy, BZDP sensitivity

Baclofen

Interactions: CNS depressants

Contraindications: Sensitivity, phenylalanine probs

Ropinirole

Interactions: Smoking, omeprazole, ciprofloxacin, estrogens, dopamine antagonists

Contraindications: Syncope, postural hypotension

Mirtazapine

Interactions: CNS depressants, MAO INHIBITORS, aspirin, NSAIDS

Contraindications: Antidepressants, abrupt discontinuation

Diazepam CIV

Interactions: CNS depressants, cimetidine, grapefruit juice

Contraindications: Myasthenia gravis, respiratory insufficiency, hepatic insufficiency, sleep apnea, children<6 yo, narrow-angle glaucoma, open-angle glaucoma

Risperidone

Interactions: Levodopa, carbamazepine, fluoxetine, clozapine

Contraindications: DEMENTIA-RELATED PSYCHOSIS, neuroleptic malignant syndrome

Ondansetron

Interactions: None

Fentanyl CII

Interactions: Phenothiazines, anesthetics, sedatives, hypnotics, alcohol, muscle relaxants, analgesics

Contraindications: Fentanyl or adhesive sensitivity

Naproxen

Interactions: Oral anticoag, lithium, methotrexate, NSAIDS

Contraindications: NSAID sensitivity

Celecoxib

Interactions: ACEI, lithium, fluconazole, WARFARIN

Contraindications: Asthma, urticaria, sulfonamide/aspirin/NSAID sensitivity, peri-operative pain

Triamcinolone

Interactions: Systemic corticosteroids

Contraindications: Sensitivity

Alendronte

Interactions: Calcium, antacids, aspirin, NOTHING W/IN 30 MIN OF DOSE

Contraindications: Esophageal abnormalities, cannot sit/stand upright for 30 min, hypocalcemia

Sitagliptin

Interactions: Digoxin

Contraindications: Renal insufficiency