PRAC 142 Top Drugs (ADRs, Contraindications, BBW, BEERS List)
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1
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Zocor (simvastatin); Lipitor (atorvastatin); Crestor (rosuvastatin)
No common ADRs
Contraindicated in: Active liver disease
No Black Box Warning
Not on BEERS List
Contraindicated in: Active liver disease
No Black Box Warning
Not on BEERS List
2
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Mevacor, Altoprev (lovastatin)
No common ADRs
Contraindicated in: Active liver disease, pregnancy/nursing
No Black Box Warning
Not on BEERS List
Contraindicated in: Active liver disease, pregnancy/nursing
No Black Box Warning
Not on BEERS List
3
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Zetia (ezetimibe); Vascepa (icosapent ethyl); Tradjenta (linagliptin); Januvia (sitagliptin)
No common ADRs
No contraindications
No Black Box Warning
Not on BEERS List
No contraindications
No Black Box Warning
Not on BEERS List
4
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Tricor, Trilipix (fenofibrate)
No common ADRs
Contraindicated in: Biliary cirrhosis, gallbladder disease, hepatic disease, renal failure/dialysis, nursing
No Black Box Warning
Not on BEERS List
Contraindicated in: Biliary cirrhosis, gallbladder disease, hepatic disease, renal failure/dialysis, nursing
No Black Box Warning
Not on BEERS List
5
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Prinivil, Zestril (lisinopril); Vasotec (enalapril); Lotensin (benazepril); Lotrel (amlodipine/benazepril)
No common ADRs
Contraindicated in: H/o angioedema, combo w/ a neprilysin inhibitor (sacubitril)
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: H/o angioedema, combo w/ a neprilysin inhibitor (sacubitril)
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
6
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Zestoretic (lisinopril/HCTZ)
No common ADRs
Contraindicated in: H/o angioedema, combo w/ a neprilysin inhibitor (sacubitril), anuria, sulfonamide allergy
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: H/o angioedema, combo w/ a neprilysin inhibitor (sacubitril), anuria, sulfonamide allergy
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
7
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Cozaar (losartan); Benicar (olmesartan); Micardis (telmisartan)
No common ADRs
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
8
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Diovan (valsartan)
Common ADRs: Dizziness
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
9
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Avapro (irbesartan)
Common ADRs: Hyperkalemia (in T2DM)
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: Use w/ aliskiren in pts w/ diabetes
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
10
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Hyzaar (losartan/HCTZ); Diovan HCT (valsartan/HCTZ)
No common ADRs
Contraindicated in: Use w/ aliskiren in pts w/ diabetes, anuria, sulfonamide allergy
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
Contraindicated in: Use w/ aliskiren in pts w/ diabetes, anuria, sulfonamide allergy
Black Box Warning: 2nd/3rd trimester in pregnancy = fetal toxicity
Not on BEERS List
11
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Lopressor (metoprolol tartrate)
Common ADRs: Bradycardia
Contraindicated in: Severe bradycardia, severe hypotension, 2nd/3rd degree AV block, cardiogenic shock, overt cardiac failure, acute decompensated HF, sick sinus syndrome, severe peripheral arterial circulatory disorders
Black Box Warning: IHD: abrupt discontinuation may exacerbate condition
Not on BEERS List
Contraindicated in: Severe bradycardia, severe hypotension, 2nd/3rd degree AV block, cardiogenic shock, overt cardiac failure, acute decompensated HF, sick sinus syndrome, severe peripheral arterial circulatory disorders
Black Box Warning: IHD: abrupt discontinuation may exacerbate condition
Not on BEERS List
12
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Toprol XL (metoprolol succinate)
No common ADRs
Contraindicated in: Severe bradycardia, severe hypotension, 2nd/3rd degree AV block, cardiogenic shock, acute decompensated HF, sick sinus syndrome w/o a pacemaker
Black Box Warning: IHD: abrupt discontinuation may exacerbate condition
Not on BEERS List
Contraindicated in: Severe bradycardia, severe hypotension, 2nd/3rd degree AV block, cardiogenic shock, acute decompensated HF, sick sinus syndrome w/o a pacemaker
Black Box Warning: IHD: abrupt discontinuation may exacerbate condition
Not on BEERS List
13
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Tenormin (atenolol)
Common ADRs: Cold extremities, dizziness, tiredness
Contraindicated in: Severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, overt cardiac failure, acute decompensated HF
Black Box Warning: CAD; abrupt discontinuation may exacerbate condition
Not on BEERS List
Contraindicated in: Severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, overt cardiac failure, acute decompensated HF
Black Box Warning: CAD; abrupt discontinuation may exacerbate condition
Not on BEERS List
14
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Bystolic (nebivolol)
No common ADRs
Contraindicated in: Severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome w/o a pacemaker, severe hepatic disease (Child Pugh Score C)
No Black Box Warning
Not on BEERS List
Contraindicated in: Severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, decompensated cardiac failure, sick sinus syndrome w/o a pacemaker, severe hepatic disease (Child Pugh Score C)
No Black Box Warning
Not on BEERS List
15
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Coreg (carvedilol)
Common ADRs: Diarrhea, hypotension, bradycardia, dizziness
Contraindicated in: Asthma, 2nd/3rd degree AV block, severe bradycardia w/o a pacemaker, cardiogenic shock, acute decompensated HF, severe hepatic disease, sick sinus syndrome
No Black Box Warning
Not on BEERS List
Contraindicated in: Asthma, 2nd/3rd degree AV block, severe bradycardia w/o a pacemaker, cardiogenic shock, acute decompensated HF, severe hepatic disease, sick sinus syndrome
No Black Box Warning
Not on BEERS List
16
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Inderal (propranolol)
No common ADRs
Contraindicated in: Asthma, severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, acute decompensated HF, sick sinus syndrome w/o a pacemaker
Black Box Warning: Angina pectoris: abrupt discontinuation may exacerbate condition
Not on BEERS List
Contraindicated in: Asthma, severe bradycardia, 2nd/3rd degree AV block, cardiogenic shock, acute decompensated HF, sick sinus syndrome w/o a pacemaker
Black Box Warning: Angina pectoris: abrupt discontinuation may exacerbate condition
Not on BEERS List
17
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Normodyne, Trandate (labetalol)
Common ADRs: Dizziness
Contraindicated in: Asthma, HF, 2nd/3rd degree AV block, cardiogenic shock, severe bradycardia, severe and prolonged hypotension
No Black Box Warning
Not on BEERS List
Contraindicated in: Asthma, HF, 2nd/3rd degree AV block, cardiogenic shock, severe bradycardia, severe and prolonged hypotension
No Black Box Warning
Not on BEERS List
18
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Betapace, Sorine, Sotylize (sotalol)
Common ADRs: Dizziness, fatigue, HA (>240 mg), bradycardia
Contraindicated in: Asthma, severe bradycardia w/o a pacemaker, 2nd/3rd degree AV block, long QT syndrome, cardiogenic shock, decompensated HF, serum K+
Contraindicated in: Asthma, severe bradycardia w/o a pacemaker, 2nd/3rd degree AV block, long QT syndrome, cardiogenic shock, decompensated HF, serum K+
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Catapres, Catapres-TTS (clonidine)
Common ADRs: Somnolence, fatigue
No contraindications
No Black Box Warning
BEERS (avoid as 1st-line antihypertensive)
No contraindications
No Black Box Warning
BEERS (avoid as 1st-line antihypertensive)
20
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Apresoline (hydralazine)
No common ADRs
Contraindicated in: CAD, rheumatic heart disease
No Black Box Warning
Not on BEERS List
Contraindicated in: CAD, rheumatic heart disease
No Black Box Warning
Not on BEERS List
21
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Norvasc (amlodipine)
Common ADRs: Edema
No contraindications
No Black Box Warning
Not on BEERS List
No contraindications
No Black Box Warning
Not on BEERS List
22
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Procardia, Procardia XL (nifedipine)
Common ADRs: Flushing, dizziness, HA
Contraindicated in: Concomitant use w/ CYP inhibitors (rifampin), cardiogenic shock
No Black Box Warning
BEERS (IR only)
Contraindicated in: Concomitant use w/ CYP inhibitors (rifampin), cardiogenic shock
No Black Box Warning
BEERS (IR only)
23
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Cardizem LA, Tiazac (Diltiazem)
No common ADRs
Contraindicated in: 2nd/3rd degree AV block, severe hypotension, cardiogenic shock, sick sinus syndrome w/o a pacemaker, acute MI, pulmonary congestion
No Black Box Warning
BEERS (Avoid in symptomatic HF)
Contraindicated in: 2nd/3rd degree AV block, severe hypotension, cardiogenic shock, sick sinus syndrome w/o a pacemaker, acute MI, pulmonary congestion
No Black Box Warning
BEERS (Avoid in symptomatic HF)
24
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Microzide (HCTZ); Thalitone (chlorthalidone); Demadex (torsemide)
No common ADRs
Contraindicated in: Anuria, sulfonamide/sulfonylurea allergy
No Black Box Warning
Not on BEERS List
Contraindicated in: Anuria, sulfonamide/sulfonylurea allergy
No Black Box Warning
Not on BEERS List
25
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Maxzide, Dyazide (triamterene/HCTZ)
No common ADRs
Contraindicated in: Hyperkalemia, concomitant K+ altering agents, impaired renal f(x), sulfonamide allergy
Black Box Warning: Hyperkalemia
Not on BEERS List
Contraindicated in: Hyperkalemia, concomitant K+ altering agents, impaired renal f(x), sulfonamide allergy
Black Box Warning: Hyperkalemia
Not on BEERS List
26
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Lasix (furosemide)
No common ADRs
Contraindicated in: Anuria
No Black Box Warning
Not on BEERS List
Contraindicated in: Anuria
No Black Box Warning
Not on BEERS List
27
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Bumex (bumetanide)
No common ADRs
Contraindicated in: Anuria, hepatic encephalopathy, electrolyte imbalance
Black Box Warning: Potent diuretic (too much = profound diuresis w/ H2O and electrolyte loss)
Not on BEERS List
Contraindicated in: Anuria, hepatic encephalopathy, electrolyte imbalance
Black Box Warning: Potent diuretic (too much = profound diuresis w/ H2O and electrolyte loss)
Not on BEERS List
28
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Entresto (sacubitril/valsartan)
Common ADRs: Hypotension
Contraindicated in: H/o angioedema, concomitant use w/ ACEi, do not use w/in 36 hrs of switching to or from ACEi, avoid use w/ aliskiren in pts w/ diabetes
Black Box Warning: Fetal toxicity (avoid in pregnancy)
Not on BEERS List
Contraindicated in: H/o angioedema, concomitant use w/ ACEi, do not use w/in 36 hrs of switching to or from ACEi, avoid use w/ aliskiren in pts w/ diabetes
Black Box Warning: Fetal toxicity (avoid in pregnancy)
Not on BEERS List
29
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Glucophage, Glucophage XR (metformin)
Common ADRs: Farts, N/V/D
Contraindicated in: Severe renal impairment, metabolic acidosis, DKA
Black Box Warning: Lactic acidosis
Not on BEERS List
Contraindicated in: Severe renal impairment, metabolic acidosis, DKA
Black Box Warning: Lactic acidosis
Not on BEERS List
30
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Jardiance (empagliflozin)
No common ADRs
Contraindicated in: Severe renal impairment (ESRD and dialysis)
No Black Box Warning
Not on BEERS List
Contraindicated in: Severe renal impairment (ESRD and dialysis)
No Black Box Warning
Not on BEERS List
31
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Trulicity (dulaglutide)
Common ADRs: N/V/D
Contraindicated in: Thyroid C-cell tumors, MTC, MEN 2
Black Box Warning: Risk of thyroid C-cell tumors
Not on BEERS List
Contraindicated in: Thyroid C-cell tumors, MTC, MEN 2
Black Box Warning: Risk of thyroid C-cell tumors
Not on BEERS List
32
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Ozempic, Wegovy, Rybelsus (semaglutide)
Common ADRs: N/V/D, constipation, tummy pain
Contraindicated in: H/o MTC, MEN2
Black Box Warning: Risk of thyroid C-cell tumors
Not on BEERS List
Contraindicated in: H/o MTC, MEN2
Black Box Warning: Risk of thyroid C-cell tumors
Not on BEERS List
33
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Amaryl (glimepiride)
Common ADRs: Hypoglycemia
Contraindicated in: DKA, sulfonamide allergy
No Black Box Warning
BEERS (increased risk of CV events, mortality, and hypoglycemia)
Contraindicated in: DKA, sulfonamide allergy
No Black Box Warning
BEERS (increased risk of CV events, mortality, and hypoglycemia)
34
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Glucotrol, Glucotrol XL (glipizide)
No common ADRs:
Contraindicated in: DKA, sulfonamide allergy
No Black Box Warning
BEERS (increased risk of CV events, mortality, and hypoglycemia)
Contraindicated in: DKA, sulfonamide allergy
No Black Box Warning
BEERS (increased risk of CV events, mortality, and hypoglycemia)
35
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Novolog (insulin aspart); Humalog (insulin lispro)
Common ADRs: Hypoglycemia
Contraindicated in: Hypoglycemia
No Black Box Warning
BEERS (if used on sliding scale w/o concurrent use of basal/long-acting insulin)
Contraindicated in: Hypoglycemia
No Black Box Warning
BEERS (if used on sliding scale w/o concurrent use of basal/long-acting insulin)
36
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Lantus (insulin glargine); Levemir (insulin detemir)
Common ADRs: Hypoglycemia
Contraindicated in: Hypoglycemia
No Black Box Warning
Not on BEERS List
Contraindicated in: Hypoglycemia
No Black Box Warning
Not on BEERS List
37
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Tylenol #2, 3, 4 (APAP/codeine)
No common ADRs
Contraindicated in: Children
Contraindicated in: Children
38
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Norco, Vicodin (APAP/hydrocodone)
No common ADRs
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, REMS, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors and benzos, hepatotoxicity, death related to ultra rapid metabolism in children
BEERS (if h/o falls/fracture, delirium)
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, REMS, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors and benzos, hepatotoxicity, death related to ultra rapid metabolism in children
BEERS (if h/o falls/fracture, delirium)
39
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Percocet (APAP/oxycodone HCl)
No common ADRs
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, REMS, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors and benzos, hepatotoxicity
BEERS (if h/o falls/fracture, delirium)
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, REMS, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors and benzos, hepatotoxicity
BEERS (if h/o falls/fracture, delirium)
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Oxycontin (oxycodone CR)
Common ADRs: N/V, constipation, somnolence, pruritis
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors, concurrent use w/ BZD or CNS depressants
BEERS (if h/o falls/fracture, delirium)
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction
Black Box Warning: Addiction/abuse/misuse, respiratory depression, accidental ingestion, neonatal opioid withdrawal syndrome, concurrent use of 3A4 inducers/inhibitors, concurrent use w/ BZD or CNS depressants
BEERS (if h/o falls/fracture, delirium)
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Duramorph, MS Contin (morphine)
No common ADRs
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction, MAOI therapy in
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction, MAOI therapy in
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Ultram, Ultram ER (tramadol, tramadol ER)
Common ADRs: N/V/D, somnolence, dizziness, constipation, dry mouth, flushing, HA, pruritis, insomnia, asthenia
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction, children
Contraindicated in: Status asthmaticus, respiratory depression, GI obstruction, children
43
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Mobic (meloxicam)
No common ADRs
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
44
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Motrin, Advil (ibuprofen)
No common ADRs
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
45
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Aleve, Naprosyn (naproxen)
No common ADRs
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
46
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Voltaren XR (diclofenac sodium ER)
No common ADRs
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
Contraindicated in: Tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS
47
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Toradol (ketorolac)
No common ADRs
Contraindicated in: Active or hx of PUD, GI bleed/perforation, pre-op pain management, tx of peri-op pain in CABG, advanced renal impairment, hypovolemia, labor and delivery, high risk bleeders, CV bleed, hemorrhage diathesis, incomplete hemostasis, intracranial bleed, concurrent ASA, NSAID, probenecid, and pentoxyfilline use
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, bleeding, tx >5 days, pediatrics, not used for minor or chronic pain, advanced risk for: renal impairment, bleeding, labor and delivery, concurrent NSAID use, geriatrics, pts
Contraindicated in: Active or hx of PUD, GI bleed/perforation, pre-op pain management, tx of peri-op pain in CABG, advanced renal impairment, hypovolemia, labor and delivery, high risk bleeders, CV bleed, hemorrhage diathesis, incomplete hemostasis, intracranial bleed, concurrent ASA, NSAID, probenecid, and pentoxyfilline use
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, bleeding, tx >5 days, pediatrics, not used for minor or chronic pain, advanced risk for: renal impairment, bleeding, labor and delivery, concurrent NSAID use, geriatrics, pts
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Celebrex (celecoxib)
No common ADRs
Contraindicated in: Sulfonamide allergy, tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS (if h/o HF)
Contraindicated in: Sulfonamide allergy, tx of peri-op pain in CABG
Black Box Warning: CV risk (MI, stroke), GI perforation, ulceration, and bleeding
BEERS (if h/o HF)
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Flexeril (cyclobenzaprine)
Common ADRs: Drowsiness, dry mouth
Contraindicated in: Acute recovery phase of MI, QT prolongation, arrhythmia, heart block, CHF, hyperthyroidism, MAOI therapy in
Contraindicated in: Acute recovery phase of MI, QT prolongation, arrhythmia, heart block, CHF, hyperthyroidism, MAOI therapy in
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Lioresal (baclofen)
Common ADRs: Drowsiness
No contraindications
No Black Box Warning
Not on BEERS
No contraindications
No Black Box Warning
Not on BEERS
51
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Robaxin (methocarbamol)
No common ADRs
No contraindications
No Black Box Warning
BEERS
No contraindications
No Black Box Warning
BEERS
52
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Xanax (alprazolam)
Common ADRs: Drowsiness, fatigue, impaired coordination, dysarthria, memory impairment, cognitive disorder, constipation, increased appetite, weight gain or loss, depression, lightheadedness; HA, confusion, insomnia, dry mouth, N/V, tachycardia, palpitations, irritability, decreased libido
Contraindicated in: Concurrent use w/ strong CYP3A4 inhibitors
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
Contraindicated in: Concurrent use w/ strong CYP3A4 inhibitors
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
53
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Ativan (lorazepam)
No common ADRs
Contraindicated in: Acute, narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
Contraindicated in: Acute, narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
54
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Valium (diazepam)
No common ADRs
Contraindicated in: Myasthenia gravis, severe respiratory and hepatic insufficiency, sleep apnea, acute narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
Contraindicated in: Myasthenia gravis, severe respiratory and hepatic insufficiency, sleep apnea, acute narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
55
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Klonopin (clonazepam)
Common ADRs: Somnolence, dizziness, upper respiratory tract infection
Contraindicated in: Significant hepatic disease, acute narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
Contraindicated in: Significant hepatic disease, acute narrow-angle glaucoma
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
56
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Restoril (temazepam)
No common ADRs
Contraindicated in: Pregnancy
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
Contraindicated in: Pregnancy
Black Box Warning: Concurrent use w/ opioids, abuse/misuse/addiction, dependence and withdrawal reactions
BEERS
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Ambien, Ambien CR, Intermezzo (zolpidem)
Common ADRs: Dizziness, somnolence
Contraindicated in: Complex sleep behaviors
Black Box Warning: Complex sleep behaviors (ex. sleep-walking
BEERS
Contraindicated in: Complex sleep behaviors
Black Box Warning: Complex sleep behaviors (ex. sleep-walking
BEERS
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Plavix (clopidogrel)
No common ADRs
Contraindicated in: Active bleed
Black Box Warning: Diminished effectiveness in poor metabolizers (CYP2C19)
Not on BEERS List
Contraindicated in: Active bleed
Black Box Warning: Diminished effectiveness in poor metabolizers (CYP2C19)
Not on BEERS List
59
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Coumadin, Jantoven (warfarin)
No common ADRs
Contraindicated in: Unsupervised pts w/ conditions associated w/ potential high level of non-compliance, bleeding, aortic dissection, aneurysm, hemorrhagic stroke, head trauma, pregnancy, bacterial endocarditis, malignant HTN, regional or lumbar block anesthesia, surgery, pericarditis, pericardial effusion, active ulceration or overt bleeding of GI, genitourinary, or respiratory tract
Black Box Warning: Bleeding risk
BEERS (avoid for nonvalvular AFib or VTE)
Contraindicated in: Unsupervised pts w/ conditions associated w/ potential high level of non-compliance, bleeding, aortic dissection, aneurysm, hemorrhagic stroke, head trauma, pregnancy, bacterial endocarditis, malignant HTN, regional or lumbar block anesthesia, surgery, pericarditis, pericardial effusion, active ulceration or overt bleeding of GI, genitourinary, or respiratory tract
Black Box Warning: Bleeding risk
BEERS (avoid for nonvalvular AFib or VTE)
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Xarelto (rivaroxaban)
No common ADRs
Contraindicated in: Bleeding
Black Box Warning: Premature D/C increases risk of thrombotic events, epidural/spinal hematomas w/ neuraxial anesthesia or spinal puncture
BEERS (Avoid for long-term tx of nonvalvular AFib or VTE)
Contraindicated in: Bleeding
Black Box Warning: Premature D/C increases risk of thrombotic events, epidural/spinal hematomas w/ neuraxial anesthesia or spinal puncture
BEERS (Avoid for long-term tx of nonvalvular AFib or VTE)
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Eliquis (apixaban)
No common ADRs
Contraindicated in: Bleeding
Black Box Warning: Premature D/C increases risk of thrombotic events, epidural/spinal hematomas w/ neuraxial anesthesia or spinal puncture
Not on BEERS List
Contraindicated in: Bleeding
Black Box Warning: Premature D/C increases risk of thrombotic events, epidural/spinal hematomas w/ neuraxial anesthesia or spinal puncture
Not on BEERS List
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Digox, Lanoxin (digoxin)
No common ADRs
Contraindicated in: VFib
No Black Box Warning
BEERS (avoid as 1st-line for HF and AFib; if used for AFib or HF, avoid doses >0.125 mg/day)
Contraindicated in: VFib
No Black Box Warning
BEERS (avoid as 1st-line for HF and AFib; if used for AFib or HF, avoid doses >0.125 mg/day)
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Pacerone (amiodarone)
No common ADRs
Contraindicated in: AV block, 2nd/3rd degree AV block unless a pacemaker is available, cardiogenic shock, sick sinus syndrome, iodine allergy
Black Box Warning: Pulmonary toxicity, hepatotoxicity, cardiac toxicity, proarrhythmic
BEERS (avoid as 1st-line for AFib unless pt has HF or substantial LVH)
Contraindicated in: AV block, 2nd/3rd degree AV block unless a pacemaker is available, cardiogenic shock, sick sinus syndrome, iodine allergy
Black Box Warning: Pulmonary toxicity, hepatotoxicity, cardiac toxicity, proarrhythmic
BEERS (avoid as 1st-line for AFib unless pt has HF or substantial LVH)
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Tambocor (flecainide acetate)
Common ADRs: Dizziness, visual disturbances, dyspnea
Contraindicated in: AV block, 2nd/3rd degree AV block unless a pacemaker is available, cardiogenic shock
No Black Box Warning
Not on BEERS List
Contraindicated in: AV block, 2nd/3rd degree AV block unless a pacemaker is available, cardiogenic shock
No Black Box Warning
Not on BEERS List
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Nitrostat (nitroglycerin SL)
No common ADRs
Contraindicated in: Increased ICP, concomitant PDE-5 inhibitors, concomitant riociguat use, severe anemia, circulatory failure/shock
No Black Box Warning
Not on BEERS List
Contraindicated in: Increased ICP, concomitant PDE-5 inhibitors, concomitant riociguat use, severe anemia, circulatory failure/shock
No Black Box Warning
Not on BEERS List
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Monoket, Imdur (isosorbide mononitrate)
No common ADRs
Contraindicated in: Concomitant PDE-5 inhibitors, concomitant riociguat use
No Black Box Warning
Not on BEERS List
Contraindicated in: Concomitant PDE-5 inhibitors, concomitant riociguat use
No Black Box Warning
Not on BEERS List
67
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Ranexa (ranolazine)
No common ADRs
Contraindicated in: Strong CYP3A4 inhibitors and inducers, liver cirrhosis
No Black Box Warning
Not on BEERS List
Contraindicated in: Strong CYP3A4 inhibitors and inducers, liver cirrhosis
No Black Box Warning
Not on BEERS List
68
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Calan, Veralan (verapamil)
No common ADRs
Contraindicated in: Severe LVD, sick sinus syndrome, AFlutter/AFib w/ accessory bypass tract, 2nd/3rd degree AV block unless a pacemaker is available, hypotension (
Contraindicated in: Severe LVD, sick sinus syndrome, AFlutter/AFib w/ accessory bypass tract, 2nd/3rd degree AV block unless a pacemaker is available, hypotension (
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Amantine (midodrone)
Common ADRs: Paresthesia, piloerection, dysuria, pruritis
Contraindicated in: Severe organ heart disease, acute renal disease, urinary retention, pheochromocytoma, thyrotoxicosis, persistent and excessive supine HTN
Black Box Warning: Marked/persistent elevation of supine BP
Not on BEERS List
Contraindicated in: Severe organ heart disease, acute renal disease, urinary retention, pheochromocytoma, thyrotoxicosis, persistent and excessive supine HTN
Black Box Warning: Marked/persistent elevation of supine BP
Not on BEERS List
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Prilosec (omeprazole); Nexium (esomeprazole magnesium); Dexilant (dexlansoprazole); Protonix (pantoprazole)
No common ADRs
Contraindicated in: Concomitant ripilvirine-containing products
No Black Box Warning
BEERS (if used >8 weeks unless high risk)
Contraindicated in: Concomitant ripilvirine-containing products
No Black Box Warning
BEERS (if used >8 weeks unless high risk)
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Pepcid (famotidine)
No common ADRs
No contraindications
No Black Box Warning
BEERS (with delirium)
No contraindications
No Black Box Warning
BEERS (with delirium)
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Celexa (citalopram)
No common ADRs
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
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Lexapro (escitalopram)
Common ADRs: Diarrhea, nausea, HA, ejaculation disorder, insomnia, somnolence
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
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Prozac (fluoxetine)
Common ADRs: Asthenia, nausea, anorexia, anxiety, insomnia, tremor, somnolence, dyspepsia, dry mouth, diarrhea, nervousness, decreased libido, pharyngitis, HA, flu syndrome
Contraindicated in: Fluoxetine use w/in 14 days of D/C MAO-I, MAO-I use w/in 5 weeks of D/C fluoxetine, concomitant pimozide, linezolid, thioridazine, and methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
Contraindicated in: Fluoxetine use w/in 14 days of D/C MAO-I, MAO-I use w/in 5 weeks of D/C fluoxetine, concomitant pimozide, linezolid, thioridazine, and methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
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Zoloft (sertraline)
Common ADRs: Nausea, diarrhea, dry mouth, somnolence, insomnia
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, linezolid, methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (with h/o falls/fractures)
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Paxil (paroxetine)
Common ADRs: Asthenia, nausea, somnolence, dizziness, insomnia, sexual dysfunction, dry mouth, sweating, constipation, HA
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, thioridazine, linezolid, IV methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
Contraindicated in: MAO-I use or w/in 14 days after D/C, concomitant pimozide, thioridazine, linezolid, IV methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
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Cymbalta (duloxetine)
Common ADRs: Nausea, dry mouth, somnolence
Contraindicated in: MAO-I use w/in 5 days of D/C med, use w/in 14 days of D/C MAO-I, concomitant linezolid and IV methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (w/ h/o falls/fractures)
Contraindicated in: MAO-I use w/in 5 days of D/C med, use w/in 14 days of D/C MAO-I, concomitant linezolid and IV methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (w/ h/o falls/fractures)
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Effexor, Effexor XR (venlafaxine)
Common ADRs: Nausea, dry mouth, dizziness, insomnia, somnolence, sweating, constipation, abnormal ejaculation
Contraindicated in: MAO-I use or w/in 7 days of D/C med, use w/in 14 days of D/C MAO-I, concomitant linezolid and methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (w/ h/o falls/fractures)
Contraindicated in: MAO-I use or w/in 7 days of D/C med, use w/in 14 days of D/C MAO-I, concomitant linezolid and methylene blue use
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (w/ h/o falls/fractures)
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Elavil (amitriptyline)
No common ADRs
Contraindicated in: MAO-I use w/in 14 days after D/C, concurrent cisapride use, use during acute recovery phase following MI
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
Contraindicated in: MAO-I use w/in 14 days after D/C, concurrent cisapride use, use during acute recovery phase following MI
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
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Pamelor (nortriptyline)
No common ADRs:
Contraindicated in: MAOIs use concurrently or w/in 14 days of stopping treatment, use during the acute recovery period after MI
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
Contraindicated in: MAOIs use concurrently or w/in 14 days of stopping treatment, use during the acute recovery period after MI
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS
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Silenor (doxepin)
No common ADRs
Contraindicated in: MAOIs use concurrently or w/in 14 days of stopping treatment, untreated narrow angle glaucoma, severe urinary retention
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (for doses >6 mg/day)
Contraindicated in: MAOIs use concurrently or w/in 14 days of stopping treatment, untreated narrow angle glaucoma, severe urinary retention
Black Box Warning: Increased risk of suicidality in children, adolescents, and young adults
BEERS (for doses >6 mg/day)
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Wellbutrin, Wellbutrin SR, Wellbutrin XL (bupropion)
No common ADRs
Contraindicated in: Seizure disorder, bulimia, anorexia nervosa, abrupt D/C of alcohol, BZDs, barbiturates, antiepileptics, MAOI therapy in
Contraindicated in: Seizure disorder, bulimia, anorexia nervosa, abrupt D/C of alcohol, BZDs, barbiturates, antiepileptics, MAOI therapy in
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Remeron (mirtazapine)
Common ADRs: Somnolence, increased appetite, weight gain, dry mouth, constipation
Contraindicated in: MAOI therapy in
Contraindicated in: MAOI therapy in
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Buspar (buspirone)
Common ADRs: Dizziness
Contraindicated in: MAOI therapy in
Contraindicated in: MAOI therapy in
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Abilify (aripriprazole)
Common ADRs: Vomiting, insomnia, fatigue, somnolence, akathisia
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis, suicidal ideation w/ antidepressant use
BEERS
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis, suicidal ideation w/ antidepressant use
BEERS
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Zyprexa (olanzapine)
Common ADRs: Constipation, somnolence, dizziness, asthenia, dry mouth, dyspepsia, EPS, increased appetite, weight gain, HA
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis
BEERS
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis
BEERS
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Seroquel, Seroquel XR (quetiapine)
Common ADRs: Somnolence, dizziness, dry mouth, constipation, asthenia, increased appetite, fatigue, HA, tachycardia
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis, suicidal ideation w/ antidepressant use
BEERS
No absolute contraindications
Black Box Warning: Increased mortality in dementia-related psychosis, suicidal ideation w/ antidepressant use
BEERS
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Risperidal (risperidone)
Common ADRs: Sedation, Parkinsonism, akathisia, EPS, insomnia, anxiety, dizziness, N/V
Contraindicated in: Paliperidone allergy
Black Box Warning: Increased mortality in dementia-related psychosis
BEERS
Contraindicated in: Paliperidone allergy
Black Box Warning: Increased mortality in dementia-related psychosis
BEERS
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Depakote, Depakote ER, Depakote Sprinkles (divalproex sodium/valproic acid)
Common ADRs: N/V/D, HA, diplopia, asthenia, somnolence, dizziness, accidental injury, tremor, abdominal pain, anorexia, respiratory infection, thrombocytopenia, alopecia
Contraindicated in: Hepatic dysfunction, mitochondrial disease, urea cycle disorders, pregnancy
Black Box Warning: Hepatotoxicity, fetal risk, pancreatitis
BEERS (w/ h/o falls/fractures)
Contraindicated in: Hepatic dysfunction, mitochondrial disease, urea cycle disorders, pregnancy
Black Box Warning: Hepatotoxicity, fetal risk, pancreatitis
BEERS (w/ h/o falls/fractures)
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Neurontin, Gralise, Horizant (gabapentin)
Common ADRs: Fatigue, somnolence, dizziness, ataxia
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures, increased risk of overdose w/ concomitant use of opioids)
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures, increased risk of overdose w/ concomitant use of opioids)
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Lyrica (pregabalin)
Common ADRs: Blurred vision, dry mouth, constipation, weight gain, dizziness, somnolence, peripheral edema, infection, accidental injury, ataxia, tremor, diplopia, fatigue
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures, increased risk of overdose w/ concomitant use of opioids)
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures, increased risk of overdose w/ concomitant use of opioids)
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Lamictal (lamotrigine)
Common ADRs: N/V, HA, rhinitis, dizziness, ataxia, somnolence, rash, diplopia, blurred vision, abdominal pain, tremor
No absolute contraindications
Black Box Warning: Serious skin rash
BEERS (w/ h/o falls/fractures)
No absolute contraindications
Black Box Warning: Serious skin rash
BEERS (w/ h/o falls/fractures)
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Keppra, Keppra XR (levetiracetam)
Common ADRs: Asthenia, infection, somnolence, fatigue, aggression, irritability, nasopharyngitis, vomiting
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures)
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures)
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Topamax (topiramate)
Common ADRs: Dizziness, ataxia, speech disorder, paresthesia, somnolence, difficulty w/ memory, confusion, diplopia, nervousness, psychomotor, slowing, diarrhea, taste disturbance, abnormal vision, fatigue, nausea, abdominal pain, URTI
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures)
No absolute contraindications
No Black Box Warning
BEERS (w/ h/o falls/fractures)
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Mysoline (primidone)
No common ADRs
Contraindicated in: Patients w/ porphyria
No Black Box Warning
BEERS
Contraindicated in: Patients w/ porphyria
No Black Box Warning
BEERS
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Aricept (donepezil)
Common ADRs: Nausea, diarrhea, insomnia
Contraindicated in: Piperidine derivative allergy
No Black Box Warning
BEERS (w/ h/o syncope)
Contraindicated in: Piperidine derivative allergy
No Black Box Warning
BEERS (w/ h/o syncope)
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Valtrex (valacyclovir)
Common ADRs: HA, abdominal pain, decreased neutrophil count
No absolute contraindications
No Black Box Warning
Not on BEERS List
No absolute contraindications
No Black Box Warning
Not on BEERS List
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Namenda (memantine); Zovirax (acyclovir); Keflex (cephalexin); Penicillin VK; Amoxil (amoxicillin); Oracea, Vibramycin, Doryx (doxycycline); Bactroban (mupirocin); Mycostatin (nystatin); Plaquenil (hydroxychloroquine sulfate); Zyloprim, Aloprim (allopurinol); Myrbetriq (mirabegron); Carafate (sucralfate); Xalatan (latanoprost)
No common ADRs
No absolute contraindications
No Black Box Warning
Not on BEERS List
No absolute contraindications
No Black Box Warning
Not on BEERS List
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Omnicef (cefdinir)
Common ADRs: Diarrhea
No absolute contraindications
No Black Box Warning
Not on BEERS List
No absolute contraindications
No Black Box Warning
Not on BEERS List
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Augmentin (amoxicillin/clavulanic acid)
No common ADRs
Contraindicated in: Patients with h/o cholestatic jaundice/hepatic dysfunction associated w/ Augmentin
No Black Box Warning
Not on BEERS List
Contraindicated in: Patients with h/o cholestatic jaundice/hepatic dysfunction associated w/ Augmentin
No Black Box Warning
Not on BEERS List