Common DDI Flashcards
Amiodarone and Warfarin
Amiodarone inhibits many things, including 2D6. Increased levels of warfarin. Decrease warfarin by 20-50%
Amiodarone and Digoxin
Amio inhibits P-gp, dig is a substrate, and decreases dig excretion. decrease dig dose by 50%
Digoxin and loop diuretics
Loop diuretics lower K, Mg, Ca and Na. Dig toxicity is worsened by lower Mg, K, and increased Ca. Loop diuretics may cause renal injury. Dig is really eliminated. Monitor combination
Valproate and Lamotrigine
valproate reduces lamotrigine metabolism. Increased risk of SJS. Avoid combination
Smoking
1A2 inhibition
Opioids
3A4 substrate
MOAi
Tranylcypromine, rasagiline, selegiline, linezolid, methylene blue
Serotonergic drugs
Opioids (fent, methadone, tramadol), dextromethorphan (when abused), lithium, St. Johns Wort
2D6 Inhibitors
Amiodarone, fluoxetine, paroxetine, fluvoxamine
2D6 substrates
Codine, tramadol
Natural Products that increase bleeding risk
Garlic, ginseng, ginkgo, ginger, glucosamine (5 G), vitamin E, willow bark, fish oils
This class of drugs increases the risk of bleeding (surprisingly)
SSRI and SNRIs
Hyperkalemia risk
Bactrim, CNIs, canagliflozin, drospirenone (and OCs that contain it)
Anti-infectives that prolong QT
antimalarials, azoles, macrolides, quinolones, lefamulin
Psych drugs that prolong QT
Citalopram, escitalopram, TCAs, mirtazapine, trazodone, venlafaxine, first-gen antipsychotics, ziprasidone