Contraindications Flashcards
Alfuzosin, doxazosin, tamsulosin, and terazosin
Contraindicated for concurrent use with PDE-5 inhibitors such as sildenafil (used for ED) due to increased hypotensive effect Severe liver dysfunction with concurrent use of potent inhibitors of P450 enzymes (e.g., ketoconazole)
Propranolol
Contraindicated in asthma patients Not effective in AfricanAmerican patients; Avoid nonselective blockers (propanolol) in COPD patients
calcium channel blockers (diltiazem and verapamil) inhibit P450 enzymes and can increase levels PREGNANCY
Dutasteride
Bicalutamide & flutamide Antiandrogens
Severe hepatic impairment
PREGNANCY
Captopril, Lisinopril, Enalapril, Ramipril; Losartan, Candesartan, Valsartan, Eprosartan; Aliskiren
respiratory insufficiency Severe hepatic impairment
Nilutamide
Captopril, Lisinopril, Enalapril, Ramipril; Losartan, Candesartan, Valsartan, Eprosartan; Aliskiren
PREGNANCY
Concurrent use with methotrexate, 6-mercaptopurine, and azathioprine–> bone marrow suppression PREGNANCY (can cross placenta)
Trimethoprim-Sulfamethoxazole
Take with food to increase bioavailability
Cinacalcet
Alprostadil
Sickle cell disease (risk of priapism) Lymphoproliferative disorders (risk of priapism) Thrombocytopenia Anticoagulants Patients with poor-quality injection technique (patients with psychiatric disorders, obese patients, patients who are blind, and patients with severe arthritis)
Cinacalcet
Take with food to increase bioavailability
Mannitol
Pulmonary congestion Heart failure Severe renal disease
Calcium acetate & calcium carbonate
Interferes with absorption of other drugs including oral iron
Ferrous sulfate and ferric gluconate
antacids, proton-pump inhibitors, H2-receptor antagonists (decrease absorption) Do not take with food or with other drugs concurrently (decrease bioavailability)
Finasteride
no clinically relevant drug interactions PREGNANCY
Interferes with absorption of other drugs including oral iron
Calcium acetate & calcium carbonate
Testosterone replacement
Prostate cancer BPH
Anesthetics and neuromuscular blockers due to neuromuscular blockade; overcome by calcium salt administration
Aminoglycosides
Nitrates (severe hypotension) Contraindicated in patients at risk of ophthalmologic problems Caution in airplane pilots
Sildenafil, tadalafil, vardenafil
Sulfonamide allergies Aminoglycosides (ototoxicity) NSAIDs (decreases efficacy) Oral hypoglycemics (efficacy decreased)
Furosemide