Contraindications/Black Box Warnings - Neuro/Psych Flashcards
Contraindication is separated by Black box warnings by a semicolon (;)
Benztropine
Hypersensitivity, use in patients <3 y of age
Carbamazepine
Hypersensitivity to carbamazepine, history of bone marrow depression, MAOIs, nefazodone; Agranulocytosis; aplastic anemia; dermatological reactions (especially in Asians); screen for HLA-B*15:02
Carbidopa/Levodopa
Hypersensitivity to carbidopa or levodopa, narrow-angle glaucoma, concurrent MAOI or linezolid
Dexmethylphenidate
Hypersensitivity to amphetamines, MAOI use, drug dependence, glaucoma, tics, or history of Tourette syndrome; Abuse and dependence
Divalproex
Hypersensitivity, hepatic disease, urea cycle disorders; Hepatotoxicity, patients with mitochondrial disease, teratogenicity, pancreatitis
Donepezil
Hypersensitivity to drug or piperidine derivatives
Eletriptan
Hypersensitivity to eletriptan, cerebrovascular syndromes, hemiplegic or basilar migraine, ischemic bowel disease, ischemic heart disease, peripheral vascular disease, severe hepatic impairment, uncontrolled HTN
Eszopiclone
Hypersensitivity, history of complex sleep behavior; Risk of complex sleep behaviors (sleepwalking, sleep driving, etc)
Gabapentin
Hypersensitivity
Guanfacine
Hypersensitivity
Lacosamide
Hypersensitivity
Lamotrigine
Hypersensitivity; Serious skin reactions
Levetiracetam
Hypersensitivity
Lisdexamfetamine
Hypersensitivity/idiosyncrasy to sympathomimetic amines, MAOIs, symptomatic cardiovascular disease or advanced arteriosclerosis, moderate-severe HTN, hyperthyroidism, glaucoma, agitated states, history of drug dependence; Risk of abuse, misuse, diversion
Memantine
Hypersensitivity
Metaxalone
Hypersensitivity; significantly impaired renal or hepatic function
Methylphenidate
Hypersensitivity to amphetamines, anxiety, agitation, concurrent MAOIs, drug dependence, glaucoma, tics or history of Tourette syndrome, HTN, angina, heart failure, concurrent halogenated anesthetics; Abuse and dependence potential
Modafinil
Hypersensitivity
Oxcarbazepine
Hypersensitivity
Phenobarbital
Hypersensitivity to barbiturates, marked liver function impairment, respiratory disease with evidence of dyspnea or obstruction, history of sedative or hypnotic addiction, personal or family history of acute intermittent porphyria; Concomitant use with opioids, dependence and withdrawal, abuse (IV only)
Phentermine
Hypersensitivity to this medication or other sympathomimetic amines, use in agitated states, cardiovascular disease, history of drug abuse, glaucoma, moderate to severe HTN, hyperthyroidism
Phenytoin
Hypersensitivity to phenytoin, sinus bradycardia, AV block; Hypotension and arrhythmias with IV administration
Pramipexole
Hypersensitivity
Pregabalin
Hypersensitivity
Rizatriptan
Cerebrovascular syndromes, hemiplegic or basilar migraine, ischemic bowel disease, ischemic heart disease, peripheral vascular disease, severe hepatic impairment, uncontrolled HTN, MAOI, ergot alkaloids
Ropinirole
Hypersensitivity
Topiramate
Hypersensitivity, alcohol use for the ER formulation (within 6 h prior to and 6 h after administration)
Trazodone
Hypersensitivity, use of MAOI; Suicidal ideation, not for use in children
Varenicline
Hypersensitivity
Zolpidem
Hypersensitivity, history of complex sleep behavior; Risk of complex sleep behaviors (sleepwalking, sleep driving, etc)
Sumatriptan
Hypersensitivity, cerebrovascular syndromes, hemiplegic or basilar migraine, ischemic bowel disease, ischemic heart disease, peripheral vascular disease, severe hepatic impairment, uncontrolled HTN, MAOIs, ergot alkaloids
Amitriptyline
Hypersensitivity, concurrent MAOI or MAOI use in last 14 d, use during acute recovery period after MI, coadministration of cisapride; Suicidality, not approved for children <12 y of age
Aripiprazole
Hypersensitivity; Dementia, suicidality
Atomoxetine
Hypersensitivity, concomitant use of MAOIs or use within 2 wk, narrow-angle glaucoma, pheochromocytoma, severe cardiac or vascular disorders in which condition would be expected to deteriorate with clinically important increases in BP or HR; Suicidality in children and adolescents
Buspirone
Hypersensitivity
Bupropion
Seizure disorder, history of anorexia/bulimia, use of MAOI within 14 d, patients undergoing abrupt discontinuation of ethanol, benzodiazepines, barbiturates, or antiepileptics; Suicidality; neuropsychiatric reactions
Citalopram
Hypersensitivity, concomitant use of pimozide, MAOIs; Suicidal ideation; not approved for use in children
Clonazepam
Hypersensitivity to benzodiazepines, narrow-angle glaucoma, liver disease; Concurrent use with opioids, abuse, misuse, and addiction, dependence and withdrawal reactions
Desvenlafaxine
Hypersensitivity, MAOI use; Suicidality, not for use in children, not for bipolar disorder
Doxepin
Hypersensitivity, MAOI use, glaucoma, severe urinary retention; Suicidality
Duloxetine
Hypersensitivity, MAOI, TCA, linezolid use, uncontrolled glaucoma; Suicidality; not approved for children
Escitalopram
Hypersensitivity, concurrent MAOI use; Suicidality
Fluoxetine
Hypersensitivity, concomitant pimozide, thioridazine, or MAOIs; Suicidality; approved in children (>7 y of age, OCD; >8 y of age, MDD)
Lithium
Severe debilitation, dehydration, or sodium depletion, significant cardiovascular disease, significant renal impairment, concomitant diuretic therapy; level monitoring required
Lithium level monitoring required
Lurasidone
Hypersensitivity, concurrent strong CYP3A4/5 inducers and inhibitors
Dementia (increased mortality), suicidality
Mirtazapine
Hypersensitivity, concurrent use or use within 14 d of MAOI, linezolid, IV methylene blue use; Suicidality, not for use in children
Nortriptyline
Hypersensitivity to nortriptyline or other TCAs, MAOI concurrent use or use within 14 d, use during acute recovery period after MI, patient using linezolid or IV methylene blue; Suicidality
Olanzapine
Hypersensitivity; Mortality in elderly patients with dementia-related psychosis, DRESS
Paroxetine
Hypersensitivity, concomitant use of thioridazine or MAOIs, pregnancy; Suicidality
Quetiapine
Hypersensitivity; Mortality in elderly with dementia, suicidality, not approved for children <10 y of age
Risperidone
Hypersensitivity, agents that increase QTc interval; Mortality in elderly with dementia, DRESS
Sertraline
Hypersensitivity, concomitant use of pimozide, thioridazine, or MAOIs; Suicidality
Venlafaxine
Hypersensitivity, MAOIs; Suicidal ideation, not approved in children
Vilazodone
Hypersensitivity, concurrent use of MAOI; Suicidal thinking and suicidal behavior, not approved for children
Ziprasidone
Hypersensitivity, acute or recent AMI, uncompensated heart failure; QTc prolongation, including congenital long QTc syndrome, concomitant administration of other drugs that cause QTc prolongation; Elderly patients with dementia are at increased risk of death, not approved for dementia related psychosis
Alprazolam
Hypersensitivity to benzodiazepines, narrow-angle glaucoma, concurrent ketoconazole, or itraconazole; Concurrent use with opioids, abuse potential, withdrawal reactions
Diazepam
Hypersensitivity to benzodiazepines, narrow-angle glaucoma, severe liver disease, myasthenia gravis, sleep apnea, respiratory insufficiency, children <6 mo; Concurrent use with opioids, addiction and dependence and withdrawal reactions
Lorazepam
Hypersensitivity to benzodiazepines, narrow-angle glaucoma; Concurrent use with opioids
Temazepam
Hypersensitivity to benzodiazepines, narrow-angle glaucoma, pregnancy; Concurrent use with opioids
Triazolam
Hypersensitivity to benzodiazepines, concurrent strong CYP3A4/5 inhibitors Pharmacogenetics; Concurrent use with opioids; abuse, misuse and addiction, which can lead to overdose or death; dependence, which can lead to withdrawal reactions
Clobazam
Hypersensitivity; Concurrent use with opioids, abuse and addition, dependence and withdrawal reactions
