Drug-drug Interactions Flashcards
Carbamazepine (Tegretol) -seizure, bipolar disorder
Effects increased by:
Erythromycin, clarithromycin, fluconazole, grapefruit juice
Digoxin (class V anti arrhythmias)
Effects increased by:
quinidine (class I anti arrhythmia)
Ginseng may increase serum digoxin levels
Fluoroquinolone (ex: levofloxacin, ciprofloxacin, moxifloxacin)
Effects decreased by:
Aluminum-, calcium-, magnesium-, and iron-containing medications
HMG CoA reductase inhibitors (statins)
Effects increased by:
Erythromycin, itraconazole, niacin, gemfibrozil, grapefruit juice
Lithium
Effects increased by:
Diuretics, NSAIDs
Morphine
Effects decreased by:
Naloxone
Nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
Effects increased by: PDE5 inhibitors (sildenafil, vardenafil, tadalafil)
Oral contraceptives
Effects decreased by:
Antibiotics
Penicillin
Effects decreased by :
Probenecid (for gout)
Phenobarbital (seizures, anxiety)
Effects decreased by:
Phenytoin (for seizures)
SSRIs (fluoxetine, escitalopram, citalopram, etc)
Effects increased by:
Triptans (for headaches: rizotriptan, sumatriptan, etc)
TCAs (tricyclic antidepressants: nortriptyline, amitriptyline, etc)
Effects increased by:
SSRIs (selective serotonin reuptake inhibitors: fluoxetine, escitalopram, sertraline, etc)
Tetracycline (antibiotic)
Effects are decreased by:
Ketoconazole (antifungal), antacids, food
Potassium chloride
Effects are increased by:
Spironolactone (potassium sparing diuretic for hypertension)
Warfarin
Effects are increased by:
Ciprofloxacin, clarithromycin, aspirin, acetaminophen, NSAIDs, ginseng
Effects are decreased by:
Vitamin k, St. John’s wort, cranberry juice, broccoli, Brussels sprouts, cabbage, romaine lettuce, spinach
Ginkgo biloba may increase risk of bleeding
Cimetidine (Tagamet) (antihistamine &antacid)
Effects decreased by:
Antacids
Ketoconazole
Effects decreased by:
Antacids
Mixed with echinacea may have additive hepatotoxic effects
Levothyroxine
Effects decreased by:
Iron tablets
Estrogens
May increase estrogen activity with black cohosh
May increase hormonal effects with ginseng
May decrease levels of estrogen with St. John’s wort
May increase effects with grapefruit juice
Terazosin
May decrease effects with garlic
May decrease effectiveness of terazosin with ginseng
NSAIDs
Ginkgo biloba may increase risk of bleeding
Clopidogrel (plavix) -blood thinner
Ginkgo biloba may increase risk of bleeding
Duloxetine (antidepressant, nerve pain)
St. John’s wort may increase adverse effects
HIV antiviral drugs
St. John’s wort may increase blood concentration and effectiveness in treating HIV
