Download Common drug interactions

Common drug interactions
Medicines can treat and even cure one’s ills, but they must be used correctly and their effects monitored — particularly when one takes more than one prescription,
herb or over-the-counter treatment at a time. The following chart lists widely used drugs and their possible interactions with other medications, herbal supplements,
food and alcohol. The list is by no means comprehensive. Patients should always discuss their treatments with each of their doctors and pharmacists.
ARTHRITIS AND PAIN RELIEVERS
CATEGORY
DRUG NAME
BRAND NAME
FOOD
ALCOHOL
ANALGESICS/
ANTIPYRETICS
Acetaminophen
Tylenol
Tempra
Take on an
empty stomach.
Increases risk for
liver damage or
stomach bleeding.
St. John’s
wort
Increases risk for Do not take with other
liver damage or
pain relievers.
stomach bleeding.
Ginkgo and
others that
impede clotting
NONSTEROIDAL Aspirin
Ibuprofen
ANTIINFLAMMATOR- Naproxen
IES (NSAIDS):
CORTICOSTEROIDS
Ketoprofen
Nabumetone
MethylPrednisolone
prednisolone Cortisone
Hydrocortisone acetate
Prednisone
Codeine
NARCOTIC
(PRESCRIPTION) Morphine
Oxycodone
ANALGESICS
Meperidine
Hydrocodone
Bayer
Ecotrin
Motrin
Advil
Anaprox
Aleve
Naprosyn
Orudis
Relafen
St. Joseph
Take with food or
milk to decrease
stomach irritation.
Medrol
Cortone
Deltasone
Pediapred
Prerlone
Cortef
Take with food or
milk to decrease
stomach irritation.
Tylenol No. 2
Tylenol No. 3
Tylenol No. 4
Roxanol
MS Contin
Percocet
Roxicet
Demerol
Vicodin
Lorcet
DRUG
HERB
Particularly with certain
cholesterol-lowering medications
such as cholestyramine; raises
blood sugar.
Avoid because of
sedative effects.
Valerian, St.
John’s wort, kava
kava and others
Increases sedative
effects of other
medications.
CARDIOVASCULAR
DIURETICS
Furosemide Bumetamide
Triamterene Metolazone
Hydrochloro- Spironolactone
thiazide
Lasix
Dyazide
Maxzide
HydroDIURIL
Dyrenium
Bumex
Zaroxolyn
Aldactone
Can cause loss of
potassium, calcium
and magnesium, or
potassium overload.
With cardiovascular and
analgesic medications.
ANGIOTENSIN
CONVERTING
ENZYME (ACE)
INHIBITORS
Captopril
Enalapril
Lisinopril
Quinapril
Moexipril
Benazepril
Capoten
Vasotec
Prinivil
Zestril
Accupril
Univasc
Lotensin
Some should not be
taken with meals; may
dangerously increase
potassium.
Increases
drowsiness.
BETA
BLOCKERS
Atenolol
Metoprolol
Propranolol
Nadolol
Tenormin
Lopressor
Inderal
Corgard
Toprol
Take with or
without food.
With propranolol With many medications; may
or Inderal, may
cause excessive drowsiness.
dangerously lower
blood pressure.
ANGIOTENSIN
II RECEPTOR
BLOCKERS
Candesartan
Irbesartan
Losartan
Olmesartan
Telmisartan
Valsartan
Avapro
Atacand
Cozaar
Benicar
Micardis
Diovan
Take with or without
food; avoid potassium
overload.
CALCIUM
CHANNEL
BLOCKERS
(CCBs)
Amlodipine
Felodipine
Diltiazem
Verapamil
Nifedipine
Isradipine
Nifedical
Norvasc
Plendil
Cardizem
Tiazac
Calan
Covera-HS
Verelan
Adalat
Cardia
Dynacirc
Do not take with
grapefruit or grapefruit
juice; take with or
without food or milk.
HMG-CoA
REDUCTASE
INHIBITORS
(STATINS)
Atorvastatin
Fluvastatin
Locastatin
Pravastatin
Simvastatin
Lipitor
Lescol
Mevacor
Pravachol
Zocor
Do not take with
grapefruit or
grapefruit juice.
NITRATES
Isosorbide dinitrate
Isosorbide mononitrate
Nitroglycerin
Isordil
Imdur
Sorbitrate
Nitro
Nitro-Dur
TransdermNitro
ANTICOAGULANTS
Warfarin
Coumadin
Do not take with potassium
supplements or diuretics, with
lithium, tetracycline and many
other medications.
Yohimbe, ephedra,
dong quai,
ginseng, garlic
Ephedra, yohimbe,
ginseng, licorice
With ACE inhibitors, beta blockers,
antacids, diuretics, some antibiotics
and pain relievers, potassium
supplements, other medications.
Dong quai,
ephedra,
yohimbe,
ginseng, garlic
Interferes with
effectiveness
and creates
side effects.
Do not take with other blood
pressure medications; with
some antibiotics, pain relievers,
stomach and antidepressant
medications.
St. John’s wort,
dong quai,
ephedra,
yohimbe, ginseng,
garlic
May increase
risk for liver
damage.
Risk of muscle damage when taken
with certain cholesterol-lowering
medications; rapid heartbeat with
amiodarone; with some antibiotics
and other medications.
With Viagra can
Avoid — may
dangerously lower increase heart rate
and prove fatal.
blood pressure.
Monitor consumption of
vitamin K foods such as
broccoli, spinach or kale
to keep drug levels
balanced; grapefruit
juice and nutrient drinks
block or decrease
concentrations.
Avoid
Do not take with pain relievers
or antibiotics, cholestyramine or
amiodarone; many restrictions
with other medications.
Do not take with
vitamin E and
herbals that
decrease clotting
such as ginkgo
biloba, feverfew,
ginseng and
others.
Avoid because
of risk of
hypoglycemia, or
low blood sugar.
With many medications, including
over-the-counter remedies with
a high sugar (sucrose, glucose)
content.
Garlic,
chromium,
gymnema
DIABETES TYPE 2
DIABETES
(TYPE 2)
Glimepiride
Pioglitazone
Rosiglitazone
Amaryl Micronase
Metformin
Take with or without
Avandia Glucophage
Glyburide
food; often taken at
Sulfonylureas DiaBeta Glucophage XR breakfast.
ANTIBACTERIALS
CEPHALOSPORINS
Cefaclor
Cefadroxil
Cefixime
MACROLIDES
Azithromycin Erythromycin Zithromax
Clarithromycin plus Sulfisox- Biaxin
Erythromycin azole
E-Mycin
NITROIMIDAZOLE
Metronidazole
Flagyl
PENICILLIN
Penicillin V
Amoxicillin
Ampicillin
Veetids
Trimox
Amoxil
Principen
Omnipen
Take on an empty
stomach unless stomach
upset ensues.
With many medications.
QUINOLONES
Ciprofloxacin
Levofloxacin
Ofloxacin
Cipro
Levaquin
Floxin
Tequin
Avelox
Take on an empty
stomach or an hour or
two after eating. Do not
take with calcium-rich
foods such as milk or
yogurt, iron pills or
antacids.
Increases sun sensitivity; with
Dong quai,
cimetidine, also with blood
St. John’s wort
thinners, pain relievers, diabetes
and other medications.
SULFONAMIDES
Sulfamethoxazole
plus trimethoprim
Bactrim
Septra
Take on an empty
stomach unless
stomach upset ensues.
Increases sun sensitivity; with
Dong quai,
warfarin, anticonvulsants, antiSt. John’s wort
arrhythmics and other medications.
TETRACYCLINES
Tetracycline
Doxycycline
Minocycline
Achromycin
Sumycin
Vibramycin
Minocin
Take on empty stomach
unless stomach upset
ensues; do not take with
dairy products, antacids
or iron supplements.
Increases sun sensitivity;
with warfarin.
Dong quai,
St. John’s wort
Alprazolam
Ativan
Valium
Xanax
Caffeine reduces
anti-anxiety effect
of medication.
Increases
drowsiness and
risk of seizures.
With levodopa and oral
contraceptives; antacids
may reduce concentrations.
Kava kava, gotu
kola, St. John’s
wort and others
Ginseng may
interact to cause
insomnia or
hallucinations;
with St. John’s
wort, SAMe and
others
Cefprozil
Cephalexin
Cefdinir
Gatifloxacin
Moxifloxacin
Ceclor
Ceclor CD
Duricef
Suprax
Cefzil
Keflex
Keftab
Omnicef
Take on an empty
stomach unless
stomach upset ensues.
May lose effectiveness if taken
with antacids or antibiotics.
Ery-Tab
Eryc
Pediazole
Take on an empty
stomach unless stomach
upset ensues.
Increases sun sensitivity; risk of
irregular heartbeat if taken with
Propulsid; interacts with antiarrhythmics and other medications.
Avoid for at least With warfarin.
three days after
prescription; may
cause nausea,
cramps, headache
and flushing.
Several herbs
change
concentrations.
MOOD DISORDERS
BENZODIAZEPINES
Lorazepam
Diazepam
MONOAMINE
OXIDASE
(MAO)
INHIBITORS
Phenelzine
Tranylcypromine
Nardil
Parnate
Potentially fatal
increases in blood
pressure if food or
alcohol containing
tyramine is ingested,
found in some cheeses,
yogurt, sour cream, liver,
cured meats, raisins, soy
sauce, avocados,
caffeine and more.
Potentially fatal
increases in
blood pressure
if food or alcohol
containing
tyramine is
ingested.
With prescribed and overthe-counter medications.
SELECTIVE
SEROTONIN
REUPTAKE
INHIBITORS
(SSRIs)
Cilalopram
Paroxetine
Sertraline
Fluoxetine
Celexa
Paxil
Zoloft
Prozac
Take with or
without food.
Increases
drowsiness and
dizziness, feelings
of depression.
Never take with Pimozide,
St. John’s wort,
Marplan, Nardil, Parnate or other kava kava,
mood disorder medications, which SAMe, valerian
can be fatal; interacts with
warfarin, antibiotics, asthma,
stomach and other medications.
TRICYCLIC
ANTIDEPRESSANTS
(TCAs)
Desipramine
Nortriptyline
Amitriptyline
Tofranil
Pamelor
Vivactil
Take with or without
food; do not take with
grapefruit or
grapefruit juice.
Avoid. Increases
drowsiness.
Increases effects of warfarin;
do not take with other antidepressants; can cause toxic
concentrations with certain
cardiovascular medications; with
asthma and other medications.
Zantac
Zantac 75
Axid
Axid AR
Take with or without
food; caffeine may
irritate stomach.
May irritate
stomach and make
stomach healing
more difficult.
Cimetidine can interact with
St. John’s
asthma, blood-thinners, antifungals wort
and seizure medications; do not
take with other antacids.
Protonix
Nexium
Take on an empty
stomach; caffeine may
irritate stomach.
May irritate
stomach and make
stomach healing
more difficult.
May interfere with warfarin and
St. John’s
phenytoin; do not take with other wort
antacids; with antidepressants,
antifungals and other medications.
Protriptyline
Elavil
Clomipramine Anafranil
Imipramine
Aventyl
Norpramin
Valerian,
St. John’s wort,
SAMe,
kava kava
STOMACH DISORDERS
HISTAMINE
BLOCKERS
Cimetidine
Famotidine
Ranitidine
Nizatadine
PROTON
PUMP
INHIBITORS
Lansoprazole
Omeprazole
Rabeprazole
Tagamet
Tagamet HB
Pepcid
Pepcid AC
Pantoprazole Prilosec
Esomeprazole Prevacid
Aciphex
SOURCES: Annie Beauchamp, doctoral candidate in pharmacy, University of Florida College of Pharmacy; U.S. Food and Drug Administration;
www.drugs.com; www.drugdigest.org; American Pharmacists Association; www.rxlist.com; Cornell Illustrated Encyclopedia of Health.
Compiled by SUSAN ASCHOFF,
Times staff writer / Times art