Taking blood thinners with certain painkillers may raise bleeding risk.Although concomitant use of gemfibrozil or niacin with an HMG-CoA reductase inhibitor may appear clinically appropriate, these combinations have been associated with a 2 to 5 percent increase in the risk of myopathy. 21 Case reports describing these interactions are questionable because gemfibrozil and niacin have independently been associated with myopathy.These interactions may increase your risk of bleeding or decrease the.
Consumer information about rivaroxaban (Xarelto), a drug prescribed to prevent or treat AFib, DVT, and pulmonary embolism.As discussed in this eMedTV article, Xarelto can cause negative drug interactions with medications like Aleve, warfarin, and carbamazepine.
Oral contraceptive pills plus antibiotics Decreased effectiveness of oral contraception Any time Avoid if possible.SSRI plus naratriptan (Amerge), rizatriptan (Mazalt), sumatriptan (Imitrex) or zolmitriptan (Zomig) Serotonin syndrome Possibly after initial dose Avoid if possible.AMENT, PHARM.D., is assistant director of pharmacy and a faculty member in the family medicine residency program at Latrobe (Pa.) Area Hospital.Warfarin Fluoroquinolones Antiepileptic Drugs Lithium Oral Contraceptives Cisapride Sildenafil 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors Selective Serotonin Reuptake Inhibitors Sources of Information on Drug Interactions References Carbamazepine (Tegretol), phenobarbital and phenytoin (Dilantin) are commonly prescribed for the management of epilepsy and other disorders.If combination therapy is necessary, recommend use of alternative contraceptive method during cycle.In addition, the INR should be monitored closely. 5 ASPIRIN Coadministration of acetylsalicylic acid (aspirin) and warfarin increases the risk of bleeding.Patients also should be informed about the risk of bleeding associated with combined warfarin and NSAID therapy.
Most pharmacies have drug-interaction software programs with their dispensing package.Common products containing divalent or trivalent cations are listed in Table 2.Phenytoin plus rifampin (Rifadin) Decreased phenytoin levels Generally within 1 week Clinical significance has not been established.Warfarin Fluoroquinolones Antiepileptic Drugs Lithium Oral Contraceptives Cisapride Sildenafil 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors Selective Serotonin Reuptake Inhibitors Sources of Information on Drug Interactions References Potentially fatal interactions can occur with coadministration of cisapride (Propulsid) and other drugs.
As use of this over-the-counter product increases, more data supporting clinically significant drug interactions should become available.This article reviews potential clinically significant drug interactions involving commonly prescribed medications ( Table 1 ).These drugs are metabolized through the cytochrome P450 pathway.
Request Appointment Give Now Contact Us About Mayo Clinic Employees Site Map About This Site.Sildenafil (Viagra) plus nitrates Dramatic hypotension Soon after taking sildenafil Absolute contraindication.
Almost all antibiotics can potentiate the effects of warfarin by inhibiting intestinal flora that produce vitamin K.Combining a cytochrome P450 inhibitor with a substrate can potentiate the pharmacologic effects of the substrate.
Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Warfarin Fluoroquinolones Antiepileptic Drugs Lithium Oral Contraceptives Cisapride Sildenafil 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors Selective Serotonin Reuptake Inhibitors Sources of Information on Drug Interactions References No single method is available to enable physicians to easily avoid drug interactions in clinical practice.Approaches to the treatment of hyperlipidemia in the solid organ transplant recipient.Divalent cations (calcium and magnesium) and trivalent cations (aluminum and ferrous sulfate) can form insoluble complexes in the gut if they are taken concurrently with fluoroquinolones. 11.If combination therapy is necessary, monitor the patient for toxicity.When concomitant use of an SSRI and a tricyclic antidepressant is required, the patient should be monitored for anticholinergic excess.Recognizing drug interactions is a daily challenge for family physicians, and remembering all potential interactions has become virtually impossible.