Drug combination S1 R2 Mechanism/Effect Recommendations
Apixaban + Enoxaparin X F Apixaban may enhance the anticoagulant effect of enoxaparin Avoid concomitant use
Carvedilol + Ipratropium Bromide/Salbutamol X F Beta-blockers (nonselective) may diminish the bronchodilatory effect of beta2-agonists Avoid combination or monitor for diminished bronchodilatory effects of the beta2-agonist
Clarithromycin + Lopinavir/Ritonavir X F Clarithromycin may increase the serum concentration of lopinavir/ritonavir, increase QT-prolongation effects Avoid combination or monitor for QTc interval prolongation and arrhythmias
Ipratropium Bromide + Diphenhydramine X F Increase the anticholinergic effects Avoid combination or monitor for anticholinergic related toxicity
Lopinavir/Ritonavir + Amiodarone X F CYP3A43 inhibitors may increase the serum concentration of amiodarone, increase QT- prolongation effect Avoid combination or monitor for amiodarone toxicity and QTc interval prolongation
Lopinavir/Ritonavir + Rivaroxaban X G P-glycoprotein and CYP3A4 inhibitors may increase the serum concentration of rivaroxaban. Avoid combination or monitor for adverse effects
Rifampin + Lopinavir/Ritonavir X G Rifampin may decrease the serum concentration of lopinavir/ritonavir. Avoid combination
Salmetrol + Fluticasone /Salmeterol X F Synergism effects of beta2-agonists (long-acting) Avoid combination
Sertraline + Selegiline X F Selective serotonin reuptake inhibitors may enhance the serotonergic effect of selegiline Avoid combination
Amiodarone + Azithromycin D F Increase QT-prolongation effects Consider alternatives to this combination, monitor for QTc interval prolongation and arrhythmias
Amiodarone + Digoxin D E Amiodarone may increase the serum concentration of digoxin Reduce the digoxin dose (30% to 50%) or the dosing frequency, monitor digoxin levels
Alprazolam + Oxycodone D F Increase CNS depressant effects Close monitoring for adverse effects
Atracurium + Dexamethasone D E Neuromuscular-blocking agents (nondepolarizing) may enhance the adverse neuromuscular effect of corticosteroids Administer the lowest possible doses, limit duration of administration, monitor closely for sign and symptom of myopathy or neuropathy
Atracurium + Hydrocortisone D E Neuromuscular-blocking agents (nondepolarizing) may enhance the adverse neuromuscular effect of corticosteroids Administer the lowest possible doses, limit duration of administration, monitor closely for sign and symptom of myopathy or neuropathy
Calcium Carbonate + Levofloxacin D E Oral calcium salts may decrease the absorption of oral quinolones Separate the doses by at least 2 hours
Calcium Carbonate + Levothyroxine D F Oral calcium salts may decrease the absorption of thyroid products Separate the doses by at least 4 hours
Carbamazepine + Alprazolam D F CYP3A4 inducers may decrease the serum concentration of alprazolam Consider using an alternative or a dosage adjustment
Celecoxib + Enoxaparin D F NSAIDs4 may enhance the anticoagulant effect of enoxaparin Monitor closely for signs and symptoms of bleeding
Citalopram + Enoxaparin D F Agents with antiplatelet effects may enhance the anticoagulant effect of Enoxaparin Monitor closely for signs and symptoms of bleeding
Citalopram + Heparin D F Antiplatelet agents may enhance the anticoagulant effect of heparin Decrease the dose of heparin or citalopram
Citalopram + Ibuprofen D G Selective serotonin reuptake inhibitors may enhance the antiplatelet effect of ibuprofen Monitor patients for evidence of bleeding
Chlorpromazine + Azithromycin D F Increase QT-prolongation effect Consider alternatives to this combination or monitor for QTc interval prolongation and arrhythmias
Diltiazem +Atorvastatin D F Diltiazem may increase the serum concentration of atorvastatin Administer lower doses of atorvastatin, monitor for signs of atorvastatin toxicity
Fluvoxamine + Heparin D F Agents with antiplatelet effects may enhance the anticoagulant effect of heparin Decrease the dose of heparin or antiplatelet agent
Lopinavir/Ritonavir + Apixaban D G P-glycoprotein and CYP3A4 inhibitors may increase the serum concentration of apixaban Administer 50% of the usual dose of apixaban
Lopinavir/Ritonavir + Colchicine D G P-glycoprotein and CYP3A4 inhibitors may increase the serum concentration of colchicine Reduce the daily dosage or dose frequency and monitor closely
Lopinavir/Ritonavir + Diltiazem D G CYP3A4 inhibitors may increase the serum concentration of diltiazem Consider using an alternative or monitor for toxicity of calcium channel blockers, a 50% dose reduction may be required
Lopinavir/Ritonavir + Isosorbide Dinitrate D F CYP3A4 inhibitors may increase the serum concentration of isosorbide dinitrate Monitor for increased adverse effects of isosorbide dinitrate
Lopinavir/Ritonavir + Lidocaine D F CYP3A4 inhibitors may increase the serum concentration of lidocaine Monitor for increased adverse effects of lidocaine
Morphine + Clopidogrel D F Morphine may decrease the serum concentration of antiplatelet agents The clinical risk associated with this interaction has not been fully investigated, administration an alternative may be considered
Morphine + Fentanyl D F Increase CNS depressant effects Close monitoring for adverse effects
Midazolam + Morphine D F Increase CNS depressant effects Close monitoring for adverse effects
Rifampin + Clarithromycin D G CYP3A4 inducers may decrease the serum concentration of clarithromycin Consider an alternative antimicrobial therapy
Propofol + Morphine D F Increase CNS depressant effects Close monitoring for adverse effects
Rifampin + Pantoprazole D F CYP2C19 inducers may decrease the serum concentration pantoprazole Consider using an alternative or monitor for decreased effects of pantoprazole