Enter drug class to drug class interaction

Drug Class 1
Drug Class 2
Drug Class 1Drug Class 2Interaction
penicillin 1
penicillin 1
ACE inhibitorNSAID Reduced antihypertensive effect and potential worsening of renal function when NSAID used with ACEI
ACE inhibitorSNRI Interaction
ACE inhibitorinsulin ACEI may increase insulin effect producing hypoglycemia - monitor sugars
ACE inhibitorsulfonylurea ACEI may increase hypoglycemic effect of sulfonylureas - most likely with enalapril
antacidfluoroquinolone Antacids interfere with absorption of quinolones (this effect is variable, depending on type of antacid and quinolone) - avoid concurrent use
antacidthyroid hormone Antacids may reduce absorption of thyroid hormones - take 2 hours before or 6 hours after antiacid administration
antacidtetracycline agonist or antagonist
antihistamine (H1)fluoroquinolone dosis
antipsychotic - phenothiazine derivativetricyclic antidepressant Possible TCA toxicity when used with phenothiazine - monitor drug levels and clinical status
benzodiazepinetetracycline interaction
beta-adrenergic blockerNSAID interaction
beta-adrenergic blockersulfonylurea DRUG INTERACTION
beta-adrenergic blockerantacid interaction
estrogen contraceptivetricyclic antidepressant Possible antidepressant toxicity when taken with oral contraceptive - monitor status
fluoroquinolonesulfonylurea hypoglycemia
H2 (histamine) antagonistantacid Decreased cimetidine, famotidine, nizatidine and ranitidine effect when taken with antacids - separate dosing by at least 1 hour
macrolidebeta-adrenergic blocker interaction
MAO (monoamine oxidase) inhibitorACE inhibitor Interactions
MAO (monoamine oxidase) inhibitorsympathomimetic amine Hypertensive crisis when MAOI used with epinephrine or isoproterenol; may also occur with OTC pseudoephedrine - avoid concurrent use
MAO (monoamine oxidase) inhibitorsulfonylurea Increased hypoglycemic effect when MAOI combined with sulfonylurea - monitor sugars
MAO (monoamine oxidase) inhibitorestrogen contraceptive interaction
MAO (monoamine oxidase) inhibitorNSAID interaction
MAO (monoamine oxidase) inhibitorseratonin 5-HT1 receptor agonist (triptan) Possible triptan toxicity when used with MAOI (naratriptan [Amerge] levels are NOT affected; selegiline in usual doses does not affect triptan levels)
MAO (monoamine oxidase) inhibitorinsulin Increased hypoglycemic effect when MAOI combined with insulin - monitor sugars
MAO (monoamine oxidase) inhibitorSNRI CONTRAINDICATED: MAOI plus SNRI may increase risk of seratonin syndrome
narcotic agonist - diphenylheptanetricyclic antidepressant TCA used with propoxyphene or methadone may cause TCA toxicity - avoid concurrent use, or monitor drug levels/effects
penicillinACE inhibitor Hyperglycemia
penicillin 1
penicillin 1
penicillin 1
phosphodiesterase type 5 inhibitornitrate Concomitant use of nitrates with PDE5 inhibitors may result in profound hypotension and death
seratonin 5-HT1 receptor agonist (triptan)SSRI Rare reports of weakness, hyperreflexia and incoordination when triptans used with SSRI; no interaction reported when rizatriptan (Maxalt) and paroxetine
SSRISNRI Increased risk of seratonin syndrome when SSRI and SNRI taken concurrently - use caution, monitor clinical status
SSRIphosphodiesterase type 5 inhibitor Hi
SSRIMAO (monoamine oxidase) inhibitor Possible seratonin syndrome when SSRI used with MAOI - suggest 2 week drug-free period when switching from one class to another (5 weeks when going from fluoxetine to MAOI); less of a concern with MAO-B inhibitors (eg selegilene) in usual doses
SSRIcholinesterase inhibitor metabolism
SSRItricyclic antidepressant SSRI may lead to tricyclic toxicity (CYP2D6 inhibitor - esp paroxetine, fluoxetine); fluoxetine may exacerbate depression when used with desipramine - monitor status and drug levels
SSRIsulfonylurea hypoglycemia
sulfonylureaNSAID interaction
sulfonylureaantihistamine (H1) interaction
sulfonylureaSNRI any
sulfonylureatricyclic antidepressant Possible hypoglycemia when TCA and sulfonylurea taken together (reported with nortriptyline and doxepin) - monitor sugars
TCAMAO (monoamine oxidase) inhibitor Combination of TCA and MAOI can result in hypertensive crisis, seizures and death - CONTRAINDICATED; stop TCA 7 days prior to beginning a MAOI, and stop MAOI 14 days prior to starting TCA
tetracyclineantipsychotic - quinolinone Antagonis
tricyclic antidepressantseratonin 5-HT1 receptor agonist (triptan) Interaction
tricyclic antidepressantbarbiturate Decreased antidepressant effect when taken with barbiturate due to increased metabolism - avoid concurrent use if possible

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