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 inhibitorinsulin ACEI may increase insulin effect producing hypoglycemia - monitor sugars
ACE inhibitorSNRI Interaction
ACE inhibitorsulfonylurea ACEI may increase hypoglycemic effect of sulfonylureas - most likely with enalapril
antacidtetracycline agonist or antagonist
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
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 blockersulfonylurea DRUG INTERACTION
beta-adrenergic blockerantacid interaction
beta-adrenergic blockerNSAID 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) inhibitorSNRI CONTRAINDICATED: MAOI plus SNRI may increase risk of seratonin syndrome
MAO (monoamine oxidase) inhibitorNSAID interaction
MAO (monoamine oxidase) inhibitorestrogen contraceptive interaction
MAO (monoamine oxidase) inhibitorsulfonylurea Increased hypoglycemic effect when MAOI combined with sulfonylurea - monitor sugars
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) inhibitorinsulin Increased hypoglycemic effect when MAOI combined with insulin - monitor sugars
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) inhibitorACE inhibitor Interactions
narcotic agonist - diphenylheptanetricyclic antidepressant TCA used with propoxyphene or methadone may cause TCA toxicity - avoid concurrent use, or monitor drug levels/effects
penicillin 1
penicillinACE inhibitor Hyperglycemia
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
SSRIcholinesterase inhibitor metabolism
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
SSRISNRI Increased risk of seratonin syndrome when SSRI and SNRI taken concurrently - use caution, monitor clinical status
SSRIsulfonylurea hypoglycemia
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
SSRIphosphodiesterase type 5 inhibitor Hi
sulfonylureatricyclic antidepressant Possible hypoglycemia when TCA and sulfonylurea taken together (reported with nortriptyline and doxepin) - monitor sugars
sulfonylureaantihistamine (H1) interaction
sulfonylureaSNRI any
sulfonylureaNSAID interaction
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 antidepressantbarbiturate Decreased antidepressant effect when taken with barbiturate due to increased metabolism - avoid concurrent use if possible
tricyclic antidepressantseratonin 5-HT1 receptor agonist (triptan) Interaction

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