|
Combination |
Risk |
|
ACEI + potassium-sparing diuretic |
Hyperkalemia |
|
Anticholinergic + anticholinergic |
Cognitive decline |
|
CCB + erythromycin or clarithromycin |
Hypotension and shock |
|
Concurrent use of ≥3 CNS active drugs |
Falls, fracture |
|
Digoxin + nitrofurantoin |
Digoxin toxicity |
|
Lithium + loop diuretic or ACEI |
Lithium toxicity |
|
Peripheral alpha-1 blocker + loop diuretic |
Urinary incontinence in women |
|
Phenytoin + SMX/TMP |
Phenytoin toxicity |
|
SU + SMX/TMP, FQ, nitrofurantoin, or cephalexin |
Hypoglycemia |
|
Tamoxifen + paroxetine (or other CYP2D6 inhibitors) |
Prevention of converting tamoxifen to its active moiety, resulting in increased breast cancer–related deaths |
|
SMX/TMP or trimethoprim alone + ACEI or ARB or spironolactone |
Hyperkalemia |
|
Warfarin + SMX/TMP, FQ, fluconazole, amoxicillin, cephalexin, amiodarone |
Bleeding |
|
Warfarin + NSAID |
GI bleeding |
|
DOAC + SSRI or SNRI |
GI bleeding |
|
ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; CNS, central nervous system; DOAC, direct oral anticoagulant; FQ, fluroquinolone; GI, gastrointestinal; NSAID, nonsteroidal anti-inflammatory drug; SU, sulfonylurea; SMX/TMP, sulfamethoxazole/trimethoprim. |
|