Table 8.3-4. Drug interactions and their harmful outcomes

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 + TMP/SMX

Phenytoin toxicity

SU + TMP/SMX, 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

TMP/SMX or trimethoprim alone + ACEI or ARB or spironolactone

Hyperkalemia

Warfarin + TMP/SMX, 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; TMP/SMX, trimethoprim/sulfamethoxazole.