If I Take This Drug
with That Drug,
What Will Happen?

This chart is to help you make informed decisions to improve the interaction of your medications with other drugs and foods. Any questions raised should be discussed with your health care provider.
 

This Drug
May Cause This Reaction
With This Drug
Antianxiety drugs:
Valium (diazepam)
Xanax (alprazolam 
dizziness > falls > broken hip > death  Acidblocker:
Tagamet (cimetidine)
Antibiotics:
Sulfa, Septra, Bactrim, 
Cotrim, (co-trimoxazole)
SMZ-TMP 
life-threatening bleeding, hemorrhaging Anticoagulant: 
Coumadin (warfarin)
Anticoagulant:
Coumadin (warfarin) 
life-threatening, ineffective immune suppression (organ rejection)  Transplant Drug:
Sandimmune, Neoral
(cyclosporine) 
Gantrisin (sulfisoxazole)  bone marrow suppression, anemia, death  Rheumatrex (methotrexate)
Anticoagulant:
Coumadin (warfarin) 
blood clots Barbituates:
Phenobarbital, Mebaral
Fiorinal, Fioricet, Butisol 
Coumadin (warfarin)  life-threatening bleeding, hemorrhaging  Any Sulfa-type Antibiotic 
Coumadin (warfarin) life-threatening bleeding, hemorrhaging  Antibiotic:
Flagyl (metronidazole)
Coumadin (warfarin) life-threatening bleeding, hemorrhaging NSAID's (aspirin and many anti-inflammatory drugs used for pain and arthritis 
Coumadin (warfarin) life-threatening bleeding, hemorrhaging Breast Cancer Drug:
Nolvadex (tamoxifen)
Coumadin (warfarin) life-threatening bleeding, hemorrhaging Endometriosis Drug:
Danocrine (danazol)
Coumadin (warfarin) life-threatening bleeding, hemorrhaging Heart Drug:
Cordarone,
Pacerone (amiodarone)
Coumadin (warfarin) life-threatening bleeding, hemorrhaging Ulcer Drug:
Tagamet (cimetidine)
Anticonvulsants:
Tegretol (carbamazepine)
life-threatening carbamazepine toxicity: dizziness, tremors, irregular breathing, tachycardia, impaired consciousness  Antibiotic macrolide type: 
Biaxin, Erythromycins, EES, Pediazole, Zithromax
Tegretol (carbamazepine) life-threatening carbamazepine toxicity Analgesic:
propoxyphene Darvon, Darvon-N, Wygesic, Darvocet-N 
Hydantoins:
Dilantin, Mesantoin, Peganone 
life-threatening organ rejection  Transplant Drug:
Sandimmune, Neoral (cyclosporine)
Antidepressants:
MAO Inihibitors:
Parnate, Nardil, Marplan 
arrhythmias, dyspnea, coma, death  Antidepressants:  Tricyclics
Elavil, Norpramin, Pamelor Etc. also anafranil for OCD. 
MAO Inihibitors:
Parnate, Nardil, Marplan 
restlessness, nausea, shivering, double vision, confusion, muscle contraction, death  Serotonin-types:
Prozac, Soloft, etc
MAO Inihibitors:
Parnate, Nardil, Marplan 
agitation, hyperthermia temp>106F, death Narcotic Anagesis:
Demerol (meperidine) 
MAO Inihibitors:
Parnate, Nardil, Marplan 
hypertensive crises hyperthermia, hemorrhage stroke, death  High tyramine - content foods: aged cheeses, aged meats as liver pate, salami, sausages, avocados, overripe bananas, brewer's yeast, many others 
MAO Inihibitors:
Parnate, Nardil, Marplan 
severe heart rhythm disturbances, death Decongestants and OTC Diet Aids with PPA (phenylpropanolamine) 
MAO Inihibitors:
Parnate, Nardil, Marplan 
arrhythmias, stroke, death  Decongestants in RX and OTCs:
pseudoephedrine Sudaged, Allegra-D, Claritin-D Cough Syrips with DM (dextromethorphan) 
Antihistamines (non-sedating): 
Hismanal (astemizole)
Seldane (terfenidine)- 
now off the market 
Abnormal EKG, cardiac arrhythmias, cardiac arrest, death Antibiotic (macrolide-type):
Biaxin, Erythromycins, Pediazole, Zithromax 
Arthritis Drugs: NSAIDS:
aspirin, Advil, Daypro, Feldene, 
Motrin, Relafen, Voltaren,
many others including butazolidin 
life-threatening hemorrhaging  Anticoagulant:
Coumadin (warfarin
Arthritis Drugs: NSAIDS:
aspirin, Advil, Daypro, Feldene,
Motrin, Relafen, Voltaren,
many others including butazolidin 
Methotrexate toxicity: Nausea, vomiting diarrhea, fever, ulcers (oral & GI), kidney failure, incoordination, confusion, blurred vision, coma, death Methrotrexate
Arthritis Drugs: NSAIDS:
aspirin, Advil, Daypro, Feldene,
Motrin, Relafen, Voltaren,
many others including butazolidin 
Lithium toxicity: diarrhea, drowsiness, weakness, blackouts, slurred speech, kidney failure, incoordination, confusion, blurred vision, coma, death  Lithium (Eskalith,  Lithobid.) 
Asthma Drugs:
Theophyllines, Elixophyllin,
Slo-bid, Theo-Bid Theolair,
Theo-24, Theo-Chron 
Theophylline toxicity: 
Nausea, diarrhea, headaches, insomnia, restlessness, cardiac arrhythmias, convulsions, 
death with no warning
Antibiotics: (quinolones):
Cipro, Floxin, Noroxin, Penetrex, etc. 
Cholesterol Lowering drugs:
HMG coenzyme A reductase Inhibitors: 
Mevacor (Iovastatin)
Lipitor (atorvastatin)
Pravachol (pravastatin) 
Zocor (simvastatin) 
myopathy, rhabdomyolysis (a severe muscle destruction) leading to kidney failure  Antibiotic (macrolide-type):
Biaxin, Erythromycins, Pediazole, Zithromax 
Cholesterol Lowering drugs:
HMG coenzyme A reductase Inhibitors: 
Mevacor (Iovastatin)
Lipitor (atorvastatin)
Pravachol (pravastatin) 
Zocor (simvastatin)
Rhabdomyolysis leading to severe muscle pain and destruction and eventual kidney failure  Other Cholesterol Lowering Agents:
 Lopid (gemfibrozil), Niaspan, Nicolar (niacin), Nicotonic acid 
Diabetic Drugs:
Diabinese, Dymelor (chlorpropamides)
Orinase (tolbutamide) 
life-threatening hypoglycemia, coma Anti-inflammatory:
Butazolin (phenylbutazone) 
Diuretics: 
(Potassium sparing types): 
Aldactazide,
Aldactone (spironolactone),
Dyazide, Dyrenium, 
Maxzide, Midamor 
can lead to dangerous hyperkalemia (elevated potassium blood levels), arrhythmias, cardiac arrest, death  Heart medications for blood pressure (ACE Inhibitors):
Accupril, Altace, Capoten, Lotensin, Monopril, Prinivil, Vasotec, Zestril 
Diuretics: 
(Potassium sparing types): 
Aldactazide,
Aldactone (spironolactone),
Dyazide, Dyrenium, 
Maxzide, Midamor 
hyperkalemia, arrhythmias, cardiac arrest, death Potassium tablets (various) Salt Substitutes
Heart Drug (digitalis):
Lanoxin (digoxin) 
EKG evident Digitalis Toxicity  Anti-arrhythmic quinidines:
Cardioquine, Quinalan Quinaglute, Quinidex, Quinora 
Heart Drug (digitalis):
Lanoxin (digoxin) 
Digitalis Toxicity: heart stops beating (asystole), ventricular fibrillation, death  Cordarone, Pacerone (amiodarone)
Heart Drug (digitalis):
Lanoxin (digoxin) 
Digitalis Toxicity  Rhythmol (propafenone)
Heart Drug (digitalis):
Lanoxin (digoxin) 
hypokalemia, asystole, death Low potassium from some diuectics (HCTZ, Lasix, Bumex, Lozol) 
Heart Drug (digitalis):
Lanoxin (digoxin) 
hypokalemia, asystole, death  Corticosteroids: Prednisone, Hydrocortisone, Medrol, etc. 
Heart Drug (digitalis):
Lanoxin (digoxin) 
hyperkalemia, cardiac arrest, death  Diuretics: 
(Potassium sparing types): 
Aldactazide,
Aldactone (spironolactone),
Dyazide, Dyrenium, 
Maxzide, Midamor 
Heart Drug (digitalis):
Lanoxin (digoxin) 
Digitalis Toxicity Hyperkalemia, cardiac arrest, death  Transplant Drug:
Sandimmune, Neoral
(cyclosporine) 
Heart & BP drugs: 
BETA-blockers:
Blocadren, Cartrol, 
Corgard, Inderal,
Lopressor, Normodyne, 
Tenormin, Toprol XL,
Trandate, Visken
rebound hypertension, stroke, death Hypertension Drug
Catapress (clonidine)

AVOID sudden discontinued
use of above agent 

Heart & BP drugs: 
Calcium channel blockers:
Adalat, Procardia (nifedipine),
Isoptin, Calan, 
Verelan (verapamil) 
Cardene, Cardizem, etc. 
possible quinidine toxicity or Calcium channel blocker toxicity Anti-arrhythmics Quinidine-type:
Quinalan, Cardioquine,
Quinaglute, Quinidex, Quinora 
Tuberculosis Drugs:
(INH, Isoniazid),
Nydrazid, Rifampin,
Rifadin (rimactane) 
hypertensive crisis, hemorrhage High tyramine- content foods:
aged cheeses, aged meats such as:
liver pate, salami, sausages, 
avocados, overripe bananas, 
brewer's yeast, many others 
Ulcer drugs:
Tagamet (Cimetidine) 
serious hemorrhaging  Anticoagulant:
Coumadin (warfarin)
Ulcer drugs:
Tagamet (Cimetidine)
Theophylline toxicity Theophylline drugs 
Ulcer drugs:
Tagamet (Cimetidine) 
Bone marrow suppression BICNU (carmustine) 
Propulsid (cisapride)  Cisapride toxicity associated with Prolonged Q-T intervals and possible Torsade de pointes and death Macrolide Antibiotics:
Erythromycins, Biaxin, Pediazole, Zithromax 
Propulsid (cisapride)  serious cardiac arrhythmias Torsade de pointes and death  Triazole Anitfunglas:
Nizoral (ketoconazole)
Diflucan (fluconazole)
Sporanox (itraconazole) 
Licorice candy may increase the risk of bleeding or potentiate the effects of warfarin therapy

causes increased production of aldosterone, a hormone that regulates the salt and water balance of the body, resulting in a rise of blood pressure. 

Thiazide diuretics, digitalis or other heart medications
Grapefruit increases serum levels of certain cardiac drugs to dangerous levels Thiazide diuretics, digitalis or other heart medications

NOTE: This in not an all-inclusive list of potentially lethal drug interactions.

There are thousands of interactions not listed here that could be potentially harmful to ones health and this site does not make claims that these reactions will occur in all situations.

It is imperative you discuss any questions about these issues with your health care provider.

MYTHS

Myth 1:
Herbal products are "natural" and therefore are always safe to use.
~~~~~~~~
Herbal therapies are definitely on the rise in the United States, and many people believe them to be safe. On the contrary, many herbs have been identified as UNSAFE, including the following:
• borage
• calamus
• coltsfoot
• comfrey
• life root
• sassafras
• chapparal
• germander
• licorice
• ma huang

The following herbs, even though considered possibly effective for various conditions, may pose to be only POTENTIALLY SAFE, or HAZARDOUS in certain conditions:
• feverfew
• garlic
• ginkgo
• Asian ginseng
• saw palmetto
• valerian
• St.John's wort

Be sure to discuss the use of any of these and any herbal product you may want to take with your physician, pharmacist or health care provider.

Myth 2:
Over the Counter (OTC) products are all safe. The FDA would not allow them to be marketed to consumers if they were unsafe.
~~~~~~~~
All OTC products are not safe; not even aspirin, one of the oldest on the market.  If you are allergic to aspirin, consuming it may cause death.

Myth 3:
I eat ORGANIC FOODS, so they are safe to eat. I don't need to be concerned with interactions with my medications.
~~~~~~~~
Organic foods have been grown without the use of dangerous pesticides. They are known to be pesticide free, or less concentrated in pesticides than non-organically grown foods. The chemical composition of food is equivalent, whether it is organically grown or not. Many foods and beverages are known to interact with certain medications. It is always wise and safer to check with your physician or pharmacist to assure there are no harmful interactions with your medications.

Heart patients should be very careful about consuming grapefruit and its juice as well as black licorice while taking some heart drugs. Both cause the heart medication to not work properly.
 

Information taken from several sources:
WEB-MD, Alert-Rx, Physicians Desk Reference, Walgreens, Yahoo Health
 



DISCLAIMER:

The materials and information on this site are intended for educational and informational purposes only. The materials and information are not intended to replace the services of a trained health professional or to be a substitute for medical advice of physicians and/or other health care professionals. You should consult your physician on specific medical questions, particularly in matters requiring diagnosis or medical attention.
 


Back to Main Lupus Site

brendarion at cfl.rr.com
© 1998 - 2004 Brenda "Rion" Sewell