25/04/2025
🔹 Vancomycin + Furosemide → Risk of hearing loss (ototoxicity).
🔹 Vancomycin + Gentamicin → Additive kidney and hearing toxicity.
🔹 Gentamicin + Amphotericin B → High risk of kidney damage.
🔹 Ceftriaxone + Calcium-containing IV (e.g., Ringer’s Lactate) → Can form fatal crystals in neonates.
🔹 Piperacillin/Tazobactam + Vancomycin → Increased kidney injury risk.
🔹 Piperacillin/Tazobactam + Gentamicin → May inactivate Gentamicin in IV line.
🔹 Meropenem + Valproic Acid → Seizure risk due to reduced valproate levels.
🔹 Linezolid + SSRIs (e.g., Fluoxetine) → Risk of serotonin syndrome.
🔹 Clindamycin + Erythromycin → Reduced effectiveness (antagonistic).
🔹 Metronidazole + Alcohol → Causes vomiting, flushing (disulfiram-like reaction).
🔹 Metronidazole + Warfarin → Increased bleeding risk (elevated INR).
🔹 Rifampin + Protease inhibitors (e.g., Lopinavir) → Reduces antiviral levels.
🔹 Rifampin + Oral contraceptives → Decreased birth control effectiveness.
🔹 Fluconazole + Warfarin → Increased bleeding (slows Warfarin breakdown).
🔹 Azithromycin + Amiodarone or QT drugs → Risk of dangerous arrhythmias.
🔹 Levofloxacin + NSAIDs (e.g., Ibuprofen) → Seizure risk increased.
🔹 Ciprofloxacin + Theophylline → Theophylline toxicity.
🔹 Ciprofloxacin + Calcium/Antacids/Iron → Reduced antibiotic absorption.
🔹 Trimethoprim-Sulfamethoxazole + Warfarin → High bleeding risk.
🔹 Trimethoprim-Sulfamethoxazole + ACE inhibitors/ARBs → Risk of high potassium.
🔹 Macrolides (e.g., Erythromycin) + Statins → Risk of muscle breakdown (rhabdomyolysis).
🔹 Chloramphenicol + Phenytoin → Toxic Phenytoin levels.
🔹 Tetracyclines + Dairy/Iron/Antacids → Reduced absorption.
🔹 Amphotericin B + Ciclosporin → Kidney toxicity.
🔹 Acyclovir IV + Other nephrotoxic drugs → Additive kidney damage.
🔹 Spironolactone + ACE inhibitors / ARBs → High potassium levels → heart rhythm issues.
🔹 Lithium + Diuretics (e.g., Furosemide, Hydrochlorothiazide) → Lithium toxicity (tremors, confusion).
🔹 Lithium + NSAIDs → Reduced kidney clearance → lithium buildup.
🔹 Digoxin + Verapamil / Diltiazem → Slows heart rate dangerously; digoxin toxicity.
🔹 Digoxin + Diuretics (esp. furosemide) → Low potassium → increased risk of digoxin toxicity.
🔹 Warfarin + Antibiotics (e.g., Metronidazole, Cotrimoxazole, Macrolides) → Bleeding risk increases.
🔹 ACE Inhibitors + NSAIDs + Diuretics (Triple Whammy) → Acute kidney injury risk.
🔹 Beta-blockers + Verapamil / Diltiazem → Too much heart rate suppression → heart block.
🔹 MAO Inhibitors (e.g., Phenelzine) + Tyramine-rich foods (cheese, wine) → Hypertensive crisis.
🔹 MAO Inhibitors + SSRIs or TCAs → Risk of serotonin syndrome or hypertensive crisis.
🔹 Methotrexate + NSAIDs → Increased methotrexate toxicity (bone marrow suppression).
🔹 Methotrexate + Trimethoprim → Dangerous bone marrow suppression → life-threatening.
🔹 Amiodarone + Warfarin → Warfarin effect increased → bleeding risk.
🔹 Amiodarone + Digoxin → Increased digoxin levels → risk of toxicity.
🔹 Phenytoin + Warfarin → Warfarin effects altered unpredictably.
🔹 Phenytoin + Rifampin → Rifampin lowers phenytoin levels → seizure risk.
🔹 Carbamazepine + Erythromycin / Fluconazole → Carbamazepine toxicity.
🔹 Carbamazepine + Grapefruit juice → Inhibits metabolism → toxic levels.
🔹 Insulin + Beta-blockers → Masks symptoms of low blood sugar (hypoglycaemia).
🔹 Cimetidine + Warfarin / Phenytoin / Theophylline → Increased drug levels → toxicity.
🔹 Benzodiazepines + Opioids (e.g., Morphine + Diazepam) → Respiratory depression → can be fatal.
🔹 SSRIs + Tramadol → Serotonin syndrome risk.
🔹 Clopidogrel + Omeprazole → Reduced clopidogrel effectiveness → risk of blood clots.
🔹 Allopurinol + Azathioprine → Bone marrow suppression → dangerous.
🔹 Iron supplements + Levothyroxine → Reduced thyroid hormone absorption.
🔹 Spironolactone + ACE inhibitors / ARBs → High potassium levels → heart rhythm issues.
🔹 Lithium + Diuretics (e.g., Furosemide, Hydrochlorothiazide) → Lithium toxicity (tremors, confusion).
🔹 Lithium + NSAIDs → Reduced kidney clearance → lithium buildup.
🔹 Digoxin + Verapamil / Diltiazem → Slows heart rate dangerously; digoxin toxicity.
🔹 Digoxin + Diuretics (esp. furosemide) → Low potassium → increased risk of digoxin toxicity.
🔹 Warfarin + Antibiotics (e.g., Metronidazole, Cotrimoxazole, Macrolides) → Bleeding risk increases.
🔹 ACE Inhibitors + NSAIDs + Diuretics (Triple Whammy) → Acute kidney injury risk.
🔹 Beta-blockers + Verapamil / Diltiazem → Too much heart rate suppression → heart block.
🔹 MAO Inhibitors (e.g., Phenelzine) + Tyramine-rich foods (cheese, wine) → Hypertensive crisis.
🔹 MAO Inhibitors + SSRIs or TCAs → Risk of serotonin syndrome or hypertensive crisis.
🔹 Methotrexate + NSAIDs → Increased methotrexate toxicity (bone marrow suppression).
🔹 Methotrexate + Trimethoprim → Dangerous bone marrow suppression → life-threatening.
🔹 Amiodarone + Warfarin → Warfarin effect increased → bleeding risk.
🔹 Amiodarone + Digoxin → Increased digoxin levels → risk of toxicity.
🔹 Phenytoin + Warfarin → Warfarin effects altered unpredictably.
🔹 Phenytoin + Rifampin → Rifampin lowers phenytoin levels → seizure risk.
🔹 Carbamazepine + Erythromycin / Fluconazole → Carbamazepine toxicity.
🔹 Carbamazepine + Grapefruit juice → Inhibits metabolism → toxic levels.
🔹 Insulin + Beta-blockers → Masks symptoms of low blood sugar (hypoglycaemia).
🔹 Cimetidine + Warfarin / Phenytoin / Theophylline → Increased drug levels → toxicity.
🔹 Benzodiazepines + Opioids (e.g., Morphine + Diazepam) → Respiratory depression → can be fatal.
🔹 SSRIs + Tramadol → Serotonin syndrome risk.
🔹 Clopidogrel + Omeprazole → Reduced clopidogrel effectiveness → risk of blood clots.
🔹 Allopurinol + Azathioprine → Bone marrow suppression → dangerous.
🔹 Iron supplements + Levothyroxine → Reduced thyroid hormone absorption.
