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Top 200 Pt 2:2

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Brand
Generic
DI's
Counseling
Lototil   Diphenoxylate and Atropine   -decrease effectivness of phenothiazines and haloperidol-use w/ haloperidol may increase risk for dyskinesia-additive drowsiness w/ CNS depressants   -take 30 minutes before meals-void before use-may see increase anti-sludge effects-could have increased sensitivity to heat and decreased perspiration -could have decreased milk if breastfeeding  
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Lopid   Gemfibrozil   -enhance effect of oral anticoagulants-w/ lovastatin may cause severe myopathy or rhabdomyolysis   -take 30 minutes before meals-take w/ milk or food if GI upset occurs-avoid EtOH-need periodic blood and lab work-do not breastfeed  
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Lovenox   Enoxaparin   -anticoagulants -NSAIDS   -only be administer by injection-don't make major changes to diet-have a tendency to bleed easier on this medication  
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Lunesta   Eszopiclone   -additive effect w/ CNS depressants-CYP 3A4 inhibitors may decrease its elimination-CYP 3A4 inducers may increase its metabolism   -UAD, do not increase or change dose-may cause physical or psychological dependence -do not use EtOH or OTC sleep aids-take immediately prior to bedtime  
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Lyrica   Pregabalin   -additive effect w/ CNS depressants on decreasing cognitive and motor fxns-peripheral edema when given w/ thiazide diuretics   -avoid EtOH-taper slowly when D/Cing-report visual disturbances, suicide ideation, and depression-breast feeding not recommended  
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Macrobid/ Macrodantin   Nitrofurantoin   -mag salts decrease effectivness   -take entire RX even if feeling better-take w/ food-shake suspension before use-maintain adequate hydration-DM pts don't use urine glucose testing-report immediately rash, swelling of face, tongues, throat, etc  
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Maxipime   Cefepime   -BCG-probenecid-typhoid vaccine   -administered via infusion or injection-maintain hydration-DMpts don't use urine glucose testing  
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Medrol   Methylprednisolone   -antagonize effects of anticholinesterases-increase metabolism: barbituates, rifampin, hydantoins-decrease metabolism: estrogens-ketoconazole may increase effects-decrease salicylate effectiveness   -avoid unusual stress, dose may need to be adjusted-may experience insomnia or nervousness-take as directed w/ food or milk-PO take once daily in the morning-intra-articular: refrain from excessive use following joint therapy even if pain is gon  
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Merrem   Meropenem   -BCG-may decrease serum [ ]'s of divaloproex and valproic acid and typhoid vaccine   -only given by infusion-maintain adequate hydration  
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Methadose   Methodone   -MAOI-rifampin may reduce plasma levles ppt'ing w/drawl symtpoms -produce CNS depressant effects when used w/ other CNS depressants   -use exactly as directed, do not change dose/ frequency -do not use EtOH or OTC sedatives -may cause hypotension, constipation, decreased appetite  
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Methotrexate   Methotrexate   -NSAIDS increase MTX levels and should not be used w/ high dose therapy-phenytoin and sulfonamides may displace protein bound MTX-may increase serum levels of 6MP-oral antibiotics decrease absorption of oral MTX-may decrease CL of theophylline   -infusion/ injection: report site reactions-avoid EtOH-more susceptible to infections-sensitivity to light-report rash, heart palpations, tarry black stools-DO NOT get pregnant-should not be used in 2-3 trimester-DO NOT breastfeed  
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Miralax   Polyethylene Glycol   -none   -do not use for longer of more frequently than prescribed-maintain adequate hydration-may take 2-4 days to produce bowel movement  
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Mirapex   Pramipexole   -cimetidine decreases elimination-decrease oral CL: ranitidine, diltiazem, triamterene, verapamil, quinidine, quinine   -avoid EtOH-may cause extreme sedation-loss of impulse control-hypotension  
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MS Contin   Morphine Sulfate   -enhance actions of: phenothiazines, anesthetics, sedatives, hypnotics, EtOH, muscle relaxors, agonist/ antagonist analgesics-may increase amylase or lipase levels   -may cause physical or psychological dependence-do not use EtOH-may cause itching, hypotension, and constipation  
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Namenda   Memantine   -drugs that alkalinize urine reduce the renal CL of memantine   -take w/ or w/out food-may cause HTN-report CNS symptoms: confusion, fatigue, aggression, chest pain  
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Naprosyn/ Anaprox/ Alieve   Naproxen   -increase effects of: oral anticoagulants, lithium, and MTX-don't use w/ other NSAIDS   -take w/ food or milk to decrease GI upset-do not use EtOH, ASA, or other anti-inflammatory agents -DO NOT take during last trimester  
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Nasonex/ Azmanex   Mometasone   -additive effects w/ systemic corticosteroids   -not a bronchodilator and not to be used for acute episodes of asthma-may take 1-2 weeks for effects to be seen -avoid exposure to chicken pox  
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Neoral/ Sandimmune/ Gengraf/ Restasis   Cyclosporine   -wait 15 minutes before using in eye and using artificial tears   -PO: take at same time daily-will be susceptible to infection and sunlight-practice good oral hygiene-no not change brands-SOLN: diluting improves taste-don't change what you mix it w/-mix in glass container, NOT plastic-do NOT breastfeed  
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Neupogen/ Neulasta   Filgrastim   -enhance toxic effects of bleomycin and topotecan   -never reuse syringes or needles -may cause bone pain, N/V, sore mouth-report unusual fever or chills  
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Neurontin   Gabapentin   -antacids decrease bioavailability when given at the same time   -may take 2-3 weeks for desired effects-may cause physical and psychological dependence-take 2 hours after antacids-do not stop medication abruptly-no EtOH & caffeine  
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Nexium   Esomeprazole   -increase plasma levels of diazepam-drugs that needs low gastric pH may be affected-decrease plasma levels of atazanavir-voriconazole may increase plasma levels   -take 1 hour prior to food at same time daily-you can mix granules w/ applesauce-do not store for future use -breast feeding not recommended  
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Nicoderm/ Nicorette   Nicoderm   -enhance AV block effect of adenosine-cimetidine may decrease metabolism of nicotine   -stop smoking while using treatment-gum: chew slowly for 30 minutes-lozenge: allow to dissolve-avoid food/drink 15 minutes prior-patch: do not cut patch-apply to a different site daily-remove patch when having MRI-spray: max 5/doses per ho  
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Niferex   Polysaccharide-Iron Complex   -antacids, H2, PPI's antagonists may decrease absorption of iron salts   -may make stools dark -take b/w meals-don't take w/ antacids-may cause constipation  
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Nitrostat   Nitroglycerin   -hypotensive effects may be increased w/ sildenafil-decrease effects of heparin   -do not change brands-keep in original container and keep tightly closed-if still having angina after 15 minutes call ER-oral: do not chew tablets-spray: do not inhale-transdermal: remove patch before MRI  
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Norvasc   Amlodipine   -none   -may cause HA, N/V  
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NovoLog   Insulin Aspart   -BB's: may enhance hypoglycemic effect-corticosteroids-thiazide's: may diminish therapeutic effect of insulin   -do not share pens, needles, or cartridges-eat w/in 5-10 minutes of injection  
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NuvaRing   Etonogestrel/ Ethinyl estradiol vaginal   -diminish the effect of anastrazole-barbituates , corticosteroids, phenytoin, oxycarmazepine may decrease effectiveness of contraception -estrogens may decrease [ ]'s of lamotrigene   -do not use longer than 21 days, keep away from heat >90* will activate, can be out of body for <3 hours and retain contraception, rinse and replace if it falls out  
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Nystatin   Nystatin   -none   -no eye contact when applying-suspension: shake well -do not chew tablets-topical: wash and dry area before applying-vaginal: lie down and insert high into vagina at bedtime  
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Omnicef   Cefdinir   -Al, Mg, Fe decrease the bioavailability of cefdinir-probenecid inhibits renal excretion, increasing plasma levels   -take around the clock-take even if feeling good-avoid taking 2 hours before antacids or iron-cold suspension equals better taste-may cause diarrhea  
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Oxycontin   Oxycodone   -enhance actions of: phenothiazines, anesthetics, sedatives, hypnotics, EtOH, muscle relaxors, agonist/ antagonist analgesics-may increase amylase or lipase levels   -drug may cause physical and psychological dependence -do not use EtOH-take med. Immediately after breast feeding or 3-4 hours prior to next feeding  
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Patanol/ Patanase   Olopatadine   -none-wait at least 10 minutes before inserting contact lenses   -do not have tip touch the eye -do not wear contact lenses if eyes are red-inhalation: may cause bitter taste-don't use alcohol-report ulcers or discomfort in nose  
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Paxil (CR)   Paroxetine   -MAOI-phenytoin, phenobarbital, cimetidine can increase or decrease either drug -displace warfarin from binding-w/ ASA or NSAID may increase the risk of upper GI bleed   -may take 2-3 weeks for desired effect-take in the morning to avoid insomnia-avoid EtOH and stimulants  
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Percocet   APAP/ Oxycodone   -Alcohol may enhance CNS depression   -may cause physical or physchological dependence, do not use EtOH or other stimulants, may cause hypotension and constipation, take after breast feeding or 3-4 hours before, max 4g/day  
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Phenergan   Promethazine   -Anticholinergics and barbituates decrease effectsCNS -depression with alcohol-Reduce dose of narcotics   May be taken with food, Avoid alcoholMay cause drowsiness,If dose is missed, skip and return to normal schedule  
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Phenobarbital   Phenobarbital   -CYP InducerDecreases concentrations of lamotrigine, CBZ, valproic acid, phenytoin-Decreases INR (warfarin)-Valproic acid can increase levels-CNS depressants and alcohol have additive effects-Increases metabolism of anticoagulants, beta blockers   May cause drowsiness, avoid operating machinery, Avoid alcohol, May be habit forming  
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PhosLo   Calcium Acetate   -diminish effects of: bisphophonates, CCB's-enhance toxicity of ceftriaxone-decrease absorption: phosphate supplements and quinolone antibiotics   Take with meals,Avoid alcohol, antacids, caffeine, and other calcium supplementsMay cause constipation or dry mouth  
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Plan B   Levonorgestrel   -barbituates may decrease its effectivness-benzo's serum [ ]'s are increased-carbamazepine and other seizure drugs may decrease its effects-may increase metab of 3A4 substrates-may diminish anti-coag effect of vit k antagonists   Does not protect against STDs or HIV,Can be given up to 120 hrs after unprotected intercourse, but efficacy may be reduced,Contact MD if you vomit within 1 hour of taking dose  
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Plavix   Clopidogrel   -NSAIDs can increase blood loss-Interferes with metabolism of phenytoin, tamoxifen, tolbutamide, warfarin, torsemide, fluvastatin, and NSAIDs-Increases risk of phenytoin toxicity-Potentiates anticoag effects of warfarin   Contact MD if side effects severe or infection developing,Bleeding time will be increased,Tell MD or dentist before surgery,Can be taken without regard to meals  
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Potassium Chloride   Potassium Chloride   -Potassium sparing diuretics, aldosterone antagonists, angiotensin converting enzyme inhibitors, potassium containing medications and salt substitutes-Duretics, high dose glucocorticoticoids or PCNs, amp B, and insulin cause hypokalemia   Take with or after meals and with a full 8oz glass of water,Swallow tablets whole,Avoid salt substitutes containing potassium, Some casings may be found in stool,If dose is missed take ASAP  
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Prednisone   Prednisone   -Antagonizes effects of anticholinesterases-Barbituates, rifampin, and hydrantoins increase metabolism-Estrogens decrease metabolism-Ketoconazole increases effects-May decrease salicylate effectiveness   May take with food,Do not discontinue w/o talking to MD first,If dose is missed take ASAP  
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Prempro   Conjugated estrogens/ medroxyprogesterone   -Barbituates, rifampin, and hydrantoins may increase metabolism and elimination-May increase toxic effects of corticosteroids   May be taken w/ or w/o food,Discontinue if pregnancy is suspected,Report severe side effects (pain in legs, coughing blood, abnormal vaginal bleeding, skin yellowing, and abdominal pain) to MD  
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Prograf   Tacrolimus   -CBZ decreases concentrations   Take on an empty stomach,Do not take within 2 hours before or after antacids,Maintain adequate hydration  
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Proscar/ Propecia   Finasteride   -Decrease levels of theophylline-Decreases PSA levels which determine if prostate is cancerous   Pregnant women should not handle crushed tablets or be exposed to semen from patient taking this  
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Provigil   Modafinil   -Decreases plasma levels of OCs, triazolam, cyclosporine-Increases plasma levels of diazepam, propranolol, phenytoin, -Increases levels ofChlorpropamine, desipramine if deficient in CYP2D6   May be taken w/ or w/o food,Stop and contact MD at first sign of rash,Take in AM,Avoid operating machinery,Avoid alcohol,May be habit forming,If dose is missed, skip and return to normal schedule  
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Prozac   Fluoxetine   -MAOIs-Increases thioridazine levels -Increases levels of TCAs, phenytoin, carbamazepine, benzos, and drugs metabolized by CYP2D6-ASA or NSAIDs may increase bleeding risk-Long half life--lots of interactions (inhibits 3A4 and 2D6)   May cause drowsiness,Avoid alcohol,Do not abruptly discontinue,Notify MD if rash or hives develop,If dose is missed skip and return to normal scheduleActivating, take in AM  
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Pulmicort/ Rhinocort/ Entocort   Budesonide   -Ketoconazole may increase plasma levels   Avoid contact with eyes,Not intended for immediate relief of bronchospasm,Avoid contact with chicken pox or measles, Not used with a spacer,If dose is missed, skip and return to normal scheduleRinse mouth to prevent thrush  
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Pyridium   Phenazopyridine   -None-False negative leukocyte esterase test   May make urine an orange or red color which may stain fabric,Take with food or milk,See MD for UTI, not a cure,Not long term (max 2-3 days)  
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Reclast/ Zometa   Zolendronic Acid   -NSAIDs may enhance adverse effects-Phosphate supplements and AMGs may enhance hypocalcemic effect   Drink 2 glasses of water a few hours before infusion,Take APAP before infusion to decrease risk of reaction,Counsel on good dental hygiene  
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Reglan   Metoclopramide   -Alcohol and other CNS depressants may increase drowsiness-Increase action of cyclosporine-Decreases serum levels of digoxin-Increases effects of succinylcholine   May cause drowsiness, Avoid alcohol,Should be taken 30min before meals,If dose is missed, skip and return to normal schedule  
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Remeron   Mirtazapine   -Additive effects with CNS depressants (other sedating drugs)-Combo with MOAIs may result in fatal reactions-Coadmin with ASA or NSAIDs may increase risk of upper GI bleed-Lacks specific CYP so not many DIs   May cause drowsiness, avoid operating machinery,Avoid alcohol, Consult MD before starting new meds,Do not stop abruptly,If dose is missed, skip and return to normal schedule,Take at bedtime  
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Renagel/ Renvela   Sevelamer   -Decreases concentrations of levothyroxine and mycophenolate-Decreases absorption of quinolone antibiotics   Take with meals,Do not break or chew tabs  
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Requip   Ropinirole   -Smoking decreases AUC by 38%Omeprazole decreases levels-Cipro increases AUC by 84%Fluvoxamine, mexiletine, and estrogens increase levels-Dopamine antagonists may decrease effects   Take w/o regard to meals,May cause dizziness or drowsiness,Orthostatic hypotension (avoid rising rapidly),Possibility of hallucinations,Avoid alcohol and other CNS depressants, Do not stop abruptly,Contact MD if starting or stopping smoking  
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Risperdal   Risperidone   -Decreases effects of levodopa-CBZ (3A4 inducers)increases clearance-Fluoxetine (SSRIs--2D6 inhibitors) may double or triple plasma concentrations-Clozapine may decrease clearance-Antihypertensives   May cause fainting,May impair judgment, Avoid alcohol,May take with food,Avoid over exposure to sunlight or extreme temps,Check with MD before starting OTC meds,Weight gain, lipid and glucose dysregulation  
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Seroquel   Quetiapine   -Additive sedative effects with other CNS depressants-Clearance is increased by phenytoin and thioridazine-3A4 inhibitors (azoles) and inducers (CBZ, phenytoin)   Use caution when rising quickly, May cause drowsiness, Taken w/o food or light meal,Do not change dose w/o contacting MD,If dose is missed, skip and return to normal schedule,Take at bedtimeWeight gain, lipid and glucose dysregulations  
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Singulair   Montelukast   -Phenobarb may increase metabolism-May decrease metabolism of paclitaxel, rosiglitazone, and repaglinide   Should be taken regularly, even when asymptomatic,Not intended to treat asthma attacks,Phenylketonurics should know chewable tab contains phenylalanine,Granules can be given directly in mouth or mixed in food,Can be used in children 1 and over  
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Spiriva   Tiotropium   -Drugs inhibiting CYP2D6 or 3A4 increase plasma levelsHowever since only a small amount of drug is absorbed and metabolized, interactions are not significant-Don’t use w/ ipatropium (increases anticholinergic effect)   Not for occasional use, use daily,Unused capsules should remain in blister strip  
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Strattera   Atomoxetine   -Given with MOAIs may produce serious rxn resembling NMS-Use with oral or inhaled albuterol may compromise CV system-Drugs inhibiting CYP2D6 increase levels (paroxetine, fluoxetine, quinidine)   May be taken w/o regard to meals,May impair cognitive or motor performance  
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Synthroid/ Levoxyl   Levothyroxine   -Increase effects of anticoagulants-Cholestyramine decreases absorption-Decreases effectiveness of digoxin   Do not discontinue w/o consulting MD,Notify MD is signs of hyper or hypothroidsim appear,Transient hair loss may be seen in children but recovery usually occurs,Take on an empty stomach (1 hour before meals)--4 hours apart from antacids, iron and ca  
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Tamiflu   Oseltamivir   -No known clinically significant interactions   Taken w/o regar,d to meals,Not a substitute for yearly vaccinationMost effective when started within 2 days of onset of symptoms,Finish complete course,Store suspension in fridge,Capsules can be mixed with sweetened syrup  
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Tegretol   Carbamazepine   -Decreases effectiveness of anticoagulants (warfarin), valproic acid, antidepressants, benzos, clozapine, theophylline -Cimetidine, azoles, isoniazid, diltiazem, fluoxetine, propoxyphene, verapamil, or MACROLIDES may increase serum levels-Decreases l   Take WITH food,Drink a full glass of water after chewable tabs,May cause drowsiness,Avoid alcohol,Use alternative BC (decreases OC)  
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Tekturna   Aliskiren   -enhance hypotensive effects of other anti-HTN meds, MAOI's-increase [ ]'s of drug: cyclosporin, ketoconazole   May be taken with meals,May cause dizziness or orthostatic hypotension (rise slowly),Report swelling of eyes, throat etc to MD immediately  
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Tessalon   Benzonatate   -No known clinically significant interactions   Extremely important to swallow capsules whole (do not chew or dissolve in mouth),Do not exceed prescribed dosage,Contact MD if difficulty breathing or swallowing after dose,If dose is missed skip it and return to normal schedule  
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Topamax   Topirimate   -Additive CNS depression w/ alcohol-May increase metabolism of estrogens-Increases metformin blood levels-Weak carbonic anyhydrase inhibitor --Phenytoin and CBZ may decrease levels-HCTZ may raise blood levels-Use with valproic acid may cause h   Without regard to meals,May cause drowsiness,Avoid alcohol,Contact MD if experiencing blurred vision or periorbital pain,Keep well hydrated to avoid kidney stones,Sprinkles can be swallowed whole or sprinkled in food,Additional BC method  
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Toprol XL/ Lopressor   Metoprolol   -Decreases effects of theophyllines-Barbituates, rifampin, or NSAIDs may decrease effects-Cimetidine may increase serum levels-Hydralazine, propafenone, or thioamines may increase effects-Toxic effects increased with VERAPAMIL-May increase toxic   Take WITH food to increase absorption, May cause dizziness,Do not discontinue w/o contacting MD,Pts w/ diabetes should know this agent can mask hypoglycemic symptoms, Side effects are worse when starting or during dose increase (pts need to get  
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Toradol/ Acular   Ketorolac   -Enhances adverse effects of ASA and NSAIDs   May be taken with food,Avoid alcohol,Do not take any OTC meds (especially ASA) w/o consulting MD  
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Tricor   Fenofibrate   -Increase action of WARFARIN-Use with HMG-coA reductase inhibitors should be avoided due to increase in adverse effects (rhabdomyolysis)-Cholestyramine may decrease absorption   Closely follow prescribed diet,Contact MD if signs of myositis occur (muscle pain, tenderness, weakness),Give w/o regard to meals  
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Tussionex   Hydrocodone/ Chlorpheniramine   -MAOIs, TCAs, and CNS depressants   May cause drowsiness,Avoid alcohol,May be habit forming,If dose is missed, skip it and return to normal schedule  
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Tygacil   Tigecycine   -May increase concentrations of warfarin   -only given IV-report rxns at the infusion site-DO NOT get pregnant  
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Tylenol w/ Codeine   APAP/ Codeine   -Other CNS depressants and alcohol may produce additive CNS depression-Potential hepatoxicity with hydantoins or sulfinpyrazone   May take with food,May cause drowsiness, Avoid alcohol,Do not exceed prescribed dose,May be habit forming,If dose is missed, skip it and return to normal schedule  
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Ultracet   Tramadol/ APAP   -Increased ADRs with MAOIs, TCAs, SSRIs, and anticonvulsants-Quinidine increases tramadol, but decreases active metabolite-CBZ increases metabolism-Do not use with other APAP products or alcohol due to increased risk of hepatotoxicity   May take w/ food but analgesia will be delayed,May cause drowsiness, Avoid alcohol and other APAP products,Do not exceed prescribed dose,If dose is missed, skip it and return to normal dosing schedule,Continuous use may produce psychic and physi  
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Valium   Diazepam   -CNS depression is increased with other CNS depressants-Cimetidine decreases clearance-Grapefruit juice may increase levels   Oral concentrate must be diluted prior to use,May cause drowsiness, Avoid alcohol,May be habit forming,If dose is missed, skip it and return to normal schedule  
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Vancocin   Vancomycin   -May enhance nephrotoxic effect of AMGs and colistimethate-NSAIDs may decrease excretion-May enhance effect of neuromuscular blocking agents   Take all prescribed medication, even if feeling better  
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Veetids   Penicillin VK   -Changes in GI flora may disrupt absorption of OCs-Theoretically not used with bacteriostatic Abx -Renal excretion decreased with probenicid   Take on empty stomach (1 hour before or 2 hours after meals),Take with full 8oz glass of water, Take at even intervals around the clock,Complete full course of therapy,Keep soln in fridge  
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Viagra   Sildenafil   -Cimetidine, erythromycin, and ketoconazole decrease clearance-NITRATES increase hypotensive effects-Grapefruit juice may increase levels   Does not protect against STDs,Report visual adverse effects to MD  
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Vibramycin/ Vibratabs   Doxycycline   -May impair action of bacteriocidal antibiotics and absorption of OCs-Increases bioavailability of digoxin-Absorption impaired by aluminum, calcium, bismuth, magnesium, zinc, iron salts, and urinary alkalinizers-Use with METHOXYFLURANE causes hepato   Take on empty stomach (1 hour before or 2 hours after meal) w/ a full 8oz glass of water,Take at even intervals, around the clock,Compete full course of therapy,Avoid prolonged exposure to sunlight  
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Vicodin/ Norco/ Lortab   APAP/ Hydrocodone   -Alcohol or other CNS depressants produce additive CNS depression-Use with MOAIs or TCAs may increase effects of either-Use with anticholinergics may produce paralytic ileus-Hepatotoxicity is increased with hydantoins or sulfinpyrazone   May take with food, May cause drowsiness,Avoid alcohol,May be habit forming,If dose is missed, skip it and return to normal dosing schedule  
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Vimpat   Lacosamide   -CBZ, phenytoin, and phenobarb may decrease levels   Avoid alcohol, May experience dizziness or lightheadness, Report thoughts of depression or suicide to MD,Do not stop w/o consulting MD  
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Vyvanse   Lisdexamfetamine   -may enhance analgesic effects of opioids-may diminish effects of antihistamines-antipsychotics may decrease effectivness of stimulants   Avoid alcohol,May cause dependence (thought to be less associated w/ dependence due to prodrug form),May cause insomnia or irritability,Report chest pain to MD  
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Wellbutrin (SR, XL)   Bupropion   -Toxicity is increased with MAOIs and L-dopa-Use with caution with drugs that affect hepatic metabolism-Alcohol may lower seizure threshold   Take IR tabs at regular intervals no sooner than 3-4 times per day,Take ER tabs in AM to avoid insomnia,Do not take OTC meds w/o consulting MD,Avoid alcohol,Weight loss or gain may be temporary,If dose is missed, wait until next scheduled dose (  
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Xalantan   Lantoprost   -Administer at least 5 min before or after other ophthalmic products-Not administered while wearing contact lenses (lenses can be reinserted in 15 min)   Wait at least 5 min before instilling other ophthalmic products,Avoid squinting or closing tightly of eyes after administering,Do not discontinue w/o consulting MD,Store unopened bottle in fridge,Increased pigmentation of lens may occur,If dose  
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Xanax   Alprazolam   -CNS depression increased when used with other CNS depressants   May cause drowsiness,Avoid alcohol,May be habit forming,If dose is missed, skip it and return to normal schedule  
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Xopenex   Levalbuterol   -Other sympathomimetics, TCAs, MAOIs increase toxicity-May worsen hypokalemia or EK changes caused by non potassium sparing diuretics-Decreases serum levels of digoxin   Do not take more than recommended,Intended to be used in a nebulizer  
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Yasmin/ Yaz   Drospirenone/ Ethinyl Estradiol   -Broad spectrum antibiotics may alter absorption-Barbituates and hydantoins decrease metabolism-Effects are decreased with rifampin and St. Johns Wort-Caution in pts receiving ACEI, potassium sparing diuretics, heparin, aldosterone antagonists, and   Does not protect against STDs or HIV,Breakthrough bleeding may occur in first few months,Missing first month period is normal, Contact MD if miss 2 months in a row,Use second method of BC for first week and if using broad spectrum antibiotics  
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Zantac   Ranitidine   -Decreases WARFARIN and lidocaine clearance-Increases absorption of triazolam-Decreases metabolism of nifedipine and TCAs   May be taken w/ food,Complete full course of therapy,Do not freeze syrup,Effervescent tab MUST be dissolved in water before ingestion  
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Zemplar   Paricalcitol   -CYP3A4 inhibitors may increase levels   Do not increase dose w/o consulting MD,Adhere to recommended diet,Do not take any other phosphate or vitamin D supplements  
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Zestril/ Prinivil   Lisinopril   -Effect is decreased with indomethacin-Capsaicin may increase coughing-High risk of allergic rxn with allopurinol-Decreases lithium elimination-Potassium supplements may cause hyperkalemia-May potentiate action of antidiabetics or insulin   Taken w/o regard to meals,Do not discontinue w/o consulting MD,Avoid OTC cough, cold, or allergy meds,Avoid salt substitutes containing potassium,Contact MD if signs of swelling occur  
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Zetia   Ezetimib   -Gemfibrozil and fenofibrate increase plasma concentrations-Cholestyramine decreases plasma concentrations   Take w/o regard to meals,Do not take within 2 hours before or 4 hours after cholestyramine,Closely follow prescribed diet,Contact MD if symptoms of myopathy occur (muscle pain or tenderness),If dose is missed take ASAP, unless over 8 hours has ela  
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Zithromax/ Zmax   Azithromycin   -Antacids slow absorption-Food decreases absorption-Nelfinavir doubles serum concentrations   Taken w/o regard to meals,Do not take antacids within 1 hour of dose,Contact MD if diarrhea is severe  
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Zocor   Simvastatin   -Increases warfarin and digoxin levels-Myopathy or rhabdo may occur if given w/ gemfibrozil, nicotinic acid, danazol, amiodarone, verapamil, immunosuppressive agents, and potent CYP3A4 INHIBITORS (itraconazole, ketaconazole, erythromycin, clarithromycin   Contact MD if signs of myopathy (muscle pain and tenderness) occur,Closely follow prescribed diet,Avoid over exposure to sunlight,Limit alcohol,Grapefruit juice increases plasma levels and should be avoided,Take at bedtime  
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Zofran   Ondansetron   -No known clinically significant interactions   Do not remove chewable tabs until just prior to use,Do not push tablet through foil, peel apart  
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Zoloft   Sertraline   -MAOIs within 14 days may cause fatal rxns-Increased PIMOZIDE levels-Decreases clearance of diazepam and tolbutamide-ASA or NSAIDs may increase risk of upper GI bleed   Continued therapy may be needed to show improvement,Do not abruptly discontinue w/o consulting MD,Avoid alcohol,Caution when performing tasks that require alertness,Contact MD before starting OTC meds,If dose is missed, skip it and return to nor  
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Zosyn   Piperacillin/ Tazobactam   -Decreases concentrations of AMGs-Decreases MTX excretion-TCNs may decrease therapeutic effect   -oly given by IV or injection-report infusion site rxns-if have DM may cause false + for Clinitest  
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Zovirax   Acyclovir   -Probenecid may decrease elimination   Not a cure,Avoid sexual intercourse when lesions are present,Notify MD if frequency and severity of attacks does not improve,Drink plenty of fluids  
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Zyloprim   Allopurinol   -Increase ampicillin induced skin rash-Increases pharmacologic and toxic effects of thiopurines (mercaptopurine and azathioprine)and cyclophosphamide-Increases INR if on warfarin   May be taken with food,May cause drowsiness,Compliance is essential, may take weeks to reach maximum effect,Avoid alcohol,High fluid intake to prevent kidney stones,If dose is missed, skip it and return to normal dosing schedule  
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Zyprexa   Olanzapine   -Additive sedative effects w/ other CNS depressants-Omeprazole, rifampin, CBZ increase clearance-Fluoxetine decreases elimination-Activated charcoal decreases bioavailability-CYP1A2Clearance increased w/ smoking   Taken w/o regard to meals,Do not change dose w/o consulting MD,Use caution when rising (orthostatic hypotension),May cause drowsiness,If dose is missed, skip it and return to normal schedule  
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Zyrtec   Cetirizine   No known clinically significant interactions   May cause drowsiness,Avoid alcohol,If dose is missed by more than 6 hours, skip it and return to normal schedule  
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Zyvox   Linezolid   MAOIs, SSRIs, TCAs, meperidine, and buspirone increase serotonin syndrome   Complete full course of therapy,Store suspension and RT and use in 21 days,Avoid alcohol,Avoid tyramine containing foods,  
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Proventil/ ProAir/ Ventolin   Albuterol   -Other sympathomimetics, trycyclic antidepressants, MOAIs may increase toxicity-May worsen hypokalemia caused by non-potassium sparing diuretics-Decreases digoxin levels   Do not take more frequently than recommended,Shake well before inhalation,Clean mouthpiece once a week  
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Sinemet   Cabridopa/ Levodopa   -Hydrantoins and pyridoxine (vit B6) may decrease effectiveness-Hypertensive crisis may occur if given with MOAIs-Discontinue current levodopa therapy at least 8 hours before starting Sinemet   May be taken with food,Avoid products containing vit B6,  
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Rocephin   Cetrriaxone   -May enhance anticoag effect of vit K-Uricosuric agents may decrease excretion-Lactated ringers and calcium salts may enhance adverse effects   Contraindicated in hyperbilirubinemic neonates (less than 2 months), causes kernicterusCaution in pts w/ a PCN allergy, renal or hepatic disease, or gastrointestinal disease  
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