| Don’t give | with | Because (Reason) |
|---|---|---|
| Tetracyclines | Penicillins | tetracyclines are bacteriostatic and inhibit the growth of bacteria and penicillins work only on actively dividing organisms. |
| Azithromycin | Antihistamines | severe chest pain and prolong QT interval |
| Anti-acid or anti-ulcer medication | Iron in pt. with IDA | iron needs acidic media to be absorbed. |
| Metronidazole | Warfarin | Metronidazole inhibits the metabolism of warfarin by blocking (CYP-2C9) which may lead to fatal bleeding |
| furosemide (lasix) | Gentamycin | maybe lead to hearing loss |
| Non-dihydropyridine (Verapamil & diltiazem) | Beta-blocker | both of them cause Severe bradycardia & heart block |
| Nifedipine or any drug ending with “dipine” | Nitrate | both of them cause vasodilation & Severe hypotension |
| Sildenafil (Viagra) | Sublingual nitroglycerin | both of them cause vasodilation –> Severe hypotension & may be death |
| Omega 3 | Antiplatelet or Anticoagulant | Because it causes bleeding |
| Statin | Gemfibrozil | increase the risk of the myopathy |
| Ciprofloxacin, Clarithromycin, Cimitidine, Fluvoxamine & erythromycin | theophylline | these drugs are Cyp450 inhibitors that lead to inc. in the theophylline level in the blood leading to death |
| Warfarin | NSAIDS | increase the risk of the GIT bleeding |
| Omperaszole | Clopidogrel (Antiplatelet) | Omeprazole decreases the effect of the clopidogrel by affecting the hepatic enzyme CYP2C19 metabolism |
| K_ sparing diuretics ( amiloride & Spironolactone ) | ACEI ( captopril ) | lead to hyperkalemia |
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