Multi-Drug Interaction Checker 4/03/2017 12:09 pm

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11 Interactions Found

Patient Regimen

amlodipine

ramipril

aspirin
acetylsalicylic acid

atorvastatin

hydrochlorothiazide

warfarin

metformin

amoxicillin

Serious - Use Alternative

aspirin + ramipril

aspirin, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug.

Coadministration may result in a significant decrease in renal function. NSAIDs may
diminish the antihypertensive effect of ACE inhibitors. The mechanism of these
interactions is likely related to the ability of NSAIDs to reduce the synthesis of
vasodilating renal prostaglandins.

Monitor Closely

amoxicillin + aspirin

amoxicillin, aspirin. Either increases levels of the other by plasma protein binding
competition. Use Caution/Monitor.

amoxicillin + aspirin

amoxicillin, aspirin. Either increases levels of the other by decreasing renal clearance.
Use Caution/Monitor.

amoxicillin + warfarin

amoxicillin increases effects of warfarin by Other (see comment). Use Caution/Monitor.

Comment: Amoxicillin may enhance anticoagulant effect of vitamin K antagonists.

amoxicillin + hydrochlorothiazide

amoxicillin, hydrochlorothiazide. Either increases levels of the other by decreasing renal

clearance. Use Caution/Monitor.

ramipril + aspirin

ramipril, aspirin. Either increases toxicity of the other by Other (see comment). Use
Caution/Monitor. Comment: May result in renal function deterioration, particularly with
high doses of aspirin, in elderly or volume depleted individuals.

warfarin + aspirin

warfarin and aspirin both increase anticoagulation. Modify Therapy/Monitor Closely.

The need for simultaneous use of low-dose aspirin and warfarin are common for

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Multi-Drug Interaction Checker 4/03/2017 12:09 pm

patients with cardiovascular disease; monitor closely.

aspirin + hydrochlorothiazide

aspirin increases and hydrochlorothiazide decreases serum potassium. Effect of

interaction is not clear, use caution. Use Caution/Monitor.

Minor

hydrochlorothiazide + aspirin

hydrochlorothiazide will increase the level or effect of aspirin by acidic (anionic) drug
competition for renal tubular clearance. Minor/Significance Unknown.

hydrochlorothiazide + metformin

hydrochlorothiazide will increase the level or effect of metformin by basic (cationic) drug
competition for renal tubular clearance. Minor/Significance Unknown.

hydrochlorothiazide + metformin

hydrochlorothiazide decreases effects of metformin by pharmacodynamic antagonism.

Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood
glucose.

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