| { | |
| "warfarin": { | |
| "aspirin": { | |
| "severity": "high", | |
| "description": "Increased risk of bleeding when combined", | |
| "recommendation": "Monitor INR closely; consider alternative pain relief" | |
| }, | |
| "ibuprofen": { | |
| "severity": "high", | |
| "description": "Increased risk of gastrointestinal bleeding", | |
| "recommendation": "Avoid combination; use acetaminophen instead" | |
| }, | |
| "naproxen": { | |
| "severity": "high", | |
| "description": "Increased anticoagulant effect and bleeding risk", | |
| "recommendation": "Avoid NSAIDs with warfarin" | |
| }, | |
| "vitamin k": { | |
| "severity": "moderate", | |
| "description": "Vitamin K can reduce warfarin effectiveness", | |
| "recommendation": "Maintain consistent vitamin K intake" | |
| } | |
| }, | |
| "metformin": { | |
| "alcohol": { | |
| "severity": "high", | |
| "description": "Increased risk of lactic acidosis", | |
| "recommendation": "Limit alcohol consumption" | |
| }, | |
| "contrast dye": { | |
| "severity": "high", | |
| "description": "Risk of contrast-induced nephropathy and lactic acidosis", | |
| "recommendation": "Hold metformin before and after contrast procedures" | |
| } | |
| }, | |
| "simvastatin": { | |
| "grapefruit": { | |
| "severity": "moderate", | |
| "description": "Grapefruit increases simvastatin levels, risk of muscle damage", | |
| "recommendation": "Avoid grapefruit and grapefruit juice" | |
| }, | |
| "erythromycin": { | |
| "severity": "high", | |
| "description": "Increased risk of rhabdomyolysis", | |
| "recommendation": "Use alternative antibiotic or statin" | |
| }, | |
| "amiodarone": { | |
| "severity": "high", | |
| "description": "Increased risk of myopathy", | |
| "recommendation": "Limit simvastatin dose to 20mg daily" | |
| } | |
| }, | |
| "lisinopril": { | |
| "potassium": { | |
| "severity": "moderate", | |
| "description": "Risk of hyperkalemia (high potassium)", | |
| "recommendation": "Monitor potassium levels regularly" | |
| }, | |
| "spironolactone": { | |
| "severity": "high", | |
| "description": "Significant risk of hyperkalemia", | |
| "recommendation": "Monitor potassium; use with caution" | |
| }, | |
| "nsaids": { | |
| "severity": "moderate", | |
| "description": "May reduce antihypertensive effect and worsen kidney function", | |
| "recommendation": "Use lowest effective NSAID dose for shortest duration" | |
| } | |
| }, | |
| "digoxin": { | |
| "amiodarone": { | |
| "severity": "high", | |
| "description": "Amiodarone increases digoxin levels significantly", | |
| "recommendation": "Reduce digoxin dose by 50%; monitor levels" | |
| }, | |
| "verapamil": { | |
| "severity": "high", | |
| "description": "Increased digoxin levels and risk of heart block", | |
| "recommendation": "Reduce digoxin dose; monitor ECG" | |
| }, | |
| "quinidine": { | |
| "severity": "high", | |
| "description": "Doubles digoxin levels", | |
| "recommendation": "Reduce digoxin dose by 50%" | |
| } | |
| }, | |
| "clopidogrel": { | |
| "omeprazole": { | |
| "severity": "moderate", | |
| "description": "Omeprazole may reduce clopidogrel effectiveness", | |
| "recommendation": "Consider pantoprazole as alternative PPI" | |
| }, | |
| "aspirin": { | |
| "severity": "moderate", | |
| "description": "Increased bleeding risk but often used together therapeutically", | |
| "recommendation": "Monitor for signs of bleeding" | |
| } | |
| }, | |
| "methotrexate": { | |
| "nsaids": { | |
| "severity": "high", | |
| "description": "NSAIDs increase methotrexate toxicity", | |
| "recommendation": "Avoid NSAIDs or use with extreme caution" | |
| }, | |
| "trimethoprim": { | |
| "severity": "high", | |
| "description": "Increased risk of bone marrow suppression", | |
| "recommendation": "Avoid combination; monitor blood counts" | |
| }, | |
| "penicillin": { | |
| "severity": "moderate", | |
| "description": "May increase methotrexate levels", | |
| "recommendation": "Monitor for methotrexate toxicity" | |
| } | |
| }, | |
| "lithium": { | |
| "nsaids": { | |
| "severity": "high", | |
| "description": "NSAIDs increase lithium levels significantly", | |
| "recommendation": "Avoid NSAIDs; monitor lithium levels if used" | |
| }, | |
| "ace inhibitors": { | |
| "severity": "high", | |
| "description": "ACE inhibitors increase lithium levels", | |
| "recommendation": "Monitor lithium levels closely" | |
| }, | |
| "diuretics": { | |
| "severity": "high", | |
| "description": "Thiazide diuretics increase lithium levels", | |
| "recommendation": "Avoid thiazides; monitor lithium if used" | |
| } | |
| }, | |
| "doxorubicin": { | |
| "trastuzumab": { | |
| "severity": "high", | |
| "description": "Increased risk of cardiotoxicity", | |
| "recommendation": "Monitor cardiac function; space administration" | |
| }, | |
| "cyclophosphamide": { | |
| "severity": "moderate", | |
| "description": "Additive cardiotoxicity risk", | |
| "recommendation": "Monitor cardiac function" | |
| }, | |
| "paclitaxel": { | |
| "severity": "moderate", | |
| "description": "Altered doxorubicin metabolism", | |
| "recommendation": "Give doxorubicin before paclitaxel" | |
| } | |
| }, | |
| "fluoxetine": { | |
| "maois": { | |
| "severity": "critical", | |
| "description": "Risk of serotonin syndrome - potentially fatal", | |
| "recommendation": "Contraindicated; allow 5-week washout" | |
| }, | |
| "tramadol": { | |
| "severity": "high", | |
| "description": "Increased risk of serotonin syndrome and seizures", | |
| "recommendation": "Avoid combination if possible" | |
| }, | |
| "triptans": { | |
| "severity": "moderate", | |
| "description": "Possible serotonin syndrome", | |
| "recommendation": "Use with caution; monitor for symptoms" | |
| } | |
| }, | |
| "ciprofloxacin": { | |
| "theophylline": { | |
| "severity": "high", | |
| "description": "Ciprofloxacin increases theophylline levels significantly", | |
| "recommendation": "Reduce theophylline dose by 50%; monitor levels" | |
| }, | |
| "tizanidine": { | |
| "severity": "critical", | |
| "description": "Dramatic increase in tizanidine levels - contraindicated", | |
| "recommendation": "Do not use together" | |
| }, | |
| "antacids": { | |
| "severity": "moderate", | |
| "description": "Antacids reduce ciprofloxacin absorption", | |
| "recommendation": "Take ciprofloxacin 2h before or 6h after antacids" | |
| } | |
| }, | |
| "aspirin": {}, | |
| "ibuprofen": {}, | |
| "naproxen": {}, | |
| "acetaminophen": {}, | |
| "paracetamol": {}, | |
| "diclofenac": {}, | |
| "celecoxib": {}, | |
| "indomethacin": {}, | |
| "ketorolac": {}, | |
| "meloxicam": {}, | |
| "tramadol": {}, | |
| "codeine": {}, | |
| "morphine": {}, | |
| "oxycodone": {}, | |
| "hydrocodone": {}, | |
| "fentanyl": {}, | |
| "buprenorphine": {}, | |
| "naloxone": {}, | |
| "naltrexone": {}, | |
| "amoxicillin": {}, | |
| "ampicillin": {}, | |
| "penicillin": {}, | |
| "piperacillin": {}, | |
| "tazobactam": {}, | |
| "levofloxacin": {}, | |
| "moxifloxacin": {}, | |
| "erythromycin": {}, | |
| "azithromycin": {}, | |
| "clarithromycin": {}, | |
| "tetracycline": {}, | |
| "doxycycline": {}, | |
| "minocycline": {}, | |
| "trimethoprim": {}, | |
| "sulfamethoxazole": {}, | |
| "metronidazole": {}, | |
| "clindamycin": {}, | |
| "vancomycin": {}, | |
| "gentamicin": {}, | |
| "amikacin": {}, | |
| "ceftriaxone": {}, | |
| "cefazolin": {}, | |
| "cephalexin": {}, | |
| "meropenem": {}, | |
| "imipenem": {}, | |
| "linezolid": {}, | |
| "rifampicin": {}, | |
| "rifampin": {}, | |
| "isoniazid": {}, | |
| "ethambutol": {}, | |
| "pyrazinamide": {}, | |
| "ticagrelor": {}, | |
| "apixaban": {}, | |
| "rivaroxaban": {}, | |
| "dabigatran": {}, | |
| "heparin": {}, | |
| "enoxaparin": {}, | |
| "enalapril": {}, | |
| "ramipril": {}, | |
| "captopril": {}, | |
| "perindopril": {}, | |
| "losartan": {}, | |
| "valsartan": {}, | |
| "irbesartan": {}, | |
| "candesartan": {}, | |
| "telmisartan": {}, | |
| "olmesartan": {}, | |
| "amlodipine": {}, | |
| "nifedipine": {}, | |
| "diltiazem": {}, | |
| "verapamil": {}, | |
| "atenolol": {}, | |
| "metoprolol": {}, | |
| "carvedilol": {}, | |
| "bisoprolol": {}, | |
| "propranolol": {}, | |
| "nebivolol": {}, | |
| "labetalol": {}, | |
| "spironolactone": {}, | |
| "furosemide": {}, | |
| "frusemide": {}, | |
| "hydrochlorothiazide": {}, | |
| "indapamide": {}, | |
| "chlorthalidone": {}, | |
| "amiodarone": {}, | |
| "atorvastatin": {}, | |
| "rosuvastatin": {}, | |
| "pravastatin": {}, | |
| "fluvastatin": {}, | |
| "ezetimibe": {}, | |
| "fenofibrate": {}, | |
| "gemfibrozil": {}, | |
| "nitroglycerin": {}, | |
| "glyceryl trinitrate": {}, | |
| "isosorbide": {}, | |
| "hydralazine": {}, | |
| "glibenclamide": {}, | |
| "glipizide": {}, | |
| "gliclazide": {}, | |
| "glimepiride": {}, | |
| "insulin": {}, | |
| "insulin glargine": {}, | |
| "insulin aspart": {}, | |
| "insulin lispro": {}, | |
| "insulin detemir": {}, | |
| "sitagliptin": {}, | |
| "saxagliptin": {}, | |
| "alogliptin": {}, | |
| "linagliptin": {}, | |
| "empagliflozin": {}, | |
| "dapagliflozin": {}, | |
| "canagliflozin": {}, | |
| "pioglitazone": {}, | |
| "rosiglitazone": {}, | |
| "exenatide": {}, | |
| "liraglutide": {}, | |
| "dulaglutide": {}, | |
| "semaglutide": {}, | |
| "acarbose": {}, | |
| "salbutamol": {}, | |
| "albuterol": {}, | |
| "salmeterol": {}, | |
| "formoterol": {}, | |
| "budesonide": {}, | |
| "beclomethasone": {}, | |
| "fluticasone": {}, | |
| "tiotropium": {}, | |
| "ipratropium": {}, | |
| "montelukast": {}, | |
| "theophylline": {}, | |
| "aminophylline": {}, | |
| "prednisolone": {}, | |
| "prednisone": {}, | |
| "dexamethasone": {}, | |
| "betamethasone": {}, | |
| "hydrocortisone": {}, | |
| "methylprednisolone": {}, | |
| "sertraline": {}, | |
| "paroxetine": {}, | |
| "citalopram": {}, | |
| "escitalopram": {}, | |
| "venlafaxine": {}, | |
| "duloxetine": {}, | |
| "mirtazapine": {}, | |
| "amitriptyline": {}, | |
| "nortriptyline": {}, | |
| "imipramine": {}, | |
| "clomipramine": {}, | |
| "haloperidol": {}, | |
| "risperidone": {}, | |
| "olanzapine": {}, | |
| "quetiapine": {}, | |
| "aripiprazole": {}, | |
| "clozapine": {}, | |
| "ziprasidone": {}, | |
| "paliperidone": {}, | |
| "valproate": {}, | |
| "valproic acid": {}, | |
| "carbamazepine": {}, | |
| "lamotrigine": {}, | |
| "phenytoin": {}, | |
| "phenobarbitone": {}, | |
| "phenobarbital": {}, | |
| "levetiracetam": {}, | |
| "topiramate": {}, | |
| "gabapentin": {}, | |
| "pregabalin": {}, | |
| "diazepam": {}, | |
| "lorazepam": {}, | |
| "alprazolam": {}, | |
| "clonazepam": {}, | |
| "midazolam": {}, | |
| "zolpidem": {}, | |
| "zopiclone": {}, | |
| "methylphenidate": {}, | |
| "atomoxetine": {}, | |
| "donepezil": {}, | |
| "memantine": {}, | |
| "rivastigmine": {}, | |
| "galantamine": {}, | |
| "omeprazole": {}, | |
| "pantoprazole": {}, | |
| "lansoprazole": {}, | |
| "esomeprazole": {}, | |
| "rabeprazole": {}, | |
| "ranitidine": {}, | |
| "famotidine": {}, | |
| "cimetidine": {}, | |
| "metoclopramide": {}, | |
| "domperidone": {}, | |
| "ondansetron": {}, | |
| "granisetron": {}, | |
| "loperamide": {}, | |
| "mesalazine": {}, | |
| "sulfasalazine": {}, | |
| "azathioprine": {}, | |
| "levothyroxine": {}, | |
| "thyroxine": {}, | |
| "carbimazole": {}, | |
| "propylthiouracil": {}, | |
| "fludrocortisone": {}, | |
| "testosterone": {}, | |
| "estradiol": {}, | |
| "progesterone": {}, | |
| "medroxyprogesterone": {}, | |
| "norethisterone": {}, | |
| "ethinylestradiol": {}, | |
| "tamoxifen": {}, | |
| "letrozole": {}, | |
| "anastrozole": {}, | |
| "exemestane": {}, | |
| "cyclophosphamide": {}, | |
| "vincristine": {}, | |
| "paclitaxel": {}, | |
| "docetaxel": {}, | |
| "cisplatin": {}, | |
| "carboplatin": {}, | |
| "fluorouracil": {}, | |
| "capecitabine": {}, | |
| "imatinib": {}, | |
| "erlotinib": {}, | |
| "trastuzumab": {}, | |
| "rituximab": {}, | |
| "bevacizumab": {}, | |
| "cyclosporine": {}, | |
| "cyclosporin": {}, | |
| "tacrolimus": {}, | |
| "mycophenolate": {}, | |
| "hydroxychloroquine": {}, | |
| "chloroquine": {}, | |
| "allopurinol": {}, | |
| "colchicine": {}, | |
| "alendronate": {}, | |
| "risedronate": {}, | |
| "zoledronic acid": {}, | |
| "calcium carbonate": {}, | |
| "vitamin d": {}, | |
| "cholecalciferol": {}, | |
| "ferrous sulphate": {}, | |
| "ferrous sulfate": {}, | |
| "folic acid": {}, | |
| "cyanocobalamin": {}, | |
| "vitamin b12": {}, | |
| "zinc sulfate": {}, | |
| "magnesium": {}, | |
| "potassium chloride": {}, | |
| "sodium chloride": {}, | |
| "albumin": {}, | |
| "dextrose": {}, | |
| "amoxicillin-clavulanate": {}, | |
| "co-amoxiclav": {}, | |
| "clavulanic acid": {}, | |
| "fluconazole": {}, | |
| "itraconazole": {}, | |
| "voriconazole": {}, | |
| "acyclovir": {}, | |
| "aciclovir": {}, | |
| "valacyclovir": {}, | |
| "oseltamivir": {}, | |
| "tenofovir": {}, | |
| "emtricitabine": {}, | |
| "lamivudine": {}, | |
| "efavirenz": {}, | |
| "lopinavir": {}, | |
| "ritonavir": {}, | |
| "atazanavir": {}, | |
| "dolutegravir": {}, | |
| "quinidine": {} | |
| } | |