Aspirin + Furosemide (237) [Good] |
SOB (29) Pedal Edema (17) Increased Blood Pressure (16) Orthopnea (11) Chest Pain (09) Generalized Edema (08) |
BUN: Normal (03), High (20) Serum Creatinine: Normal (13), High (08) Serum Sodium: High (02) Serum Potassium: High (03) |
Patients should be monitored for signs of worsening renal function, diuretic efficacy, appropriate effects on blood pressure and high dose aspirin should be avoided. |
Aspirin+ Clopidogrel (189) [Fair] |
SOB (20) Orthopnea (08) Nausea (05) Anemia (04) Epistaxis (01) Melena (01) |
Hemoglobin: Low (07), Normal (35) Platelets Count: Low (04), High (04) INR: High (03) PT: High (02) APTT: High (02) |
Patients should be monitored for signs and symptoms of bleeding and close assessment of blood counts. Caution is advised while using this combination, owing its increased risk of thrombotic events, therefore coprescription may be considered carefully. |
Aspirin+ Nitroglycerin (172) [Good] |
Hypotension (31) Dizziness (08) Nausea & Vomiting (06) Headache (05) Dyspnea (05) Vertigo (02) |
Hemoglobin: Low (05), High (01) Platelets: Low (02), Normal (04), High (01) BUN: Normal (03), High (14) Bilirubin: Normal (02), High (03) |
The combination may benefit the patients with acute myocardial infarction (AMI). Nevertheless, monitoring for an exaggerated response to nitroglycerin (headache, syncope) and platelet function is advised. |
Aspirin+ Spironolactone (137) [Good] |
Basal Crepitations (26) SOB (16) Orthopnea (08) Generalized Edema (06) Chest Pain (06) Headache (05) |
BUN: Normal (02), High (07) Serum Sodium: Low (02), Normal (02), High (01) Serum Potassium: Normal (05), High (01) INR: High (02) PT: High (01) |
Patients should be monitored for signs of worsening renal function, diuretic efficacy and blood pressure in patients chronically receiving spironolactone and salicylates. The effects of interaction can be reversed by increasing the spironolactone dose. |
Furosemide+ Ramipril (132) [Good] |
Hypotension (26) Pedal Edema (10) Dizziness (09) Generalized Edema (05) Nausea (03) Vomiting (02) Vertigo (01) |
BUN: High (10) Serum Creatinine: Normal (05), High (05) Serum Sodium: Low (01), Normal (03), High (01) |
The patients with sodium depletion and hypovolemia are at high risk. Closely monitor blood pressure of the patients for a severe hypotensive response for four hours after the initial dose. Temporarily discontinue furosemide and/or the patient should be started at very low dose angiotensin converting enzyme (ACE) inhibitors, particularly in evening; monitor for hypotension, fluid status, and body weight regularly for up to two weeks after dose adjustments. |
Digoxin+ Furosemide (112) [Fair] |
Dizziness (05) Nausea (04) Vomiting (03) Headache (02) |
BUN: Normal (01), High (07) Serum Creatinine: Normal (03), High (04) Serum Potassium: Normal (05), High (03) |
Frequent monitoring of serum potassium and serum magnesium levels. Educate patients about the decrease intake of dietary potassium and/or potassium supplements. |
Aspirin+ Ramipril (101) [Fair] |
Basal Crepitations (19) SOB (12) Cough (06) Chest Pain (03) Pedal Edema (05) Headache (02) |
BUN: Normal (01), High (08) Serum Creatinine: Normal (06), High (03) Serum Sodium: Low (01), Normal (04), High (01) |
Aspirin may result in reduced ramipril effectiveness. Patient’s blood pressure and hemodynamic parameters should be monitored. Consider the following option in case of any adverse effect; (a) aspirin dosage less than 100 mg per day (b) an alternative non-aspirin antiplatelet agent (c) replacing ACE inhibitors with angiotensin receptor blockers. |
Clopidogrel+ Enoxaparin (92) [Fair] |
Pallor (14) SOB (13) Chest Pain (07) Pedal Edema (04) Nausea (04) Melena (01) Epistaxis (01) |
Serum Bilirubin: High (05) Hemoglobin: Low (02), Normal (01) INR: High (02) PT: High (01) APTT: High (01) |
Prompt evaluation for signs or symptoms of bleeding is advised. Additionally, if possible discontinue the antiplatelet agent prior to initiating a low molecular weight heparins (LMWHs). |
Ramipril+ Spironolactone (80) [Good] |
Increased Blood Pressure (06) Cough (05) Hyperkalemia (05) |
BUN: High (05) Serum Potassium: High (05) Serum Creatinine: Normal (03), High (01) |
Patients should be monitored for persistent elevations of serum potassium, especially in patients with renal dysfunction or diabetes and the elderly; which can lead to severe arrhythmias and death. In patients receiving co-prescription (ramipril & spironolactone); spironolactone may be used 25 mg daily or on alternate day. |
Aspirin+ Bisoprolol (79) [Good] |
SOB (10) Increased Blood Pressure (07) Chest Pain (05) Pedal Edema (04) Headache (03) |
BUN: Normal (01), High (08) Serum Creatinine: Normal (06), High (03) INR: High (01) PT: High (01) APTT: High (01) |
Monitoring of blood pressure is advised. In heart failure, the beta blockers are considered to be narrow therapeutic index. Concomitant use of NSAIDs should generally be avoided in patients with heart failure. |