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Table 5 Description of the top-20 and clinically important potential drug–drug interactions in patients with pneumonia

From: Potential drug-drug interactions among pneumonia patients: do these matter in clinical perspectives?

Interacting pairsFrequencySeverityDocumentationPotential adverse outcomes
Aspirin – Furosemide40MajorGoodReduced diuretic effectiveness and possible nephrotoxicity
Furosemide – Hydrocortisone39ModerateFairHypokalemia
Aspirin – Clopidogrel37MajorFairIncreased risk of bleeding
Aspirin – Insulin33ModerateFairHypoglycemia
Isoniazid – Rifampin33MajorGoodHepatotoxicity
Calcium containing products – Ceftriaxone33ContraindicatedGoodFormation of ceftriaxone-calcium precipitates and is contraindicated in neonates
Pyrazinamide – Rifampin32MajorGoodHepatotoxicity
Aspirin – Ramipril28ModerateFairDecreased ramipril effectiveness
Albuterol – Furosemide28ModerateFairECG changes or hypokalemia
Aspirin – Bisoprolol23ModerateGoodIncreased blood pressure
Furosemide – Ramipril23ModerateGoodPostural hypotension (first dose)
Clarithromycin – Dexamethasone23MajorFairDecrease clarithromycin exposure and increased dexamethasone exposure
Aspirin – Dexamethasone21ModerateGoodIncreased risk of gastrointestinal ulceration and subtherapeutic aspirin serum concentrations
Aspirin – Nitroglycerin20ModerateGoodIncrease in nitroglycerin concentrations and additive platelet function depression
Clopidogrel – Esomeprazole17MajorExcellentReduced plasma concentrations of clopidogrel active metabolite and reduced antiplatelet activity
Azithromycin – Moxifloxacin16MajorFairIncreased risk of QT-interval prolongation
Aspirin – Spironolactone16MajorGoodReduced diuretic effectiveness, hyperkalemia, or possible nephrotoxicity
Clopidogrel – Omeprazole13MajorExcellentReduced plasma concentrations of clopidogrel active metabolite and reduced antiplatelet activity
Omeprazole – Rifampin13ModerateFairDecreased omeprazole plasma concentrations
Ramipril – Spironolactone13MajorGoodHyperkalemia