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Ahmed Abdalbagi – Drug Interactions Every Healthcare Professional Must Know
Ahmed Abdalbagi/LinkedIn
Oct 4, 2025, 12:39

Ahmed Abdalbagi – Drug Interactions Every Healthcare Professional Must Know

 

Ahmed Abdalbagi, Pharmacist at Pharma Trading Co.Ltd., posted on LinkedIn:

”CRITICAL ALERT: Drug Interactions Every Healthcare Professional Must Know

Patient safety hinges on our vigilance. As medication experts, pharmacists play a pivotal role in intercepting dangerous drug interactions that can lead to hospitalizations, permanent harm, or   worse.
Here are clinically significant interactions, updated with current guidelines, that demand our immediate attention:

Sildenafil (and all PDE5 inhibitors) + Organic Nitrates (Nitroglycerin)
Risk: Profound, refractory hypotension. This is an absolute contraindication. Life-threatening.
Clopidogrel + Omeprazole/Esomeprazole
Risk: Significant reduction in Clopidogrel’s antiplatelet effect due to CYP2C19 inhibition. Increases risk of stent thrombosis and cardiovascular events. Use Pantoprazole or Rabeprazole if PPI is essential.

Warfarin + NSAIDs or Metronidazole
Risk: Potentiated anticoagulation and synergistic GI irritation. High risk of major bleeding. Monitor INR closely; recommend paracetamol for pain.
Potassium-Sparing Diuretics+ ACEi/ARB (Captopril, Lisinopril)
Risk: Severe hyperkalemia. Mandatory potassium monitoring is required, especially in patients with renal impairment or diabetes.

Gentamicin + Loop Diuretics (Furosemide)
Risk: Additive ototoxicity. Permanent hearing damage can occur. Closely monitor renal function and avoid concurrent use when possible.
SSRIs+ NSAIDs/Aspirin
Risk: Significantly increased risk of upper GI bleeding. The combination requires gastroprotection with a PPI.

Ondansetron + Tramadol
Risk: Ondansetron can blunt the analgesic effect of Tramadol by inhibiting its activation via CYP2D6. Consider alternative antiemetics like Metoclopramide.
QTc-Prolonging Agents: Fluoroquinolones (Levofloxacin) + Macrolides (Clarithromycin) + Antipsychotics
Risk: Additive QTc prolongation, potentially leading to Torsades de Pointes. A critical consideration in polypharmacy patients.

Statins (Simvastatin, Atorvastatin) + CYP3A4 Inhibitors (Clarithromycin, Fluconazole)
Risk: Dramatically increased statin levels, leading to rhabdomyolysis and acute kidney injury.
Digoxin + Amiodarone / Clarithromycin / Verapamil
Risk: These drugs increase Digoxin serum concentrations, leading to Digoxin toxicity (nausea, bradycardia, arrhythmias). Dose reduction and close monitoring are essential.

Why This Matters:
Polypharmacy is on the rise. In our collaborative practice, a single alert from a pharmacist can be the line of defense against a preventable adverse drug event (ADE). Medication safety is a non-   negotiable team sport.

What is the most critical drug interaction you’ve intervened on recently? Share your experience to elevate our collective practice.”

Drug Interactions

 

Stay informed with Hemostasis Today.

ACEi/ARB Ahmed Abdalbagi Amiodarone Antipsychotics Aspirin Atorvastatin Captopril Clarithromycin Clinical Pharmacy clopidogrel CYP3A4 Inhibitors Digoxin Drug Interactions Esomeprazole Fluconazole Fluoroquinolones Furosemide Gentamicin Health Hematology Hemostasis Hemostasis Today Hospital Pharmacy Levofloxacin Lisinopril Loop Diuretics Macrolides Medical Alert Medication Safety Medicine Metronidazole Nitroglycerin NSAIDs Omeprazole Ondansetron Organic Nitrates PDE5 Inhibitors Pharmacology Polypharmacy Potassium-Sparing Diuretics QTc-Prolonging Agents Sildenafil Simvastatin SSRIs statins thrombosis Tramadol Verapamil Warfarin
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