CI in HLD
This drug has mainly GI ADRs and can increase risk of gallstones. DDIs include warfarin and statins. CI in breastfeeding, pregnancy, biliary disease, and renal/liver disease
Fibrates (fenofibrate, gemfibrozil)
This drug is associated with angioedema
ACEIs
These drugs may cause hyperkalemia and should be monitored with labs after initiation
ACEI, ARB, ARNI
This drug should be avoided in patients older than 60 (or 70)
Aspirin
This drug may cause SJS/TEN, hepatotoxicity, pulmonary toxicity and has proarrhythmic effects
Amiodarone
This drug only has ADRs at the site of injection
PCSK9 inhibitors (cumabs)
This drug may produce cyanide toxicity
Venodilator - nitroprusside
This drug should be avoided in bradycardia. It is CI in hypotensive pts (90/50), ADHF, atrial arrhythmias (sick sinus syndrome, SA block, 3rd degree AVB).
Sinus node inhibitor - ivabradine
These drugs should be avoided in patients with AV conduction arrhythmias and depressed cardiac function
Calcium channel blockers (amlodipine, felodipine, verapamil, diltiazem)
This drug may cause interference of BNP lab values
ARNI
This drug has DDIs with warfarin, macrolides and fibrates + can cause rhabdo. CI in breast feeding
HMG-CoA reductase inhibitors - statins
These are CI in pregnant patients
ACEIs, ARBs, direct renin inhibitors
This drug can cause angioedema and is CI in pregnancy due to the BBW of injury/death to the developing fetus. It should not be used with an ACEI within 36 hours of last dose.
Angiotensin receptor neprilysin inhibitor (ARNI) - sacubitril + valsartan
This drug may cause bronchospasms in patients with COPD/asthma
Beta blockers (olols)
This HTN drug causes multiple CNS effects and is CI in liver disease but is used for one specific patient population
Methyldopa
This drug has ADRs of cutaneous flushing, pruritis and increased gout risk
Niacin
This drug is CI in patients with gout
Thiazide diuretics
This drug has a very narrow therapeutic index and can cause arrhythmias and toxicity. It should be avoided in HFpHF and ADHF.
Digoxin
This drug's main DDI is with PDE-5 inhibitors (used to treat BPH, erectile dysfunction, and pulmonary HTN). It can also cause facial flushing, headache and hypotension
Organic nitrates
This drug should be temporarily discontinued in patients with ADHF
Beta blockers
This drug can impair absorption of drugs like warfarin, digoxin, aspirin, thiazides, etc. They should not be used with high TG levels
Bile acid sequestrants (cholestyramine/coles)
These drugs are CI in patients with AV blocks
Beta blockers (olols), non-DHP CCBs (diltiazem, verapamil)
This drug has a BBW for fetal-embryo toxicity. Patients must exclude pregnancy before treatment and use contraception up to one month after d/c treatment.
Soluble guanylate cyclase (sGC) - Vericiguat
This last-ditch effort drug can cause cardiac conduction abnormalities and should not be used in those that have ACS or liver/kidney disease. It is also a CYP3A4/2D6 metabolizer
Sodium channel blocker - ranolazine
This HTN drug used to be CI in pregnant patients but is now allowed if the benefits outweigh the risks. Caution should still be taken
Thiazide diuretics