PCT Cardio CI

CI in HLD

100

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)

200

This drug only has ADRs at the site of injection

PCSK9 inhibitors (cumabs)

300

This drug has DDIs with warfarin, macrolides and fibrates + can cause rhabdo. CI in breast feeding

HMG-CoA reductase inhibitors - statins

400

This drug has ADRs of cutaneous flushing, pruritis and increased gout risk

Niacin

500

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)

CI in HTN

100

This drug is associated with angioedema

ACEIs

200

This drug may produce cyanide toxicity

Venodilator - nitroprusside

300

These are CI in pregnant patients

ACEIs, ARBs, direct renin inhibitors

400

This drug is CI in patients with gout

Thiazide diuretics

500

These drugs are CI in patients with AV blocks

Beta blockers (olols), non-DHP CCBs (diltiazem, verapamil)

CI in HF

100

These drugs may cause hyperkalemia and should be monitored with labs after initiation

ACEI, ARB, ARNI

200

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

300

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

400

This drug has a very narrow therapeutic index and can cause arrhythmias and toxicity. It should be avoided in HFpHF and ADHF.

Digoxin

500

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

CI in Angina

100

This drug should be avoided in patients older than 60 (or 70)

Aspirin

200

These drugs should be avoided in patients with AV conduction arrhythmias and depressed cardiac function

Calcium channel blockers (amlodipine, felodipine, verapamil, diltiazem)

300

This drug may cause bronchospasms in patients with COPD/asthma

Beta blockers (olols)

400

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

500

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

CI in Antiarrhythmias + Misc.

100

This drug may cause SJS/TEN, hepatotoxicity, pulmonary toxicity and has proarrhythmic effects

Amiodarone

200

This drug may cause interference of BNP lab values

ARNI

300

This HTN drug causes multiple CNS effects and is CI in liver disease but is used for one specific patient population

Methyldopa

400

This drug should be temporarily discontinued in patients with ADHF

Beta blockers

500

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