VIDEO: Common drug interactions clinicians should be aware of

SAN DIEGO — In this video at the ACP Internal Medicine Meeting, Douglas S. Paauw, MD, MACP, discusses recent evidence on drug interactions and other safety indications with common medications.

“One interesting interaction that many clinicians worry about is the interaction between nitroglycerin and sildenafil, or phosphodiesterase inhibitors,” said Paauw, a professor of medicine at the University of Washington. “We’ve been very worried for many years that it causes severe hypotension and that you cannot use these drugs in individuals who take nitrates.”

However, a recent study in Denmark “showed there was really no increase in bad outcomes over the last 20 years, with a 20-fold increase of these drugs being co-prescribed,” Paauw said.

“Even at very, very high levels, it seems to be okay for patients to potentially have this interaction,” he said. “We don’t want patients to have it, but I don’t think that there’s a reason to not give phosphodiesterase inhibitors to patients who have sublingual nitroglycerin in their house.”

Paauw also discusses common drug interactions with Paxlovid (nirmatrelvir/ritonavir, Pfizer) used to treat COVID-19, particularly with statins, as well as concerns related to trimethoprim-sulfamethoxazole.

References:

• Paauw D. What medications should we be wary of? The fine print. Presented at: ACP Internal Medicine Meeting; April 27-29, 2023; San Diego.