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. 2014 May;4(Suppl 1):S204–S208. doi: 10.12980/APJTB.4.2014C1172

Table 3. Most frequently identified major or moderate interactions and potential adverse outcomes.

Interaction Frequency (%) Potential adverse outcomes
Major Rifampin+pyrazinamide 9 (17.0%) Combination may cause liver damage
Rifampin+isoniazid 9 (17.0%) Combination may cause liver damage
Cotrimoxazole+leucovorin 8 (15.0%) Combination may increase risk of treatment failure
Phenytoin+artemether 5 (9.4%) Phenytoin may significantly reduce the blood levels of artemether
Warfarin+heparin 4 (7.5%) Combination can cause bleeding more easily
Ceftriaxone+leucovorin 4 (7.5%) May cause precipitation of ceftriaxone-calcium salt
Moderate Ceftriaxone+furosemide 12 (4.7%) Furosemide increase the risk of kidney damage by cephalosporin
Sulfadiazine+pyrimethamine 10 (3.9%) Combination may increase the risk of anemia
Isoniazid+ethambutol 9 (3.5%) Combination may increase the risk of nerve damage
Cotrimoxazole+pyrimethamine 8 (3.2%) Combination may increase the risk of anemia
Metronidazole+phenytoin 6 (2.4%) Combination may increase phenytoin level
Leucovorin+phenytoin 6 (2.4%) Leucovorine can decrease the bood level and effects of phenytoin
Sulfadiazine+phenytoin 6 (2.4%) Sulfodiazine increase the effect of phenytoin
Minor Ceftriaxone+phenytoin 9 (8.4%) Ceftriaxone may displace phenytoin from serum protein bleeding site
Ceftriaxone+heparin 7 (6.5%) Combination can increase risk of bleeding
Furosemide+aspirins 6 (5.6%) Salicylates in anti-inflammatory dosage may blunt the diuretic and natriuretic response to loop diuretics
Furosemide+doxycycline 5 (4.7%) Combination may decrease renal function manifested by increase in clotting factor
Digoxin+spironolactone 4 (3.7%) Spironolactone may reduce tubular secretion of digoxin
Warfarin+furosemide 4 (3.7%) Furosemide may displace warfarin from plasma protein binding site
Warfarin+spironolactone 4 (3.7%) Spironolactone may cause dieresis and hemo concentration of clotting factor
SMX+phenytoin 4 (3.7%) SMX may displace phenytoin from serum protein binding site