UofL Health Care Outpatient Center
401 E. Chestnut St., Ste 170
Louisville, KY 40202
Tel: 502.588.4271
Fax: 502.588.4280
UofL Geriatrics Link
Drug Alerts
Medication Alerts
Actos® (Pioglitazone)
Celexa® (Citalopram)
Zocor® (Simvastatin)
Birth Control Pills
(Containing Drospirenone)

Actos® (pioglitazone) and Avandia® (rosiglitazone):
A recent systemic review and meta-analysis of observational studies found that Avandia® is associated with significantly higher odds of congestive heart failure, myocardial infarction (heart attack) and death relative to pioglitazone in real world settings. Both medications have been associated with increased risk of worsening congestive heart failure.

Citalopram:
Citalopram should not be used at doses over 40mg daily. Doses of citatlopram over 40mg have been associated with increased risk of fatal heart problems related to the electrical activity of the heart. The maximum recommended dose of citatlopram is 20mg for people over 60 years of age and people taking other medications, which inhibit CYP2C19 metabolic pathway such as cimetidine (Tagamet®) or are genetically slow CYP2C19 metabolizers.
Celexa, Citalopram

Read more here about the FDAs warning; linking heart problems to high doses of Celexa®.



Simvastatin:
The 80mg dose should be sharply curtailed because of the risk of muscle injury. This dosage should only be used by those who have taken it for 12 months or longer without experiencing ill effects. When simvastatin is taken with some medications, the dose of simvastatin should be restricted. Do not exceed 10 mg simvastatin daily with:
  • Amiodarone
  • Verapamil
  • Diltiazem
Do not exceed 20 mg simvastatin daily with:
  • Amlodipine (New)
  • Ranolazine (New)
Common drugs contraindicated with simvastatin:
  • Erythromycin
  • Clarithromycin
  • HIV protease inhibitors
  • Cyclosporine
*Avoid large quantities of grapefruit juice.
Zocor, Simvastatin

Read more here about the FDAs warning; linking muscle damage to Zocor®, especially in women.



Birth Control Pills containing Drospirenone:
FDA Drug Safety Communication: Updated information about the risk of blood clots in women taking birth control pills containing drospirenone. Based on this review, FDA has concluded that drospirenone-containing birth control pills may be associated with a higher risk for blood clots than other progestin-containing pills.
Birth Control Pills Containing Drospirenone

Read more here about the FDAs warning; regarding birth control pills containing drospirenone, such as Yaz® and Yasmin®.
The information provided in this website is aimed at helping people become empowered through knowledge to help protect themselves from medication related harm. You should consult with your physicians before making any changes to your prescription regimen, including herbal, supplement and over the counter products recommended by your physician(s). Increased awareness about the medications and products you are taking will help you have an effective problem solving discussion with your physician(s) and care managers.
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