Key Drug Interactions

Supportive Care & Reference · ICU Decoded chapter 90 · Free in full

Cited to Reference.

Key points

Anchor on CYP450: rifampicin induces and kills warfarin, OCP, and DOAC efficacy, while azoles, macrolides, and amiodarone inhibit.
QT stacks (macrolides + fluoroquinolones + antipsychotics + ondansetron) mean check QTc.
Serotonin risk: linezolid/tramadol + SSRIs; bleeding stacks: anticoagulant + antiplatelet + NSAID.
Adjust renally cleared drugs on CRRT and get a daily pharmacist review.
DOACs interact strongly with CYP3A4/P-gp inhibitors and inducers (azoles, rifampicin, amiodarone) — check before combining.

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