SERTRALINE

Trade name: Zoloft (Roerig) Other common trade name: Atruline Indications: Depression, panic disorders, obsessive compulsive disorders Category: Antidepressant; Selective serotonin reuptake inhibitor (SSRI) Half-life: 24-26 hours Clinically important, potentially hazardous interactions with: amphetamines,

clarithromycin, dextroamphetamine, diethylpropion, erythromycin, isocarboxazid, linezolid, MAO inhibitors, mazindol, methamphetamine, metoclopramide, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, pimozide, pseudoephedrine, selegiline, sibutramine, St John’s wort, sumatriptan, sympathomimetics, tranylcypromine, trazodone, troleandomycin

Reactions

Skin Acne (<1%)

Allergic reactions (sic) (1998): Beauquier B+, Encephale (French) 24, 62 (1991): Guthrie SK, Drug Intell Clin Pharm 25, 952 Angioedema (2001): Adson DE+, Ann Pharmacother 35(11), 1375 (1994): Gales BJ+, Am J Hosp Pharm 51, 118 Balanoposthitis (<1%) Bullous eruption (<1%) Dermatitis (sic) (<1%) Diaphoresis (8.4%) (2002): Ahmed A, Am J Geriatr Psychiatry 10(4), 484 (2002): Fisher AA+, Ann Pharmacother 36(1), 67 (2000): Henney JE, JAMA 283, 596 (1991): Guthrie SK, Drug Intell Clin Pharm 25, 952 (1990): Reimherr FW+, J Clin Psychiatry 51,18 (1988): Doogan DP+, J Clin Psychiatry 49, 46 Discoloration (sic) (<1%) Edema (<1%) Erythema Erythema multiforme (<1%) (1994): Gales BJ+, Am J Hosp Pharm 51, 118 Exanthems (<1%)

(2000): Fernandes B+, Contact Dermatitis 42, 287 (2000): Kittay SA, (from Internet) (observation) (1999): Blumenthal HL, Beachwood, OH (personal case) (observation) (1998): Litt JZ, Beachwood, OH (personal case) (observation) Fixed eruption (1997): Sawada KY, Wheat Ridge, CO (from Internet) (observation) Flushing (2.2%) Lupus erythematosus (1998): Hill VA+, J R Army Med Corps 144, 109 Night sweats (2002): Ahmed A, Am J Geriatr Psychiatry 10(4), 484 Periorbital edema (<1%) Photosensitivity (<1%) Pruritus (<1%) (1999): Blumenthal HL, Beachwood, OH (personal case) (observation) Purpura (<1%) Rash (sic) (2.1%) Stevens-Johnson syndrome (1999): Jan V+, Acta Derm Venereol 79, 401 Urticaria (<1%) Xerosis (<1%)

Hair Hair-abnormal texture (sic) (<1%)

Hair-alopecia (<1%) (1996): Bourgeois JA, J Clin Psychopharmacol 16, 91 Hair-hirsutism (<1%)

Other Akathisia

(2002): Walker L, Psychiatr Serv 53(11), 1477 Aphthous stomatitis (<1%) Bromhidrosis (<1%) Bruxism (<1%) Death (2002): Musshoff F+, Arch Kriminol 210(1), 51 (2001): Fartoux-Heymann L+, J Hepatol 35(5), 683 (2001): Gillespie JA, Ann Pharmacother 35(12), 1671 (2001): Hoehns JD+, Ann Pharmacother 35(7), 862 (with clozapine) Dysgeusia Dystonia (2002): Walker L, Psychiatr Serv 53(11), 1477 Foetor ex ore (halitosis) (<1%) Galactorrhea (1993): Bronzo MR+, Am J Psychiatry 150, 1269 Gingival hyperplasia (<1%)

Glossitis (<1%) Gynecomastia (<1%) Headache Hyperesthesia (<1%) Paresthesias (2%) Priapism (1998): Rand EH, J Clin Psychiatry 59, 538 Serotonin syndrome (2002): Fisher AA+, Ann Pharmacother 36(1), 67 (2001): Adson DE+, Ann Pharmacother 35(11), 1375 (2000): Vandermegel X+, Rev Med Brux (French) 21(3), 161 (with metoclopramide) (2000): Voirol P+, J Clin Psychopharmacol 20(6), 713 Sialorrhea (<1%) Stomatitis (<1%) Tinnitus Tongue edema (<1%) Tongue ulceration (<1%) Tremor (1-10%) (2002): No Author, Prescrire Int 11(59), 69 Vaginitis (atrophic) Xerostomia (16.3%) (2000): Brady K+, JAMA 283, 1837 (1992): Berman H+, Hosp Community Psychiatry 43, 671 (1991): Guthrie SK, Drug Intell Clin Pharm 25, 952 (1990): Reimherr FW+, J Clin Psychiatry 51, 18 (1988): Doogan DP+, J Clin Psychiatry 49, 46

Scientific names: Acanthopanax senticosus; Eleutherococcus senticosus Family: Araliaceae Trade and other common names: Ciwuija; Devil’s root; Eleuthero; Ezoukogi;

Medexport; Shigoka; Taiga Wurzel; Touch-me-not Category: Adaptogen; Antidementia; Emmenagogue; Immunoregulator Purported indications and other uses: Alzheimer’s disease, anaphylaxis, arthritis,

colds, depression, fatigue, flu, impotence, infertility, menopause, multiple sclerosis, osteoporosis, perimenopause, PMS, stress

Half-life: N/A Clinically important, potentially hazardous interactions with: antihypertensives,

digoxin

Reactions

Skin None

Other Headache

Mastalgia Note: Eleutherococcus may prevent biotransformation of some drugs to less toxic

compounds

Trade name: Meridia (Abbott) Indications: Obesity Category: Anorexiant; Obesity management Half-life: 1.1 hours Clinically important, potentially hazardous interactions with: dextromethorphan,

dihydroergotamine, ephedra, ergot, fluoxetine, fluvoxamine, isocarboxazid, linezolid, lithium, MAO inhibitors, meperidine, methysergide, naratriptan, nefazodone, paroxetine, phenelzine, rizatriptan, sertraline, sumatriptan, tranylcypromine, tryptophan, venlafaxine, verapamil, zolmitriptan

Reactions

Skin Acne (1.0%)

Allergic reactions (sic) (1.5%) Diaphoresis (2.5%) Ecchymoses (0.7%) Edema (2%) Flu-like syndrome (sic) (1-10%) Herpes simplex (1.3%) Peripheral edema (>1%) Pruritus (>1%) Rash (sic) (3.8%)

Other Death

(2002): London, Reuters Health Information 3-26-02 (2 cases)

Dysgeusia (2.2%) Headache Myalgia (1.9%) Paresthesias (2.0%) Tooth disorder (sic) Vaginal candidiasis (1.2%) Xerostomia (17.2%) (2001): Scheen AJ, Rev Med Liege 56(9), 656

Trade name: Viagra (Pfizer) Indications: Erectile dysfunction Categoty: Phosphodiesterase (type 5) enzyme inhibitor Half-life: 4 hours Clinically important, potentially hazardous interactions with: amprenavir, amyl

nitrite, atazanavir, erythromycin, indinavir, isosorbide dinitrate, isosorbide mononitrate, itraconazole, ketoconazole, nelfinavir, nitrates, nitroglycerin, ritonavir, saquinavir

Reactions

Skin Allergic reactions (sic) (<2%)

Dermatitis (<2%) Diaphoresis (<2%) Edema (<2%) Exfoliative dermatitis (<2%) (2002): Smith JG, Mobile, AL (from Internet) (observation) Facial edema (<2%) Fixed eruption (urticarial) (1998): Reed BR, Denver, CO (from Internet) (observation) Fixed eruption (glans penis) (2002): Panagotacos P, San Francisco, CA (from Internet) (observation) Flushing (10%) (2002): Becher E+, Int J Impot Res 14, S33 (2002): Coelho OR, Int J Impot Res 14, S54 (2002): Fink HA+, Arch Intern Med 162(12), 1349 (12%) (2002): Glina S+, Int J Impot Res 14, S27 (2002): Lim PH+, Ann N Y Acad Sci 962, 378 (2002): Salonia A+, J Urol 168(6), 2486 (with paroxetine) (2001): Chen KK+, Int J Impot Res 13(4), 221 (25%)

(2001): Rosenkranz S+, Dtsch Med Wochenschr 126(41), 1144 (2001): Steers W+, Int J Impot Res 13(5), 261 Genital edema (<2%) Herpes simplex (<2%) Lichenoid eruption (2000): Goldman BD, Cutis 66, 282 Peripheral edema (<2%) Photosensitivity (<2%) Pruritus (<2%) Rash (sic) (2%) Ulcerations (<2%) Urticaria (<2%)

Other Death

(2002): Dumestre-Toulet V+, Forensic Sci Int 126(1), 71 Dyschromatopsia (3%) (blue-green vision) (2002): Coelho OR, Int J Impot Res 14, S54 (2002): Laties A+, Prog Retin Eye Res 21(5), 485 (1998): Craig D+, Cleveland Clinic Foundation 52, 963 (11%) Gingivitis (<2%) Glossitis (<2%) Gynecomastia (<2%) Headache Hyperesthesia (<2%) Myalgia (<2%) Ocular pigmentation (<2%) Paresthesias (<2%) Priapism (2002): Goldmeier D+, BMJ 324(7353), 1555 (2000): Sur RL+, Urology 55, 950 Seizures (2002): Gilad R+, BMJ 325(7369), 869 Stomatitis (<2%) Visual halos (2002): Potter MJ+, Ophthalmology 109(5), 823 Xerostomia (<2%)

Trade name: Zocor (Merck) Other common trade names: Denan; Lipex; Liponorm; Lodales; Simovil; Sivastin;

Zocord Indications: Hypercholesterolemia Category: Antihyperlipidemic (cholesterot-lowering); HMG-CoA reductase inhibitor Half-life: 1.9 hours Clinically important, potentially hazardous interactions with: atazanavir,

azithromycin, bosentan, clarithromycin, cyclosporine, diltiazem, erythromycin, gemfibrozil, imatinib, itraconazole, ritonavir, selenium, tacrolimus, verapamil

Reactions

Skin Actinic dermatitis (sic)

(1998): Granados MT+, Contact Dermatitis 38, 294 Angioedema Ankle edema (1991): Borland Y+, Nephron 57, 365 Cheilitis (1998): Mehregan DR+, Cutis 62, 197 Dermatomyositis (1994): Khattak FH+, Br J Rheumatol 32(2), 199 Diaphoresis (1991): Scott RS+, N Z Med J 104, 493 Eczema (sic) (1995): Proksch E, Hautarzt (German) 46, 76 (1991): Steyn K+, S Afr Med J 79, 639 Eczema (generalized) (1993): Feldmann R+, Dermatology 186, 272 (1993): Krasovec M+, Dermatology 186, 248 Eosinophilic fasciitis (2001): Choquet-Kastylevsky G+, Arch Intern Med 161(11), 1456 Erythema multiforme Erythematous plaques (1993): Feldmann R+, Dermatology 186, 272 Exanthems (1991): McDowell IF+, Br J Clin Pharmacol 31, 340 Flushing Lichen planus (1991): Steyn K+, S Afr Med J 79, 639 Lichenoid eruption (1994): Roger D+, Clin Exp Dermatol 19, 88 Lupus erythematosus (2000): Ahmad A+, Tenn Med 93(1), 21 (1998): Hanson J+, Lancet 352, 1070 (1998): Khosia R+, South Med J 91, 873

(1992): Bannwarth B+, Arch Intern Med 152, 1093 Petechiae (1997): Horiuchi Y+, J Dermatol 24, 549 Photosensitivity (1995): Morimoto K+, Contact Dermatitis 33, 274 (1991): Brocard JJ+, Schweiz Med Wochenschr (German) 121, 977 Pruritus (1993): Feldmann R+, Dermatology 186, 272 (1991): Steyn K+, S Afr Med J 79, 639 Purpura (1998): Koduri PR, Lancet 352, 2020 (1991): Steyn K+, S Afr Med J 79, 639 Pustules Radiation recall (1995): Abadir R+, Clin Oncol R Coll Radiol 7, 325 Rash (sic) (1-10%) (2001): Coverman M, The Schoch Letter 51, 23 (with atorvastatin) (1993): Feldmann R+, Dermatology 186, 272 (1990): Ziegler O+, Cardiology 77(Suppl 4), 50 Rosacea (1991): Brocard JJ+, Schweiz Med Wochenschr (German) 121, 977 Stevens-Johnson syndrome Thrombocytopenic purpura (1998): McCarthy LJ+, Lancet 352, 1284 Toxic epidermal necrolysis Urticaria Vasculitis

Hair Hair-alopecia

(1999): Litt JZ, Beachwood, OH (personal case) (observation) (1998): Robb-Nicholson C, Harv Womens Health Watch 5, 8 (anecdote) (1997): Shelley WB+, Cutis 60, 20 (observation) (1995): Litt JZ, Beachwood, OH (personal case) (observation) (1994): Litt JZ, Beachwood, OH (personal case) (observation)

Other Anaphylactoid reactions

Death (2001): Federman DG+, South Med J 94(10), 1023 Dysgeusia (<1%) (1991): Saito Y+, Arterioscler Thromb 11, 816 Gynecomastia Headache Hypersensitivity Myalgia (1.6%)

(2003): Litt JZ, Beachwood, OH (personal case) (observation) (2003): Olsson AG+, Clin Ther 25(1), 119 (2.4%) (2002): Litt JZ, Beachwood, OH (personal observation) (2002): Sinzinger H, Wien Klin Wochenschr 114(21), 943 (2001): Litt JZ, Beachwood, OH (personal case) (2001): Rehbein H, Jacksonville, FL (from Internet) (observation) (1998): Galper JB, Am J Cardiol 81(2), 259 Myopathy (1-10%) (2002): Hsu WC+, Clin Neuropharmacol 25(5), 266 (with colchicine) (2002): Udawat H+, J Assoc Physicians India 50, 439 (1995): Garnett WR, Am J Health Syst Pharm 52(15), 1639 (1994): al-Jubouri MA+, BMJ 308, 588 (1991): Deslypere JP+, Ann Intern Med 114, 342 (1990): Bilheimer DW, Cardiology 77(Suppl 4), 58 Paresthesias Porphyria cutanea tarda (1994): Perrot JL+, Ann Dermatol Venereol (French) 121, 817 Rhabdomyolysis (2002): Hare CB+, Clin Infect Dis 35(10), 111 (with nelfinavir) (2002): Rhodes CA+, Clin Nucl Med 27(11), 793 (2002): Thompson M+, Am J Psychiatry 159(9), 1607 (with nefazodone) (2001): Borrego FJ+, Nefrologia 21(3), 309 (2001): Federman DG+, South Med J 94(10), 1023 (with gemfibrozil) (2001): Kanathur N+, Tenn Med 94(9), 339 (with diltiazem) (2001): Lee AJ, Ann Pharmacother 35(1), 26 (with clarithromycin) (2001): Peces R+, Nephron 89(1), 117 (with diltiazem) (2001): Reed BR, Denver, CO (from internet) (observation) (2001): Stirling CM+, Nephrol Dial Transplant 16(4), 873 (2000): Al Shohaib, Am J Nephrol 20(3), 212 (2000): Davidson MH, Curr Atherosder Rep 2(1), 14 (2000): Kusus M+, Am J Med Sci 320(6), 394 (with cyclosporine, digoxin and

verapamil) (2000): Oldemeyer JB+, Cardiology 94(2), 127 (with gemfibrozil) (1999): Bottorff M, Atherosclerosis 147(Suppl 1), S23 (1999): Corsini A+, Pharmacol Ther 84, 413 (with either cyclosporine, mibefradil or

nefazodone) (1996): Ballantyne CM+, Am J Cardiol 78(5), 532 (1995): Farmer JA+, Baillieres Clin Endocrinol Metab 9(4), 825 (1995): Garnett WR, Am J Health Syst Pharm 52(15), 1639 (with either cyclosporine,

erythromycin, gemfibrozil or niacin) (1995): Meier C+, Schweiz Med Wochenschr 125(27), 1342 (with cyclosporine) (1992): Blaison G+, Rev Med Interne 13(1), 61 (with cyclosporine) Tendinopathy (2001): Chazerain P+, Joint Bone Spine 68(5), 430