Brand: Propranolol

Brand: Propranolol

Brand: Quetiapine

Brand: Raloxifene

Brand: Ramipril

Brand: Risperidone

Brand: Rivaroxaban

Brand: Rizatriptan

Brand: Ropinirole

Brand: Rosuvastatin

Brand: Sacubitril/Valsartan

Brand: Sertraline

Brand: Sildenafil

Brand: Sildenafil

Brand: Simvastatin

Brand: Sitagliptin

Brand: Spironolactone

Brand: Spironolactone

Brand: Sucralfate

Class: β-Adrenergic Blocker, Nonselective

Class: Antipsychotic (Atypical)

Class: Selective Estrogen Receptor Modulator

Class: ACEI, Antihypertensive

Class: Benzisoxazole, Antipsychotic

Class: Anticoagulant, Factor Xa inhibitor

Class: Antimigraine, Serotonin Receptor Agonist

Class: Dopamine Agonist

Class: HMG-CoA Reductase Inhibitor

Class: Neprilysin Inhibitor, Angiotensin II Receptor Antagonist

Class: SSRI Antidepressant

Class: Erectile Dysfunction Agent; Pulmonary HTN Agent

Class: Dipeptidyl Peptidase-4 Inhibitor, Antidiabetic

Class: Potassium-Sparing Diuretic; Selective Aldosterone Blocker

Class: Gastrointestinal Agent, Miscellaneous

Dosage: Oral Tablet: 10 mg, 20 mg, 40 mg, 60 mg, 80 mg; Oral Capsule, Extended Release, 24 h: 60 mg, 80 mg, 120 mg, 160 mg; Oral Solution: 4.28 mg/mL, 20 mg/5 mL, 40 mg/5 mL

Dosage: Oral Tablet: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg; Oral Tablet, Extended Release: 50 mg, 150 mg, 200 mg, 300 mg, 400 mg

Dosage: Oral Tablet: 60 mg

Dosage: Oral Capsule: 1.25 mg, 2.5 mg, 5 mg, 10 mg

Dosage: Oral Tablet: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg; Oral Dispersible Tablet: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg; Oral Solution: 1 mg/mL

Dosage: Oral Tablet: 2.5 mg, 10 mg, 15 mg, 20 mg

Dosage: Tablet, Oral: 5 mg, 10 mg; Tablet, Oral, Disintegrating: 5 mg, 10 mg

Dosage: Oral Tablet: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg; Oral Tablet, Extended Release 24 h: 2 mg, 4 mg, 6 mg, 8 mg, 12 mg

Dosage: Oral Tablet: 5 mg, 10 mg, 20 mg, 40 mg; Oral Capsule, Sprinkle: 5 mg, 10 mg, 20 mg, 40 mg

Dosage: Oral Tablet: (Sacubitril/Valsartan) 24 mg/26 mg, 49 mg/51 mg, 97 mg/103 mg

Dosage: Oral Tablet: 25 mg, 50 mg, 100 mg; Oral Concentrate: 20 mg/mL; Oral Capsule: 150 mg, 200 mg

Dosage: Oral Tablet: 20 mg, 25 mg, 50 mg, 100 mg; Oral Suspension: 10 mg/mL

Dosage: Oral Tablet: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg; Oral Suspension: 20 mg/5 mL, 40 mg/5 mL

Dosage: Oral Tablet: 25 mg, 50 mg, 100 mg

Dosage: Oral Tablet: 25 mg, 50 mg, 100 mg; Oral Suspension: 25 mg/5 mL

Dosage: Tablet, Oral: 1 g; Suspension, Oral: 1 g/10 mL

Indication: Angina pectoris, chronic: Immediate release, 80-320 mg po daily in 2-4 doses; extended release, 80-160 mg po daily; Cardiac dysrhythmia: Adults, 10-30 mg po tid-qid; Children, 2-6 mg/kg po in 3-4 doses, max 60 mg/d; HTN: Adults, immediate release, 40 mg po bid, may titrate to 240 mg po daily in 2-3 doses; Adults, extended release, 80 mg po daily, may titrate to 160 mg po daily; Children, immediate release, 0.5-1 mg/kg po daily in 3-4 doses, may titrate to 16 mg/kg/d; Migraine, prophylaxis: Immediate release, 80 mg po daily in divided doses, may titrate to 240 mg po daily; extended release, 80 mg po daily, may titrate to 240 mg po daily

Indication: Bipolar disorder or schizophrenia, therapy initiation: Adults, immediate release, 50 mg po bid × 1 d, increase 50 mg/d × 3 d, may titrate to 800 mg/d; Adults, extended release, 300 mg po HS × 1 d, then 600 mg po HS × 1 d, may titrate to 800 mg/d; Children 10-17 y of age, immediate release, 50 mg po × 1 d, then 100 mg po × 1 d, then 200 mg po × 1 d, then 300 mg po × 1 d, then 400 mg po × 1 d, may titrate to 600 mg/d; Bipolar disorder or schizophrenia, maintenance: Adults, immediate release: 400-800 mg/d po; Adults, extended release, 400-800 mg/d po; Children 10-17 y of age, regular release, titrate to lowest effective dose; Major depressive disorder, adjunct to antidepressants: Adults, extended release, 50 mg po daily HS, may titrate to 300 mg/d;

Indication: Breast cancer, invasive, in postmenopausal women at high risk; prophylaxis: 60 mg po daily; Postmenopausal osteoporosis, prevention or treatment: 60 mg po daily

Indication: Heart failure post-MI: 1.25-2.5 mg po bid × 7 d, may titrate to 5 mg po bid; HTN: 2.5 mg po daily, may titrate to 2.5-20 mg po daily; Reduce risk of myocardial infarction, stroke, and death from cardiovascular causes: 2.5 mg po bid × 7 d, may titrate as tolerated to 10 mg daily

Indication: Autistic disorder, irritability: Children ≥5 y of age and weighing <20 kg, 0.25 mg po daily, titrate to response; Children ≥5 y of age and weighing >20 kg, 0.5 mg po daily, titrate to response; Acute manic or mixed episodes of bipolar I disorder: Adults, 2-3 mg po daily, may titrate to 6 mg/d or 25-50 mg IM every 2 wk; Children ≥10 y of age, 0.5 mg po daily, may titrate to 6 mg/d; Schizophrenia: Adults, 1 mg po bid, may titrate to 18 mg/d or 25-50 mg IM every 2 wk; Children ≥13 y of age, 0.5 mg po daily, may titrate to 6 mg/d;

Indication: Prevention of thromboembolism in patients after orthopedic surgery: 10 mg po daily beginning at least 6 h after surgery × 12-14 d for knee replacement or 35 d for hip replacement; if CrCl 30-50 mL/min no dose adjustment, use with caution; do not use if CrCl <30 mL/min; Prevention of thromboembolism in patients with nonvalvular atrial fibrillation: 20 mg po daily if CrCl >50 mL/min; 15 mg po daily if CrCl 15-50 mL/min; do not use if CrCl <15 mL/min; Treatment and secondary prevention of DVT or pulmonary embolism: Adults, 15 mg po bid × 21 d, then 20 mg po daily; do not use if CrCl <30 mL/min; Children ≥ 2 yo, oral suspension should be used, and dosing is weight based; Coronary artery disease (stable) or peripheral artery disease: 2.5 mg po bid

Indication: Migraine: Adults, 5-10 mg po at onset of migraine, may repeat after 2 h prn; max 30 mg/d; Children ≥6 y and Adolescents, <40 kg, 5 mg po at onset of migraine, multiple doses in a 24-h period not recommended

Indication: Parkinson disease: Immediate release, 0.25 mg po tid × 1 wk, then 0.5 mg po tid × 1 wk, then 0.75 mg po tid × 1 wk, then 1 mg po tid, then may titrate to 24 mg/d; extended release, 2 mg po daily × 1-2 wk, then may titrate to 24 mg/d; Restless legs syndrome: Immediate release only, 0.25 mg po daily HS × 2 d, then 0.5 mg po daily HS × 5 d, then 1 mg po daily × 1 wk, then 1.5 mg po daily HS for 1 wk, then 2 mg po daily HS, then may titrate to 4 mg po daily HS

Indication: Hyperlipidemia, prevention of cardiovascular disease: Adults, 10-20 mg po daily, may titrate to 40 mg po daily; Familial hypercholsterolemia: Adults, 10-20 mg po daily, may titrate to 40 mg po daily; Children ≥7 yo, 5-40 mg po daily, may titrate to 40 mg po daily

Indication: Heart failure with reduced ejection fraction: ____ po bid, may titrate to ____ po bid

Indication: Depression: 50 mg po daily, may titrate to 200 mg/d; OCD: Children 6-12 y of age, 25 mg po daily, may titrate to 200 mg/d; Children 13-17 y of age and Adults, 50 mg po daily, may titrate to 200 mg/d; Panic disorder, PTSD, social phobia disorder: 25 mg po daily for 1 wk, then titrate to 50 mg po daily, may titrate to 200 mg/d; Premenstrual dysphoric disorder: 50 mg po daily continuously or only during luteal phase, may titrate to 100 mg/d

Indication: Erectile dysfunction: 25-100 mg po prn 1 h prior to anticipated sexual activity; Pulmonary HTN (WHO group I): 5-20 mg po tid

Indication: Hyperlipidemia: 20-40 mg po daily in the evening; Primary and secondary preventions of atherosclerotic cardiovascular disease: 20-40 mg po daily in the evening; Secondary prevention of cardiovascular events: 5-40 mg po daily in the evening; Familial hypercholesterolemia (homozygous): Children (boys and postmenarchal girls 10-17 y of age), 10 mg po daily, may titrate to 40 mg po daily in the evening; Adults, 20-40 mg po daily in the evening

Indication: Diabetes mellitus, Type 2: 100 mg po daily

Indication: Heart failure, NYHA class III-IV: 12.5-25 mg po daily, may titrate to max 50 mg; Primary aldoseronism: 12.5-25 mg po daily, may titrate to 400 mg/d; HTN: 50-100 mg po daily in single or divided doses, may titrate to 400 mg/d; Ascites, cirrhosis of liver: 100 mg po daily in single or divided doses, may titrate to 400 mg/d

Indication: Duodenal ulcer: Adults, 1 g po qid × 4-8 wk, then 1 g po bid if maintenance therapy is needed

MOA: ____ is a nonselective β-adrenergic blocker that competitively blocks β1 and β2 receptors, thereby preventing β-adrenergic stimulation. The mechanism of its antihypertensive and antimigraine effects is not completely understood.

MOA: ____ is an antagonist at multiple neurotransmitter receptors in the brain. It antagonizes serotonin 5-HT1A and 5-HT2, dopamine D1 and D2, histamine H1, and adrenergic α1 and α2 receptors. Efficacy in schizophrenia and bipolar disorder is due to the antagonism of a combination of D2 and 5-HT2 receptors.

MOA: ____ is a selective estrogen receptor modulator (SERM) and binds to estrogen receptors, resulting in activation of estrogenic pathways in some tissues (agonism) and blockade of estrogenic pathways in others (antagonism). : ____ appears to act as an estrogen agonist in bone, decreasing bone resorption and bone turnover and increasing BMD.

MOA: ____ is a competitive ACEI. It is also a prodrug for the more potent ACEI ramiprilat. ACEI prevents conversion of angiotensin I to angiotensin II (a vasoconstrictor). It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and inhibits the tissue renin-angiotensin system.

MOA: ____ is a potent serotonin-5-HT2 antagonist with weaker dopamine-D2 antagonism. Whereas typical antipsychotics are dopamine antagonists, the additional serotonin antagonism increases efficacy for negative symptoms of schizophrenia and reduces the likelihood of extrapyramidal symptoms.

MOA: ____ is an orally bioavailable factor Xa inhibitor that selectively blocks the active site of factor Xa and does not require a cofactor (such as antithrombin III) for activity. Activation of factor X to factor Xa via the intrinsic and extrinsic pathways plays a central role in the cascade of blood coagulation.

MOA: ____ binds with high affinity to serotonin (5HT) receptor subtypes 1B and 1D. Serotonin receptor agonists are believed to be effective in migraine either through vasoconstriction (via activation of 5-HT1 receptors located on intracranial blood vessels) or through activation of 5-HT1 receptors on sensory nerve endings in the trigeminal system resulting in the inhibition of proinflammatory neuropeptide release.

MOA: ____ is a nonergoline dopamine agonist that has a higher specificity to D3 than to D2 and D4 subtypes of dopamine receptors. The drug has a moderate affinity for opioid receptors and has insignificant effects on D1, 5-hydroxytryptamine 1 (5-HT1), 5-HT2, benzodiazepine, GABA, muscarinic, α1-, α2-, and β-adrenoreceptors. It is suggested that ropinirole stimulates the postsynaptic D2-type receptor found in the brain’s caudate putamen in Parkinson disease.

MOA: HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol can also decrease because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.

MOA: ____ is a prodrug that inhibits neprilysin through the active metabolite LBQ657, leading to increased levels of peptides, including natriuretic peptides. ___ is a selective, reversible, competitive antagonist of the angiotensin II receptor, which is responsible for the physiologic effects of angiotensin II, including vasoconstriction, aldosterone secretion, sympathetic outflow, and stimulation of renal sodium reabsorption.

MOA: ____ is an SSRI that indirectly results in a downregulation of β-adrenergic receptors. It has no clinically important effect on noradrenergic or histamine receptors and no effect on MAO. It lacks stimulant, cardiovascular, anticholinergic, and convulsant effects.

MOA: Inhibition of phosphodiesterase type 5 : ____ increases the amount of cyclic guanosine monophosphate (GMP) enhancing erectile function and pulmonary vasculature relaxation. Penile erection during sexual stimulation is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic GMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum and vasodilation in the pulmonary bed.

MOA: HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.

MOA: ____ phosphate is a DPP-4 enzyme inhibitor that inhibits the degradation of incretin hormones by DPP-4 and enhances the function of GLP-1 and GIP to increase insulin release and decrease glucagon levels in the circulation in a glucose-dependent manner.

MOA: ____ is a steroidal competitive aldosterone antagonist that acts from the interstitial side of the distal and collecting tubular epithelium to block sodium-potassium exchange, producing a delayed and mild diuresis. The diuretic effect is maximal in states of hyperaldosteronism. Excretion of sodium and chloride excretion is increased; excretion of potassium and magnesium is decreased. ___ has mild antihypertensive activity and has demonstrated a beneficial effect in NYHA classes III and IV heart failure.

MOA: Forms a complex with positively charged proteins that forms a protective coating for local protection of the gastric lining against peptic acid, pepsin, and bile salts.

BBW: Mortality in elderly with dementia, suicidality, not approved for children <10 y of age

BBW: Venous thromboembolism, stroke

BBW: Pregnancy

BBW: Mortality in elderly with dementia

BBW: Premature discontinuation increases thrombotic risk, risk of spinal/epidural hematoma

BBW: Suicidality

BBW: Tumorigenic in animal models

Common: Hypotension

Common: Agitation, headache, HTN, somnolence, weight gain, xerostomia

Common: Hot flashes, arthralgia, flu-like symptoms

Common: None known

Common: Extrapyramidal symptoms, insomnia, anxiety, fatigue, metabolic changes (hyperglycemia, dyslipidemia, weight gain, DM)

Common: Bleeding

Common: None known

Common: Dizziness, dyskinesia, nausea, orthostatic hypotension, somnolence, vomiting, hallucinations

Common: Arthralgia

Common: Hypotension, hyperkalemia, increased SCr

Common: Diarrhea, fatigue, headache, insomnia, nausea

Common: Flushing, nausea, headache, visual disturbances, lack of blue/green color discrimination

Common: None known

Common: Hypoglycemia

Common: None known

Common: None known

Less Common: Bradyarrhythmias, bronchospasm, constipation, dizziness, dyspnea, disorder of glucose regulation, fatigue, headache, heart block, impotence, nausea, pruritus, rash, vomiting, urticaria

Less Common: Abdominal pain, asthenia, anxiety, backache, cataracts, constipation, dizziness, extrapyramidal effects, fatigue, hyperglycemia, hyperlipidemia, hyperprolactinemia, increased appetite, indigestion, insomnia, lethargy, nasal congestion, nausea, orthostatic hypotension, rash, tachycardia, tremor, vomiting

Less Common: Rash, sweating, weight gain, flatulence, nausea, vaginitis, bronchitis

Less Common: Diarrhea, dizziness, dry cough, headache, hypotension, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia, vomiting

Less Common: Abdominal pain, akathisia, GI symptoms (constipation, N/V, diarrhea, dyspepsia), cough, dizziness, hyperprolactinemia, orthostatic hypotension, edema, rash, rhinitis, tachycardia, tremor, xerostomia, dysphagia

Less Common: Peripheral edema, dizziness, headache, fatigue, bruising, pruritus, rash, nausea, vomiting

Less Common: Nausea, asthenia, dizziness, somnolence

Less Common: Abdominal pain, abnormal vision, constipation, edema, fatigue, headache, increased HR, sleep attack, syncope, vomiting, restless leg syndrome augmentation and rebound

Less Common: Abdominal pain, asthenia, constipation, diarrhea, indigestion, headache, increased liver enzymes, influenza-like symptoms, myalgia, nasopharyngitis, nausea, pharyngitis, rhinitis

Less Common: Angioedema, dizziness, orthostatic hypotension, nausea, nephrotoxicity

Less Common: Abdominal pain, anxiety, bleeding, constipation, dizziness, diaphoresis, disorder of ejaculation, indigestion, loss of appetite, rash, reduced libido, somnolence, sweating, tremor, vomiting, weight gain, xerostomia

Less Common: Nasopharyngitis, angina, chest pain, hypotension, retinal hemorrhage

Less Common: Abdominal pain, constipation, diarrhea, headache, increased liver enzymes, myalgia, nausea, rash

Less Common: Headaches, nasopharyngitis, nausea, diarrhea

Less Common: Breast tenderness, diarrhea, disorder of menstruation, gastritis, gynecomastia, headache, hyperkalemia, hyponatremia, impotence, lethargy, nausea, rash, stomach cramps, vomiting, urticaria

Less Common: Constipation

Rare: Heart failure, interstitial nephritis

Rare: Neuroleptic malignant syndrome, neutropenia, pancreatitis, sudden cardiac death, syncope, tardive dyskinesia, slowed or difficult breathing when used in combination with opioids

Rare: Edema, hypertriglyceridemia, venous thromboembolism, cerebrovascular accident, pulmonary embolism

Rare: Angioedema, birth defects, liver failure

Rare: Neuroleptic malignant syndrome, pancreatitis, stroke, pancytopenia, sudden cardiac death, syncope, tardive dyskinesia, priapism, slowed or difficult breathing when used in combination with opioids, seizure, suicidal ideation or behavior

Rare: Syncope, major bleeding, epidural hematoma, anaphylaxis, intracranial bleeding

Rare: Angina, cardiac dysrhythmia, coronary arteriosclerosis, heart block, HTN, acute myocardial infarction, aphasia, cerebral ischemia, stroke, dystonia, hemiplegia, neuropathy, transient ischemic attack, oculogyric crisis

Rare: Sinus node dysfunction, neuroleptic malignancy syndrome, impulse control/compulsive behaviors

Rare: Rhabdomyolysis, tendon rupture

Rare: Rhabdomyolysis

Rare: Serotonin syndrome, suicidal thoughts

Rare: AMI, seizures, strokes, sudden hearing loss, priapism

Rare: Rhabdomyolysis, myopathy, hepatotoxicity, tendon rupture, elevated HgA1c, immune-mediated necrotizing myopathy

Rare: Pancreatitis, hypersensitivity, acute renal failure, Stevens-Johnson syndrome, rhabdomyolysis, severe arthralgias

Rare: Cardiac arrhythmias, gastric hemorrhage

Rare: Bezoar formation, diarrhea, GI distress, hyperglycemia

Counseling: Take immediate-release tablets on an empty stomach; ER can be taken with or without food but administer consistently with respect to food. Avoid alcohol. Avoid abrupt discontinuation; exacerbations of angina may occur. Report signs/symptoms of hypotension, CHF, or exacerbation of angina with initial dosing and dose changes. This medicine may cause dizziness. Diabetic patients should carefully follow blood glucose as beta-blockers may mask symptoms of hypoglycemia.

Counseling: Take with food but avoid alcohol. Avoid activities requiring mental alertness or coordination. Use caution with activities leading to an increased core temperature. Rise slowly from a sitting/supine position. Report signs/symptoms of hyperglycemia, bradycardia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome.

Counseling: ___ increases the risk of blood clots, especially during the first 4 mo of therapy. Avoid sitting for long periods and be aware of the symptoms of DVT. If taking for osteoporosis, consider calcium and vitamin D supplementation.

Counseling: Avoid pregnancy. Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated.

Counseling: Take with food. Avoid alcohol or other CNS depressants. Avoid activities requiring mental alertness or coordination until drug effects are known. Use caution during activities leading to an increased core temperature. Rise slowly from a sitting/supine position. Report signs/symptoms of hyperglycemia, arrhythmia, tardive dyskinesia, or neuroleptic malignant syndrome. Keep dispersible tablet in blister pack until use. Place on tongue and swallow after dissolved. Oral solution may be mixed with water, coffee, orange juice, or low-fat milk but should not be mixed with cola or tea.

Counseling: Educate patient on signs and symptoms of bleeding and interactions with other anticoagulant or antiplatelet medications, including OTC medications. Warn of risks of epidural (spinal) anesthesia while taking ___ . Doses ≥15 mg should be taken with food. If taking for nonvalvular atrial fibrillation, take with evening meal.

Counseling: Avoid alcohol, CNS depressants. Caution with driving and other tasks requiring alertness. Allow disintegrating tablet to dissolve on tongue and then swallow, do not chew.

Counseling: Take with food to reduce nausea. Avoid driving and other activities requiring mental alertness or coordination until drug effects are realized. Rise slowly from sitting/lying-down position. Report new onset or exacerbation of dyskinesia, changes in BP, fainting, or unusual urges. Avoid sudden discontinuation of drug; it increases risk of neuroleptic malignancy syndrome. Do not drink alcohol or take other CNS depressants while using this drug.

Counseling: Do not drink alcohol. ___ does not take the place of diet and exercise to lower cholesterol levels. May be taken without regard for food.

Counseling: Do not discontinue abruptly. Use potassium supplements or salt substitutes only under medical supervision. This medicine may cause dizziness. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Avoid NSAIDs while taking this drug.

Counseling: Avoid activities requiring mental alertness or coordination until drug effects are realized. Symptomatic improvement may not be seen for several weeks. Report worsening depression, suicidal ideation, unusual changes in behavior, or unusual bleeding. Avoid abrupt discontinuation; may precipitate withdrawal symptoms. Do not drink alcohol or use NSAIDs or aspirin while taking this drug.

Counseling: Take 30 min-4 h prior to anticipated sexual activity, but do not take more frequently than once q24h.

Counseling: Avoid excessive alcohol. There are multiple significant drug-drug interactions with ___ . Consult a HCP prior to starting any new medications, including OTC and herbal drugs. ___ does not take the place of lifestyle changes (diet, exercise) to lower cholesterol levels.

Counseling: Monitor blood glucose in frequent intervals (2-4 times/d). Take with morning meal if once-daily dosing. Take with morning and evening meal if twice-a-day dosing. When used in combination with insulin or sulfonylureas, risk of hypoglycemia may be increased.

Counseling: May cause dizziness. Avoid driving, using machinery, or doing anything else that could be dangerous if not alert. Report signs/symptoms of hyperkalemia (muscle weakness, fatigue, bradycardia) and hyponatremia (confusion, dry mouth, thirst, weakness, hypotension, decreased urination). Avoid potassium supplements, foods/salt substitutes that are high in potassium. Avoid alcohol and NSAIDs.

Counseling: Take on an empty stomach and do not take any other medications within 2-4 h of ___ . Shake suspension well before use; suspension can be stored at room temperature.

Pearls: When discontinuing ___ , dosage should be gradually reduced. Avoid in patients with poorly controlled asthma or bronchospasm as beta-blockade may exacerbate symptoms. Consider cardioselective beta-blocker as an alternative. No longer a drug of first choice for hypertension; can be used in patients with inadequate BP control in combination with other antihypertensives.

Pearls: Regular release may be switched to extended release at the equivalent total daily dose taken once daily; individual dosage adjustments may be required. Elderly patients with dementia-related psychosis taking quetiapine are at an increased risk of death compared to placebo. Avoid concomitant use with opioids.

Pearls: ___ and ___ are equivalent in efficacy for preventing breast cancer; however, ___ causes less endometrial hyperplasia, thromboembolic events, and cataracts. Medication guide required at dispensing.

Pearls: Contents of capsule may be mixed with water, apple juice, or apple sauce for administration but do not chew. Dry cough associated with ACEI is typically a class effect; consider switching to an ARB. May require 2-4 wk to reach full treatment effect. Can lead to renal dysfunction and potassium imbalance; recheck SCr and serum potassium 1 wk after initiation.

Pearls: Monitor closely for tardive dyskinesia; movements may become permanent if not treated appropriately. Increases risk of death in elderly patients with dementia-related psychosis. Patients should be initiated on oral ___ and if tolerable can transition to RisperDAL CONSTA (IM injection every 2 wk), also continue oral antipsychotic for 3 wk after first injection, then discontinue. Avoid concomitant use with opioids.

Pearls: Detailed dosing conversion protocols to convert patients from warfarin or parenteral anticoagulants to ___ are available in the product package labeling. Many drug-drug interactions; monitor concurrent drug use carefully. Tablets may be crushed and mixed with apple sauce immediately prior to administration; may mix with water for NG tube administration.

Pearls: Serotonin agonists are not for prophylaxis; only for the treatment of acute migraine headache. Several serotonin agonists (“___ ”) are available for migraine, administered via a variety of routes (oral, inhaled, and injected). Each differs in onset and duration of action. If one agent is ineffective at max dose, recommend changing agents or route.

Pearls: May switch directly from immediate-release ___ to extended release; start an extended-release dose that matches most closely with the total daily immediate-release dose.

Pearls: Lipid-level assessment should be done within 4 wk following dose initiation or titration. May increase risk of diabetes. Given its long half-live may be dosed every other day in patients who have myopathy. In July 2021, the FDA removed the pregnancy contraindication from all statin products. While statin therapy should be discontinued in most patients who become pregnant, this change allows HCPs and patients to make individual decisions about the benefit and risk of treatment, especially for those at very high risk of heart attack or stroke. Statins remain contraindicated in patients who are breastfeeding.

Pearls: ___ are superior to enalapril in reducing all-cause mortality in patients with heart failure. When switching from ACEI to ___ , ___ is started at least 36 h after the last dose of ACEI.

Pearls: If intolerable withdrawal symptoms occur following a decrease in dose or therapy discontinuation, may need to resume the previous dose and taper at a more gradual rate. Oral concentrate must be diluted before administration. Medication guide required at dispensing. For pediatric patients with depression, fluoxetine and escitalopram are FDA approved in children and are preferred over sertraline.

Pearls: The choice between ___ is largely one of patient preferences; ___ would be indicated in those desiring “full-day coverage.” Sexual stimulation is required to initiate the local release of nitric oxide; the inhibition of PDE5 has no effect in the absence of sexual stimulation. Dose-dependent increase in mortality in children using for PAH; use alternative agent if possible. Many antidepressant and antihypertensive agents cause erectile dysfunction; assess and consider discontinuing. Advise patients that lifestyle modifications (stopping smoking, weight loss) can also improve sexual functioning. ___ is brand name for PAH indication. Injectable formulation also available.

Pearls: May increase fasting blood glucose; however, cardiovascular benefits outweigh the risk of dysglycemia. Myopathy is related to both dose and interacting medications. ___ is limited to patients previously maintained on this dose >12 mo without myopathy or interacting medications, for patients newly initiated on treatment, max dose 40 mg. Patients not at LDL goal on 40 mg of simvastatin or requiring high-intensity therapy (eg, LDL >190 mg/dL) should receive alternative therapy. In July 2021, the FDA removed the pregnancy contraindication from all statin products. While statin therapy should be discontinued in most patients who become pregnant, this change allows HCPs and patients to make individual decisions about the benefit and risk of treatment, especially for those at very high risk of heart attack or stroke. Statins remain contraindicated in patients who are breastfeeding.

Pearls: Not for use in children. Metformin is first-line therapy for diabetes mellitus type 2.___ may be used as monotherapy in a patient with contraindications to metformin. Also available in combination dosage form with metformin. Incretin mimetics may increase risk of pancreatitis and pancreatic duct metaplasia. Medication guide must be dispensed with this product.

Pearls: Reduce dose when used in combination with other diuretics. May use a loading dose of 2-3 times the daily dose on the 1st day for faster diuresis. Tablets smell like peppermint … no kidding.

Pearls: Proton pump inhibitors are more effective than sucralfate, therefore ___ is now rarely used for ulcer management, other than in pregnant patients.