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Table 4 Most common Beers-listed drug classes, DDIs, and drug classes involved in DDIs

From: Epidemiology and associated factors of polypharmacy in older patients in primary care: a northern Italian cross-sectional study

Beers-listed drug classes [24]

n drugs

% of n = 579 patients

Possible clinical consequences

Benzodiazepines + Zolpidem

114

19.7%

cognitive impairment, delirium, falls/fractures

NSAIDs + COX-2-inhibitors (Coxibe)

38

6.6%

bleeding, nephrotoxicity

Antiarrhythmics

37

6.4%

toxicity, QT alteration

Alpha-blockers

30

5.2%

hypotension

Diuretics + Spironolacton

29

5.0%

↑ potassium

CCBs

26

4.5%

myocardial ischemia, hypotension

Antithrombotic drugs, mainly Ticlopidine

22

3.8%

toxicity, safer alternatives available

Antidepressants and antipsychotics

20

3.5%

anticholinergic effects, cardio-vascular events, hyponatriaemia

Cardiac glycosides

13

2.2%

toxicity, safer alternatives available

Da or Xa drug-drug interactions [26]

n DDIs

% of n = 579 patients

Possible clinical consequences

Acenocoumarol/Warfarin - Allopurinol

32

5.5%

↑ risk of bleeding

Alendronate - Calcium carbonate

29

5.0%

↓ absorption of alendronate

Amlodipine/Lercanidipine - Simvastatin

27

4.7%

myopathy/ rhabdomyolysis

Levothyroxine - Calcium carbonate

26

4.5%

↓ absorption of levothyroxine

Allopurinol – Ramipril/Lisinopril/Enalapril

21

3.6%

allergic reactions to allopurinol

Bisoprolol - Tamsulosin

18

3.1%

hypotension

Acenocoumarol/Warfarin - Acetylsalicylic acid

16

2.8%

↑ risk of bleeding

Ibuprofen/Diclofenac - Acetylsalicylic acid

15

2.6%

↑ risk of bleeding

Acetylsalicylic acid - Etoricoxib

12

2.1%

↑ toxicity of etoricoxib, bleeding

Clopidogrel - Pantoprazole

11

1.9%

↓ effectiveness of clopidogrel

Bisoprolol - Doxazosin

9

1.6%

hypotension

Ibuprofen - Warfarin

9

1.6%

↑ risk of bleeding

Ibuprofen - Furosemide

8

1.4%

nephrotoxicity

Prednison - Calcium carbonate

7

1.2%

↓ absorption of prednison

Drug classes involved in Da or Xa DDIs

n DDIs

% of n = 579 patients

 

Antithrombotic / anticoagulant drugs

176

30.4%

 

Antidepressants / antipsychotics

134

23.1%

 

Calcium carbonate

77

13.3%

 

Beta-blockers

74

12.8%

 

Alpha-blockers

72

12.4%

 

Statins

64

11.1%

 

NSAIDs + COX-2-inhibitors (Coxibe)

62

10.7%

 

ARBs/ACE-inhibitors

61

10.5%

 

CCBs

54

9.3%

 

Drugs for gout treatment-Allopurinol

48

8.3%

 
  1. NSAIDs Non-steroidal anti-inflammatory drugs, COX Cyclooxygenase, CCBs Calcium channel blockers, DDIs Drug-drug interactions, ARBs Angiotensin II receptor antagonists, ACE Angiotensin converting enzyme
  2. a Drug-drug interactions: category D = consider drug modification, category X = avoid combination [26]
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BMC Geriatrics

ISSN: 1471-2318

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