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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]