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Table 3 Most frequently identified interactions, their levels and potential adverse outcomes

From: Potential drug-drug interactions in outpatient department of a tertiary care hospital in Pakistan: a cross-sectional study

Interacting Pair Severity levels Documentation levels Patients: n (%a) Potential adverse outcomes
Ibuprofen – Levofloxacin Moderate Fair 50 (2) Seizures
Ciprofloxacin – Diclofenac Moderate Excellent 32 (1.3) Increased ciprofloxacin plasma concentrations
Aspirinb – Atenolol Moderate Good 24 (1) Decreased antihypertensive effect
Diclofenac – Levofloxacin Moderate Fair 19 (0.8) Seizures
Diclofenac – Metronidazole Moderate Fair 17 (0.7) Increased exposure of diclofenac
Aspirinc – Clopidogrel Moderate Fair 16 (0.7) Bleeding
Ciprofloxacin – Metronidazole Major Fair 14 (0.6) QT-interval prolongation
Amlodipine – Diclofenac Moderate Good 14 (0.6) Gastrointestinal hemorrhage and/or antagonism of hypotensive effect
Levofloxacin – Prednisolone Moderate Excellent 13 (0.5) Tendon rupture
Atorvastatin – Clopidogrel Moderate Excellent 13 (0.5) Increased platelet reactivity
Aspirinb – Glimepiride Moderate Good 13 (0.5) Hypoglycemia
Glimepiride – Levofloxacin Major Fair 12 (0.5) Hypoglycemia or hyperglycemia
Aspirinc – Bisoprolol Moderate Good 12 (0.5) Decreased antihypertensive effect
Levofloxacin – Thioridazine Contraindicated Fair 12 (0.5) QT interval prolongation
Aminophylline – Levofloxacin Major Fair 12 (0.5) Theophylline toxicity (nausea, vomiting, palpitations, seizures)
  1. -aPercentage was calculated out of 2400, i.e., total number of patient’s prescriptions
  2. -bAspirin was prescribed as analgesic doses
  3. -cAspirin was prescribed as antiplatelet doses