Antibiotic Spectrum 

Anaerobes Gram Negatives Acinetobacter Pseudomonas MRSA Enterococcus ​🌸 Gram Positives

Pip-Tazo Pip-Tazo Doripenem ≤2 Pip-Tazo ≤ 16 Ceftaroline ⭐ Ampicillin ± sulb ≤8 Penicillins

Penicillin Amp-Sulb Meropenem ≤2 Doripenem ≤2 Vancomycin Amoxicillin ± clav Carbapenems

Ampicillin-Sulb Amox-Clav Imipenem ≤2 Meropenem ≤2 Daptomycin Pip/Tazo Fluoroquinolones

Amoxicillin-Clav Cephalosporins Minocycline ≤4 Imipenem ≤2 Doxycycline Imipenem Cephalosporins

Ceftaz/Avibac Aminoglycosides Ampicillin/Sulb ≤ 8/4 Aztreonam ≤8 Minocycline Vancomycin ≤4 Chloramphenicol

Ceftol/Tazo Carbapenems SMX-TMP ≤ 2/38 Ciprofloxacin ≤1 Tigecycline* Linezolid ≤2 Clindamycin

Carbapenems Fluoroquinolones Ciprofloxacin ≤1 Levofloxacin ≤2 Telavancin Tetracyclines ≤4 Tetracyclines

Cefoxitin Macrolides Levofloxacin ≤2 Ceftaz ± Avibac ≤ 8/4 Oritavancin Daptomycin ≤4 Vancomycin

Cefotetan Tetracyclines Colistin, Poly B ≤2 Ceftol/Tazo ≤ 4/4 Linezolid Daptomycin

Chloramphenicol TMP-SMX Tigecycline Cefepime ≤8 TMP-SMX Telavancin

Clindamycin Fosfomycin Gentamicin ≤4 Fosfomycin Oritavancin

Metronidazole Polymyxin B Amikacin ​

≤ 16 Clindamycin* Linezolid

Colistin ESBL GNR Tobramycin ≤4 Rifampin Fosfomycin

⭐Carbapenems Colistin ≤2 TMP-SMX

Ceftaz/Avibac Polymyxin B ≤2 VRE Macrolides

Ceftol/Tazo Linezolid

Aminoglycosides Stenotrophomonas Tetracyclines

Atypicals CRE Tigecycline SMX-TMP ≤ 2/38 Daptomycin

Fluoroquinolones Ceftaz/Avibac Fosfomycin Minocycline ≤4 Nitrofurantoin

Macrolides Colistin Polymyxin B Levofloxacin ≤2 Fosfomycin

Tetracyclines Polymyxin B Colistin Tigecycline Quinupristin/Dalfo

⭐ ​Drug of Choice 
🌸 Enterococci have intrinsic resistance to all cephalosporins 
Enterobacter-cefepime, carbapenems, bactrim, quinolone 
  

Hydrophilic Lipophilic Cmax/MIC AUC/MIC T/MIC No Renal Adjustment

Small Vd Large Vd Dicloxacillin, nafcillin, oxacillin

Renal elimination Hepatic metabolism Ceftriaxone
Increased CL in sepsis IV:PO often = 1 Moxifloxacin
IV:PO ≠ 1 ↑ ​[Intracellular] Azithromycin, erythromycin
Aminoglycosides Vancomycin
Doxycycline, minocycline, tigecycline
Quinolones Macrolides Beta lactams
Quinolones Linezolid, tedizolid
Beta lactams Daptomycin Tetracyclines
Macrolides Quinupristin/dalfopristin
Aminoglycosides colistin
Rifampin Clindamycin
Glycopeptides
Linezolid Metronidazole, tinidazole
Daptomycin
Tetracyclines Rifaximin, rifampin, fidaxomicin
Colistin
Chloramphenicol Chloramphenicol

IV:PO 1:1 Light Protection D5W Only NS Only NS/LR Only No food

Ampicillin (cap/susp)
Levofloxacin, moxifloxacin Dalbavancin Azithromycin ER susp
Doxycycline, minocycline Oritavancin Ceftibuten susp
SMX/TMP Doxycycline Pentamidine Ampicillin Levofloxacin susp
Caspofungin
Linezolid, tedizolid Micafungin Quinupristin/dalfopristin Ampicillin/sulbactam Metronidazole ER
Daptomycin
Metronidazole Pentamidine SMX/TMP Ertapenem Penicillin
Fluconazole, isavuconazole, voriconazole, Ampho B Rifampin, isoniazid
posaconazole (tablets) ​ (​Ambisome, Abelcet) Voriconazole
Itraconazole solution

G6PD (+) Coombs Test Lupus (DILE) False ​↑​aPTT False ​↑​INR False ​↑​Urine Glucose No Refrigeration (IV)

Penicillins
Chloroquine Cephalosporins
Penicillins Acyclovir
Primaquine Imipenem, meropenem Isoniazid Oritavancin
Oritavancin Cephalosporins Metronidazole
Dapsone Nitrofurantoin Minocycline Telavancin
Telavancin Imipenem Moxifloxacin
Nitrofurantoin Rifampin, isoniazid Terbinafine Daptomycin
Isoniazid SMX/TMP
SMX SMX
Quinine

Available PO Seizure SJS/TENS/DRESS Photosensitivity QT Prolongation

Carbapenems (DRESS)
Quinolones (SJS/TENS)
Pen VK, amoxicillin (± clav), ampicillin, dicloxacillin Macrolides Beta lactams
Azithromycin (all) Quinolones
Cefaclor, cefprozil, cefuroxime, cefdinir, cefixime, Tetracyclines Quinolones
Tetracyclines (DRESS) Tetracyclines Quinolones
cefpodoxime, ceftibuten SMX/TMP SMX/TMP
SMX/TMP (SJS/TENS) SMX/TMP Macrolides
Quinolones (except gatifloxacin) Linezolid, tedizolid Linezolid
Vancomycin (SJS/TENS) Tigecycline
Metronidazole, tinidazole Clindamycin Metronidazole
Metronidazole
(SJS/TENS)
 
 1st Generation 2nd Generation 3rd Generation 4th Generation 5th Generation

Cefdinir (Omnicef) PO
Cefixime (Suprax) PO
Cefpodoxime (Vantin) PO
Cefaclor (Ceclor) PO
Ceftriaxone (Rocephin) IV/IM
Cefuroxime (Ceftin, Zinacef) PO/IV/IM
Cefazolin (Ancef, Kefzol) IV/IM Cefotaxime (Claforan) IV/IM
Cefotetan (Cefotan) IV/IM Cefepime ​(Maxipime) IV/IM Ceftaroline (Teflaro) IV
Cephalexin (Keflex) PO
Cefoxitin (Mefoxin) IV/IM
Ceftazidime​ (Fortaz,
Cefprozil (Cefzil) PO IV/IM
Tazicef)
IV
+Avibactam (Avycaz)
IV
Ceftolozane/Tazo (Zerbaxa)

Rocephin + ​pseudomonas​,
Staphylococci, streptococci, HNPEK, Staphylococci, streptococci, HNPEK,
Staphylococci, streptococci, citrobacter, acinetobacter, Rocephin + MRSA
GP anaerobes GP anaerobes
PEK, GP anaerobes providencia, enterobacter, Broadest GP coverage
+ GN anaerobes (B. fragilis) + ​pseudomonas
serratia
HNPEK: Haemophilus, Neisseria, Proteus, E Coli, Klebsiella 
 
 Lab Values & monitoring
Calcium Vitamin D Magnesium Phosphate Potassium Sodium Bicarbonate

ACE/ARB/ARA​,
aliskiren, NSAIDs,
cyclosporine,
Mg-containing tacrolimus​,
Calcium, ​vitamin D, Loop diuretics
↑ laxatives/antacids, Renal failure mycophenolate, Hypertonic saline
thiazide diuretics Steroids
renal impairment drospirenone BCP​,
SMX/TMP, chronic
heparin, ​canagliflozin​,
pentamidine

Steroids, ​chronic PPIs, diuretics​,

Steroids, ​Beta-2 Carbamazepine,
heparin, loop diuretics, Osteoporosis, CVD, amphotericin, Topiramate
Phosphate binders, agonists​, conivaptan, oxcarbazepine, SSRis,
↓ bisphosphonates, DM, HTN, infectious foscarnet, Zonisamide
foscarnet, calcium diuretics, insulin​, diuretics,
cinacalcet​, calcitonin, diseases echinocandins, Salicylate overdose
mycophenolate desmopressin
foscarnet, topiramate diarrhea, chronic EtOH

BUN SCr WBC Neutrophils/Bands Eosinophils Lymphocytes RBC

False:
SMX/TMP, H2RAs
True: ​AG, amphoB, Drug allergy
Steroids ESA
Renal impairment, cisplatin, colistin, Asthma Viral infections
↑ CSF Infection Smoking
dehydration cyclosporine, loop Inflammation Lymphoma
Epinephrine Polycythemia
diuretics, NSAIDs, Parasitic infection
contrast, tacrolimus,
vancomycin

Clozapine, Chemo
carbamazepine​, Low production
Muscle mass, Bone marrow
cephalosporins, Blood loss
↓ amputation, suppression, HIV,
procainamide, B12/folate deficiency
hemodilution steroids
vancomycin, chemo, hemolytic/sickle cell
immunosuppressants anemia

Hbg/Hct MCV Iron Folic Acid Vitamin B12 (+) Coombs Test G6PD

↑ ESA B12/Folate deficiency Supplementation Hemolytic Anemia

Hemolytic Anemia
Fava beans
Phenytoin, Penicillins,
Chloroquine, dapsone,
fosphenytoin, cephalosporins,
PPIs methylene blue,
Anemia phenobarbital, isoniazid, levodopa,
Blood loss Metformin nitrofurantoin,
↓ Bleeding Iron deficiency primidone, methyldopa,
Low intake Colchicine primaquine,
(​Coombs/G6PD​) methotrexate​, nitrofurantoin,
Chloramphenicol probenacid, quinidine,
sulfasalazine, quinidine, quinine,
quinine, rasburicase,
SMX/TMP rifampin, sulfonamides
sulfonamides (SUs)
 PT/INR aPTT/PTT Platelets Albumin Alk Phos AST ALT

↑ Heparins,
Drugs affected:
True: UFH, DTIs fondaparinux, valproic Liver Muscle
False: daptomycin,
False: oritavancin, acid, ​Gp IIb/IIIa Biliary tract Brain Liver
oritavancin, telavancin Warfarin, phenytoin,
↓ telavancin antagonists, linezolid, Bone Liver
valproic acid, calcium
chemo

GGT Ammonia Amylase/Lipase CK/CPK TSH Uric Acid Autoimmune (DILE)

Anti-TNF, hydralazine,
isoniazid, methimazole,
Daptomycin, statins,
Lithium​, Diuretics, niacin, methyldopa,
Valproic acid tenofovir, raltegravir,
↑ Didanosine​, stavudine carbamazepine, pyrazinamide minocycline,
Topiramate dolutegravir,
Liver, biliary tract, GLP-1 agonists oxcarbazepine Cyclosporine, procainamide,
quinupristin/
pancreas Valproic acid tacrolimus, ribavirin, propylthiouracil,
dalfopristin, fibrates,
DPP-4 inhibitors high-dose ASA, quinidine, terbinafine
emtricitabine,
pancreatic enzymes
tipranavir, telbivudine
↑/​↓ ​amiodarone,
↓ Lactulose CRP, RF, ESR, ANA
interferons

Lactic Acid Prolactin

Haloperidol,
NRTIs, metformin​, risperidone,
↑
alcohol, cyanide paliperidone​,
methyldopa

Regulated by
↓
dopamine

Photosensitivity TTP Severe Skin Reactions SJS/TENS DRESS

Carbamazepine Carbamazepine,
St. John’s wort
Diuretics celecoxib,
Sulfa antibiotics Abacavir, isavuconazonium, doxycycline,
(loop/thiazide) Clopidogrel (Key)
Tacrolimus carbamazepine, letrozole, nevirapine, ethosuximide,
Methotrexate Ticlopidine Allopurinol
Tetracycline caspofungin, oseltamivir, fosphenytoin,
Retinoids Lamotrigine
Voriconazole clindamycin, oxcarbazepine, gabapentin,
Quinolones Penicillins clopidogrel, peramivir, ibuprofen,
Phenytoin deferasirox, phenobarbital, quinine, lacosamide,
Others: Acyclovir, Piroxicam ethosuximide, terbinafine, ticlopidine, minocycline,
Others: Amiodarone, antihistamines (1st gen), fosphenytoin, tiagabine, varenicline, oxcarbazepine,
famciclovir, quinine, Sulfamethoxazole
chloroquine, Coal Tar, fluorouracil, griseofulvin, hydroxychloroquine, voriconazole, zonisamide sulfasalazine,
sulfamethoxazole,
NSAIDs, quinidine, tigecycline terbinafine, valproate,
valacyclovir
vancomycin
Drug Interactions

CYP ENZYMES

Inducers PS PORCS
P​henobarbital
Strong ≥ 80 ↓ AUC P​henytoin O​xcarbazepine (eslicarbazepine)
Moderate 50 - 80% ↓ AUC S​moking R​ifampin (rifabutin, rifapentine)
Weak 20 - 50% ↓ AUC C​arbamazepine (autoinducer)
S​t. John’s wort

Inhibitors G PACMAN
P​I’s (+ ritonavir)
Strong ≥ 5-fold ↑ AUC A​zole’s
Moderate ≥ 2-fold ↑ AUC G​rapefruit C​yclosporine, ​Ci​ metidine, ​C​obicistat
Weak ≥ 1.25-fold ↑ AUC M​acrolides (NOT azithromycin)
A​miodarone (dronedarone)
N​on-DHP CCB’s (diltiazem, verapamil)

3A4
Anti-infectives ​(azole’s, clarithromycin, erythromycin, isoniazid)
Substrates CV drugs​ (amiodarone, dronedarone, diltiazem, verapamil, quinidine, ranolazine)
Analgesics HIV Drugs ​(efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, saquinavir)
Anticoagulants Others​ (aprepitant, cimetidine, cyclosporine, fluvoxamine, grapefruit, haloperidol,
Diabetics nefazodone, sertraline)
Antiplatelet
CV drugs
Immunosuppressants
Statins
HIV drugs
PDE-5 inhibitors

P-gp
Apixaban, edoxaban, rivaroxaban, dabigatran, carvedilol, digoxin, ranolazine, cyclosporin, sirolimus, tacrolimus, dasabuvir, paritaprevir, ombitasvir simeprevir, sofosbuvir,
atazanavir, colchicine, dolutegravir, fexofenadine, posaconazole, raltegravir, saxagliptin

Carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampin, St. John’s wort, tipranavir

Anti-infectives (clarithromycin, itraconazole, posaconazole)

CV drugs (amiodarone, dronedarone, carvedilol, conivaptan, diltiazem, quinidine, verapamil)
HIV drugs (cobicistat, ritonavir)
HCV (daclatasvir, ledipasvir, paritaprevir, simeprevir)
Others (cyclosporin, flibanserin, ticagrelor)
 Non-Sterile Compounding
Adsorbents Anti-foaming Antioxidants Buffers Coatings Coloring Diluents

Liquid: water, glycerin,

alcohol
Ascorbic acid
Dry: starches, calcium
Magnesium Ascorbyl palmitate Shellac
Simethicone Potassium phosphate Caramel salts, lactose, sorbitol,
oxide/carbonate Sodium ascorbate/ Gelatin
Dimethicone Sodium acetate/ citrate Ferric oxide mannitol, cellulose,
Kaolin bisulfate/ sulfoxylate/ Gluten
gelatin, bentonite
thiosulfate
Topical: mineral oil,
petrolatum, lanolin

Disintegrants Emollients Enteric-coating Flavoring Gelling, stabilizer Glidant Humectant

Agar
Alginates
Aquaphor Syrups, oils
Alginic acid Guar gums
Aquabase Sucrose
Polacrilin potassium Acacia
Vaseline Cellulose acetate Aspartame Magnesium stearate Glycerin
(Amberlite) Gelatins
Petrolatum phthalate Saccharin Silica Sorbitol
Cellulose products Tragacanth
Polybase shellac Glycerin Propylene glycol
Compressible sugar Bentonite
Eucerin Lactose
(Nu-Tab) Carbomer
Cetaphil Phenylalanine
Cellulose
starches

Hydrophilic solvents Hydrophobic solvents Levigating agents Lubricants Preservatives Suppository bases Surfactants

Oral: parabens, sodium

benzoate, benzoic acid
Magnesium stearate Glyceryl monostearate
Mineral oil Topical/nasal:
PEG Oils: canola, coconut, Calcium Cocoa butter (3.8)
Glycerin chlorhexidine, acids,
Alcohol borage PEG (theobroma), vegetable PEG 400 (11.4)
Glycols alcohols
Terpenes Glycerin oils (palm, coconut), Span 65 (sorbitan
PEG
Lauric acid Fats: Omega 3’s, 6’s Mineral oil PEG, polymers, gelatin tristearate-2.1)
Propylene glycol Ophthalmic: EDTA,
Talc Tween (polysorbate)
sodium benzoate,
benzalkonium chloride,
thimerosal

Continental English Wet

Emulsifiers Emulsion HLB Number
Dry Gum Method Gum Method

Acacia 2 immiscible liquids Gum + Oil Gum + Water

Agar Low: oil soluble
Carbomers Heterogenous Water all at once Oil slowly
Glyceryl monostearate High: water soluble
Pectin Uses emulsifier Triturate until cracking Other ingredients
 PEG sound
Sodium lauryl sulfate 4:2:1 (o:w:e)
Sorbitan (span, tween) Other ingredients
 Oncology
Bleomycin Doxorubicin Cisplatin Vincristine

Pulmonary toxicity Cardiotoxicity Nephrotoxicity Neuropathy

Lifetime cumulative dose: 400 Lifetime cumulative dose: 450-550 Dose/cycle not to exceed: 100 Single dose
units​2 mg/m​2 mg/m​2 capped at: 2 mg

Myelosuppression N/V Mucositis Diarrhea Constipation

Fluorouracil
All except: Cisplatin
Capecitabine Fluorouracil
Asparaginase Doxorubicin Vincristine
Irinotecan Capecitabine
Bleomycin Epirubicin Pomalidomide
Methotrexate Irinotecan
Vincristine Cyclophosphamide Thalidomide
Many TKIs (afatanib, ponatinib, Many TKIs
Most monoclonal ABs,TKIs Ifosfamide
sorafenib, sunitinib)

BM frequency
Monitoring​: CBC w/diff, Temp, s/sx superinfection (oral ulcers
Hydration status Hydration status BM frequency
bleeding, fatigue, SOB HSV, thrush candida)
K+/electrolytes

Management​:
Neurokinin-1 receptor antagonist
Neutropenia: CSFs IV/PO fluid hydration
(NK1-RA) Symptomatic treatment:
Anemia: RBC transfusions, and Antimotility agents (loperamide) Stimulant laxatives
5HT3-RA Mucosal coating agents
ESAs PEG
Dexamethasone Topical local anesthetics
Thrombocytopenia: platelet Irinotecan: atropine
IV/PO fluid hydration
transfusions

Xerostomia Cardiotoxicity Pulmonary Toxicity

QT prolongation
Cardiomyopathy Arsenic trioxide Pulmonary fibrosis
Pneumonitis
Anthracyclines Leuprolide
Methotrexate (chronic)
HER2 inhibitors (ado trastuzumab, Many TKI​ (dasatinib, nilotinib, Bleomycin
Radiation to head/neck Immunotherapy agents
trastuzumab, pertuzumab) vemurafenib, dabrafenib, Busulfan
(atezolizumab, ipilimumab,
Fluorouracil trametinib, crizotinib, ceritinib, Carmustine
nivolumab, pembrolizumab)
Lapatinib erlotinib, gefitinib, lapatinib, Lomustine
sorafenib, sunitinib)

LVEF
O2 Sat, ABGs, Max lifetime dose (bleomycin):
Dry mouth Lifetime cumulative dose/LCD ECG, K/Mg/Ca
Symptoms (SOB, DOE) 400 mg (IU)
(anthracycline)

Symptomatic therapy
Do not exceed LCD for doxorubicin Stop therapy
Artificial saliva substitutes Hold if QTc > 500 ms
Dexrazoxane ppx in select patients Corticosteroids (if an autoimmune mechanism is suspected) for some
Pilocarpine K/Mg/Ca within range
(Doxorubicin) immunotherapy agents
 Hepatotoxicity
Anti-androgens (bicalutamide,
flutamide, nilutamide)
Folate antimetabolites
(methotrexate, pemetrexed,
pralatrexate)
Pyrimidine analogs (cytarabine,
gemcitabine)
Many TKIs
ipilimumab, nivolumab,
pembrolizumab, atezolizumab
LFTs, jaundice, ascites
Symptomatic management
Consider stopping therapy
Corticosteroids (if an autoimmune
mechanism is suspected) for PD1
immunotherapy agents
Nephrotoxicity
Cisplatin
Methotrexate
Pemetrexed, pralatrexate
Carfilzomib
Cyclophosphamide (higher dose, >
Bevacizumab, nivolumab,
pembrolizumab, atezolizumab,
ipilimumab
BUN, SCr, urinalysis, UOP,CrCl
Amifostine (Ethyol) ppx reduces
Mesna (Mesnex) always for ppx to
nephrotoxicity of cisplatin
Do not exceed max dose
Adequate hydration
Hemorrhagic cystitis Neuropathy Thromboembolic
Peripheral Sensory:
Vinca alkaloids, platinums, taxanes,
proteasome inhibitors
Ifosfamide (all doses) (bortezomib, carfilzomib), Aromatase inhibitors (anastrozole,
thalidomide, ado-trastuzumab, letrozole), SERMs (tamoxifen),
cytarabine (higher doses), immunomodulators (thalidomide,
1 g/m​2 brentuximab lenalidomide, pomalidomide)
Autonomic:
Vinca alkaloids
Urinalysis for blood, dysuria Vincristine:​ limiting dose/week to S/sx DVT/PE, stroke, MI
2 mg
Oxaliplatin:​ causes acute
cold-mediated sensory
reduce risk
neuropathy. Avoid cold Consider thromboprophylaxis
temp/beverages
Adequate hydration
Bortezomib:​ SC < IV neuropathy
Diabetes- Stability at Room Temperature
10 days 14 days 21 days 28 days 40 days 56 days

Humalog pens/vials
Novolog pens/vials
Apidra pens/vials
Humulin N pen
Afrezza unopened Lantus pens/vials
Novolog ​MIX​ pen
Humalog ​MIX​ pens Bydureon pens/vials
Soliqua pen Xultophy pen Humulin R U-500 vial
Humulin ​MIX​ pen Humalog ​MIX​ vials
Trulicity pen
Novolog ​MIX​ vial
Adlyxin pen
Humulin R U-500 pen
Tanzeum pen
Basaglar pen

Insulins 30 days 42 days

Humalog Humulin R Humulin N Symlin pen Tresiba pen

Pen 14 days Byetta pen
28 days Vial 31 days Victoza pen
U-100: 31 days
Mix: U-500 pen: 28 days Mix
Novolin R U-100 vial
Pens 10 days U-500 vial: 40 days Pen 10 days 31 days
Novolin N vial
Vials 28 days Vial 31 days
Novolin ​MIX​ vial
Toujeo pen
Novolog Novolin Levemir
Levemir pens/vials
28 days 42 days
Humulin R U-100 vial
Humulin N vial
Mix 42 days
Humulin ​MIX​ vial
Pen 14 days Everything else
Vial 28 days 28 days
 Diabetes-Medications
Insulin Metformin GLP-1 agonist DPP-4 inhibitor SGLT2 inhibitor TZD

Exenatide (Byetta)
-ER (Bydureon)
Glucophage
Liraglutide (Victoza)
Humulin 70/30 mix = Fortamet
weight loss (Saxenda)
70% NPH/30% R Glumetza
Lixisenatide (Adlyxin)
Riomet (liquid)
Albiglutide (Tanzeum)
Dulaglutide (Trulicity)
Sitagliptin (Januvia) Pioglitazone (Actos)
Canagliflozin (Invokana)
Saxagliptin (Onglyza) Rosiglitazone (Avandia)
Empagliflozin (Jardiance)
Linagliptin (Tradjenta)
Dapagliflozin (Farxiga)
Alogliptin (Nesina) MedGuide

BBW: thyroid cancer

Injection site reactions,
pancreatitis, GI disease,
CI eGFR < 30
nausea
B12 deficiency
Trulicity: tachycardia, 1st
ER ghost tablet
degree AV block, PR
prolongation
Exenatide: not for CrCl < 30
Pancreatitis, arthralgia, SJS, BBW (C): ↑ risk leg
nasopharyngitis, URTI, UTI, amputations
edema, rash CI: eGFR < 30, ESRD
Ketoacidosis, genital mycotic
Saxa/alo: risk of HF infections, urosepsis, ↑
Alo: hepatotoxicity Mg/PO4, hypotension, AKI
Saxa: 3A4/p-gp substrate, C: hyperkalemia
limit dose to 2.5 D: bladder cancer
BBW: worsen HF,
↑ risk of MI (R)
CI: Class II/IV HF
Hepatic failure, fractures,
edema, bladder tumors (P),
weight gain

Meglitinide Pramlintide Sulfonylurea Alpha-glucosidase I Bladder Cancer CrCl <30

SGLT2 inhibitors
Glipizide (Glucotrol) Pioglitazone
Repaglinide (Prandin) Acarbose (Precose) Exenatide
Symlin Glimepiride (Amaryl) Dapagliflozin
Nateglinide (Starlix) Miglitol (Glyset) Metformin
Glyburide (Glynase)
Glyburide

BBW: hypoglycemia with

CI: T1DM, DKA, sulfa allergy Take with first bite of each
CI: T1DM, DKA insulin Hepatotoxicity
G6PD, weight gain meal
Weight gain CI: gastroparesis GLP-1 thyroid cancer
XL ghost tablet
URTI N/V/HA, weight loss, TZDs, alogliptin
Take w/ breakfast Inhibits sucrose
anorexia