|
Cardiovascular system
|
|
Loop diuretic as first line-monotherapy for hypertension (safer, more effective alternatives available)
|
9
|
0.26
|
0.55
|
|
Thiazide diuretic with a history of gout (may exacerbate gout)
|
3
|
0.09
|
3.80
|
|
Beta-blocker with COPD (risk of increased bronchospasm)
|
31
|
0.90
|
18.02
|
|
Beta-blocker with verapamil (risk of symptomatic heart block)
|
4
|
0.12
|
0.52
|
|
Aspirin and warfarin without histamine H2 receptor antagonist (except cimetidine) or proton pump inhibitor (high risk of gastrointestinal bleeding)
|
13
|
0.38
|
1.00
|
|
Dipyridamole as monotherapy for cardiovascular secondary prevention (no evidence of efficacy)
|
5
|
0.14
|
0.20
|
|
Aspirin with a past history of peptic ulcer disease without histamine H2 receptor antagonist or Proton Pump Inhibitor (risk of bleeding)
|
38
|
1.10
|
16.38
|
|
Aspirin with no history of coronary, cerebral, or peripheral vascular symptoms or occlusive event (not indicated)
|
112
|
3.24
|
12.50
|
|
Central nervous system and psychotropic drugs
|
|
TCA and glaucoma (exacerbate glaucoma)
|
3
|
0.09
|
2.36
|
|
TCA and opiate or calcium channel blockers (risk of severe constipation)
|
16
|
0.46
|
2.36
|
|
Phenothiazines in patients with epilepsy (may lower seizure threshold)
|
3
|
0.09
|
2.46
|
|
Anticholinergics to treat extra-pyramidal side-effects of neuroleptic medications (risk of anticholinergic toxicity)
|
3
|
0.09
|
6.82
|
|
Gastrointestinal system
|
|
Prochlorperazine or metoclopramide with parkinsonism (risk of exacerbating parkinsonism)
|
1
|
0.03
|
3.23
|
|
Respiratory system
|
|
Theophylline as monotherapy for COPD (safer, more effective alternative: risk of adverse effects due to narrow therapeutic index)
|
11
|
0.32
|
6.40
|
|
Nebulised ipratropium with glaucoma (exacerbate glaucoma)
|
0
|
–
|
–
|
|
Musculoskeletal system
|
|
NSAID with history of peptic ulcer disease or gastrointestinal bleeding, unless with concurrent histamine H2 receptor antagonist, PPI or misoprostol (risk of peptic ulcer relapse)
|
10
|
0.29
|
4.31
|
|
NSAID with moderate-severe hypertension (moderate: 160/100–179/109 mmHg; severe: ≥180/110 mmHg) (risk of exacerbation of hypertension)
|
200
|
5.79
|
10.92
|
|
NSAID with heart failure (risk of exacerbation of heart failure)
|
5
|
0.14
|
9.26
|
|
Warfarin and NSAID (risk of gastrointestinal bleeding)
|
8
|
0.23
|
1.57
|
|
Urogenital system
|
|
Antimuscarinic drugs with chronic glaucoma (>3 months) (risk of acute exacerbation of glaucoma)
b
|
5
|
0.15
|
3.94
|
|
Alpha-blockers in males with frequent incontinence i.e., one or more episodes of incontinence daily (risk of urinary frequency and worsening of incontinence)
c
|
9
|
0.55
|
8.18
|
|
Endocrine system
|
|
Glibenclamide or chlorpropamide with type 2 diabetes mellitus (risk of prolonged hypoglycemia)
|
3
|
0.09
|
0.82
|
|
Drugs that adversely affect those prone to falls (≥ 1 fall in past 3 months)
|
|
Benzodiazepines (sedative, may cause reduced sensorium, impair balance)
d
|
40
|
1.16
|
14.55
|
|
Neuroleptic drugs (may cause gait dyspraxia, Parkinsonism)
d
|
6
|
0.17
|
2.18
|
|
First generation antihistamines (sedative, may impair sensorium)
d
|
1
|
0.03
|
0.36
|
|
Duplicate drug class prescription (optimization of monotherapy within a single drug class)
|
|
Two concurrent opiates
|
3
|
0.09
|
2.26
|
|
Two concurrent NSAIDs
|
21
|
0.61
|
5.97
|
|
Two concurrent SSRIs
|
0
|
–
|
–
|
|
Two concurrent antidepressants
|
2
|
0.06
|
3.03
|
|
Two concurrent loop diuretics
|
0
|
–
|
–
|
|
Two concurrent ACE inhibitors
|
23
|
0.67
|
2.28
|