Table 3 Adverse drug reactions caused by actual drug-drug interactions and management of the toxicities

Hypoglycemia

Linezolid-Insulin

C-Moderate

Moderate

5

3, 3, 4, 4, 4

6.2 ± 0.75

Adjust insulin/hypoglycemic agent dose, and monitor blood glucose

Levofloxacin-Hypoglycemic agent

C-Moderate

Major

4

3, 3, 5, 5

4.25 ± 0.83

Nephrotoxicity

Cefoperazone-Furosemide

C-Moderate

Major

4

4, 5, 5, 6

6 ± 1.58

Adjust dose of cephalosporins, monitor renal function

Vancomycin-Loop Diuretics

C-Moderate

None

3

5, 6, 7

3.67 ± 0.47

Discontinue vancomycin or

Change it to linezolid

Vancomycin-Piperacillin/Tazobactam

C-Moderate

Major

3

4, 6, 7

5.67 ± 2.05

Levofloxacin-NSAIDs^*

C-Major

Moderate

1

6

6

Change quinolones to other antibiotics

Amikacin-Vancomycin

D-Moderate

Major

1

8

4

Change vancomycin or

amikacin to other antibiotics

Amikacin-Torsemide

C-Moderate

Moderate

1

6

5

Amikacin-Furosemide

C-Moderate

Moderate

2

7, 7

5.5 ± 0.5

Hypertension

Linezolid-Dopamine

D-Major

Contraindicated

2

5, 5

7.5 ± 0.5

Add antihypertensive drugs and monitor blood pressure

Linezolid-Noradrenaline

D-Moderate

Major

2

5, 5

4.5 ± 0.5

Linezolid-Aminophylline

D-Moderate

none

2

2, 3

6.5 ± 0.5

Linezolid-Metoclopramide

X-Moderate

None

1

2

6

Linezolid-Epinephrine

None

Contraindicated

2

3, 4

4.5 ± 0.5

QT prolongation

Linezolid-Ondansetron

C-Moderate

Major

3

3, 4, 4

5.33 ± 1.25

Monitor clinical symptoms and change or discontinue related medications as needed

Levofloxacin-Ondansetron

C-Moderate

Major

3

3, 4, 4

4.33 ± 1.25

Fluconazole-Amiodarone

D-Major

Contraindicated

2

6, 6

7 ± 1

Fluconazole-Ondansetron

None

Contraindicated

2

3, 4

7 ± 2

Levofloxacin-Famotidine

None

Major

2

5, 6

8.5 ± 1.5

Levofloxacin-Amiodarone

X-Major

None

1

7

4

Voriconazole-Propofol

C-Moderate

None

1

6

7

Metronidazole-Famotidine

None

Major

1

4

6

Bleeding

Cefoperazone-Heparin

None

Major

4

3, 3, 3, 4

4 ± 1.22

Adjust the dose of anticoagulant drugs to monitor coagulation function and bleeding

Fluconazole-Rivaroxaban

C-Major

Moderate

1

5

11

Cardiac arrhythmias

Metronidazole-Dexmedetomidine

None

Major

1

5

9

Discontinue metronidazole

Angina

Fluconazole-Clopidogrel

D-Major

Major

1

3

6

Change fluconazole to voriconazole

Nausea, vomiting

Ciprofloxacin-Aminophylline

D-Major

None

3

5, 6, 6

5.67 ± 1.25

Add antiemetics

Imipenem-Theophylline

None

Major

1

4

3

Seizures

Voriconazole-Tramadol

C-Moderate

Major

1

3

5

Change tramadol to flurbiprofen

Serotonin syndrome

Linezolid-Morphine

X-Moderate

None

1

6

4

Change linezolid to vancomycin

Respiratory depression

Voriconazole-Sufentanil

C-Moderate

Major

1

3

3

Discontinue sufentanil