Key Pharmacological Details for Common Medications
1. Diabeta/Glynase (Glyburide)
Brand and generic name: Diabeta/Glynase (glyburide) Dosage forms: Oral tablets Pharmacologic category: Sulfonylurea FDA-approved indications: Type 2 diabetes mellitus Dosage and frequency: Initial 2.5-5 mg daily, max 20 mg daily Mechanism of action: Stimulates insulin secretion from pancreatic β-cells by binding to ATP-sensitive potassium channels 1 Contraindications: Type 1 diabetes, diabetic ketoacidosis, severe renal/hepatic impairment Adverse effects: Hypoglycemia, weight gain, lack of durable effect on glucose lowering 1 Drug interactions: Increased hypoglycemia risk with other hypoglycemic agents, certain antibiotics, and salicylates Patient counseling points: Take with meals, recognize/treat hypoglycemia, regular blood glucose monitoring
2. Lopressor/Toprol XL (Metoprolol)
Brand and generic name: Lopressor/Toprol XL (metoprolol) Dosage forms: Immediate-release and extended-release tablets Pharmacologic category: Selective β1-adrenergic blocker FDA-approved indications: Hypertension, angina pectoris, heart failure, post-MI Dosage and frequency: 25-100 mg daily or twice daily (immediate-release); 25-400 mg once daily (extended-release) Mechanism of action: Selectively blocks β1-adrenergic receptors, decreasing heart rate and contractility 1 Contraindications: Severe bradycardia, heart block greater than first degree, cardiogenic shock, decompensated heart failure Adverse effects: Bradycardia, fatigue, dizziness, erectile dysfunction (often psychological rather than pharmacological) 2 Drug interactions: Severe bradycardia with CYP2D6 inhibitors like paroxetine, fluoxetine, and bupropion 3 Patient counseling points: Don't stop abruptly, monitor heart rate/BP, may cause fatigue
3. Androgel/Androderm (Testosterone)
Brand and generic name: Androgel/Androderm (testosterone) Dosage forms: Topical gel, transdermal patch Pharmacologic category: Androgen FDA-approved indications: Testosterone replacement in male hypogonadism Dosage and frequency: Gel: 50-100 mg applied daily; Patch: 2-6 mg applied nightly Mechanism of action: Exogenous testosterone replacement Contraindications: Male breast or prostate cancer, pregnancy, breastfeeding Adverse effects: Acne, application site reactions, increased hematocrit, prostate enlargement Drug interactions: May enhance effects of oral anticoagulants Patient counseling points: Apply to clean, dry skin; avoid skin-to-skin contact with women/children after application
4. BuSpar (Buspirone)
Brand and generic name: BuSpar (buspirone) Dosage forms: Oral tablets Pharmacologic category: Anxiolytic FDA-approved indications: Management of anxiety disorders Dosage and frequency: 7.5-30 mg daily in divided doses Mechanism of action: Partial agonist at serotonin 5-HT1A receptors Contraindications: Concomitant use with MAOIs Adverse effects: Dizziness, headache, nausea, nervousness Drug interactions: Increased levels with CYP3A4 inhibitors Patient counseling points: May take 1-2 weeks for effect, take consistently with or without food
5. Glucophage (Metformin)
Brand and generic name: Glucophage (metformin) Dosage forms: Immediate-release and extended-release tablets Pharmacologic category: Biguanide FDA-approved indications: Type 2 diabetes mellitus Dosage and frequency: Initial 500 mg twice daily or 850 mg once daily, max 2550 mg daily Mechanism of action: Decreases hepatic glucose production, increases peripheral glucose uptake 1 Contraindications: eGFR <30 mL/min/1.73 m² 1 Adverse effects: GI intolerance, vitamin B12 deficiency 1 Drug interactions: Increased risk of lactic acidosis with iodinated contrast agents Patient counseling points: Take with meals to reduce GI effects, monitor vitamin B12 levels periodically
6. Tenormin/Tenoretic (Atenolol/Atenolol-chlorthalidone)
Brand and generic name: Tenormin (atenolol); Tenoretic (atenolol-chlorthalidone) Dosage forms: Oral tablets Pharmacologic category: Selective β1-adrenergic blocker; combination with thiazide-like diuretic FDA-approved indications: Hypertension, angina pectoris Dosage and frequency: 25-100 mg once daily Mechanism of action: Selectively blocks β1-adrenergic receptors; chlorthalidone inhibits sodium reabsorption 1 Contraindications: Severe bradycardia, heart block greater than first degree, cardiogenic shock Adverse effects: Fatigue, bradycardia, erectile dysfunction Drug interactions: Additive hypotensive effects with other antihypertensives Patient counseling points: Don't stop abruptly, monitor heart rate/BP
7. Cialis (Tadalafil)
Brand and generic name: Cialis (tadalafil) Dosage forms: Oral tablets Pharmacologic category: Phosphodiesterase-5 (PDE-5) inhibitor FDA-approved indications: Erectile dysfunction, benign prostatic hyperplasia, pulmonary arterial hypertension Dosage and frequency: 2.5-20 mg as needed or daily Mechanism of action: Inhibits PDE-5, increasing cGMP in corpus cavernosum, enhancing erectile function Contraindications: Concomitant use of nitrates, uncontrolled hypertension/hypotension Adverse effects: Headache, dyspepsia, back pain, myalgia, flushing Drug interactions: Severe hypotension with nitrates; additive but not potentiating effects with antihypertensives 4 Patient counseling points: May take 30 minutes before sexual activity or daily; avoid with nitrates
8. Ativan (Lorazepam)
Brand and generic name: Ativan (lorazepam) Dosage forms: Oral tablets, injection Pharmacologic category: Benzodiazepine FDA-approved indications: Anxiety disorders, insomnia, status epilepticus (injection) Dosage and frequency: 1-10 mg daily in divided doses Mechanism of action: Enhances GABA effects at GABA-A receptors Contraindications: Acute narrow-angle glaucoma, severe respiratory insufficiency Adverse effects: Sedation, dizziness, weakness, unsteadiness Drug interactions: Enhanced CNS depression with alcohol, opioids, other CNS depressants Patient counseling points: Avoid alcohol, may cause dependence, don't stop abruptly
9. Januvia (Sitagliptin)
Brand and generic name: Januvia (sitagliptin) Dosage forms: Oral tablets Pharmacologic category: DPP-4 inhibitor FDA-approved indications: Type 2 diabetes mellitus Dosage and frequency: 100 mg once daily Mechanism of action: Inhibits DPP-4 enzyme, increasing incretin levels, stimulating insulin release and decreasing glucagon secretion 1 Contraindications: History of serious hypersensitivity to sitagliptin Adverse effects: Upper respiratory tract infection, headache, rare pancreatitis 1 Drug interactions: Minimal; dose adjustment needed with renal impairment Patient counseling points: Can be taken with or without food, report unusual symptoms
10. Zebeta/Ziac (Bisoprolol/Bisoprolol-hydrochlorothiazide)
Brand and generic name: Zebeta (bisoprolol); Ziac (bisoprolol-hydrochlorothiazide) Dosage forms: Oral tablets Pharmacologic category: Selective β1-adrenergic blocker; combination with thiazide diuretic FDA-approved indications: Hypertension Dosage and frequency: 2.5-20 mg once daily Mechanism of action: Selectively blocks β1-adrenergic receptors; hydrochlorothiazide inhibits sodium reabsorption 1 Contraindications: Severe bradycardia, heart block greater than first degree, cardiogenic shock Adverse effects: Fatigue, dizziness, bradycardia Drug interactions: Additive hypotensive effects with other antihypertensives Patient counseling points: Don't stop abruptly, monitor heart rate/BP
11. Viagra (Sildenafil)
Brand and generic name: Viagra (sildenafil) Dosage forms: Oral tablets Pharmacologic category: Phosphodiesterase-5 (PDE-5) inhibitor FDA-approved indications: Erectile dysfunction, pulmonary arterial hypertension Dosage and frequency: 25-100 mg as needed Mechanism of action: Inhibits PDE-5, increasing cGMP in corpus cavernosum, enhancing erectile function Contraindications: Concomitant use of nitrates, uncontrolled hypertension/hypotension Adverse effects: Headache, flushing, dyspepsia, visual disturbances Drug interactions: Severe hypotension with nitrates; additive but not potentiating effects with antihypertensives 4 Patient counseling points: Take 30-60 minutes before sexual activity; avoid with nitrates
12. Klonopin (Clonazepam)
Brand and generic name: Klonopin (clonazepam) Dosage forms: Oral tablets, orally disintegrating tablets Pharmacologic category: Benzodiazepine FDA-approved indications: Seizure disorders, panic disorder Dosage and frequency: 0.5-20 mg daily in divided doses Mechanism of action: Enhances GABA effects at GABA-A receptors Contraindications: Significant liver disease, acute narrow-angle glaucoma Adverse effects: Sedation, dizziness, cognitive impairment, ataxia Drug interactions: Enhanced CNS depression with alcohol, opioids, other CNS depressants Patient counseling points: Avoid alcohol, may cause dependence, don't stop abruptly
13. Onglyza (Saxagliptin)
Brand and generic name: Onglyza (saxagliptin) Dosage forms: Oral tablets Pharmacologic category: DPP-4 inhibitor FDA-approved indications: Type 2 diabetes mellitus Dosage and frequency: 2.5-5 mg once daily Mechanism of action: Inhibits DPP-4 enzyme, increasing incretin levels, stimulating insulin release and decreasing glucagon secretion 1 Contraindications: History of serious hypersensitivity to saxagliptin Adverse effects: Upper respiratory tract infection, urinary tract infection, possible increased risk of heart failure hospitalization 1 Drug interactions: Dose reduction with strong CYP3A4/5 inhibitors Patient counseling points: Can be taken with or without food, report unusual symptoms
14. Chlorthalidone
Brand and generic name: Generic only (chlorthalidone) Dosage forms: Oral tablets Pharmacologic category: Thiazide-like diuretic FDA-approved indications: Hypertension, edema Dosage and frequency: 12.5-25 mg once daily Mechanism of action: Inhibits sodium reabsorption in distal renal tubule 1 Contraindications: Anuria, sulfonamide hypersensitivity Adverse effects: Electrolyte imbalances, hyperuricemia, hyperglycemia 1 Drug interactions: Enhanced effects of other antihypertensives, decreased lithium excretion Patient counseling points: Take in morning to avoid nocturia, monitor electrolytes
15. Estrace (Estradiol)
Brand and generic name: Estrace (estradiol) Dosage forms: Oral tablets, vaginal cream Pharmacologic category: Estrogen FDA-approved indications: Menopausal symptoms, vulvar/vaginal atrophy, osteoporosis prevention Dosage and frequency: 0.5-2 mg daily Mechanism of action: Binds to estrogen receptors, replacing depleted endogenous estrogen Contraindications: Breast cancer, estrogen-dependent neoplasia, undiagnosed abnormal genital bleeding, thromboembolism Adverse effects: Nausea, breast tenderness, headache, increased risk of endometrial cancer, thromboembolism Drug interactions: Decreased effectiveness with CYP3A4 inducers Patient counseling points: Use lowest effective dose for shortest duration, report unusual bleeding
16. Xanax (Alprazolam)
Brand and generic name: Xanax (alprazolam) Dosage forms: Oral tablets, extended-release tablets, orally disintegrating tablets Pharmacologic category: Benzodiazepine FDA-approved indications: Anxiety disorders, panic disorder Dosage and frequency: 0.25-4 mg daily in divided doses Mechanism of action: Enhances GABA effects at GABA-A receptors Contraindications: Acute narrow-angle glaucoma, concomitant use with ketoconazole or itraconazole Adverse effects: Sedation, dizziness, cognitive impairment, dependence Drug interactions: Enhanced effects with CYP3A4 inhibitors, enhanced CNS depression with alcohol Patient counseling points: Avoid alcohol, may cause dependence, don't stop abruptly
17. Tradjenta (Linagliptin)
Brand and generic name: Tradjenta (linagliptin) Dosage forms: Oral tablets Pharmacologic category: DPP-4 inhibitor FDA-approved indications: Type 2 diabetes mellitus Dosage and frequency: 5 mg once daily Mechanism of action: Inhibits DPP-4 enzyme, increasing incretin levels, stimulating insulin release and decreasing glucagon secretion 1 Contraindications: History of serious hypersensitivity to linagliptin Adverse effects: Nasopharyngitis, hypoglycemia (when used with sulfonylureas) Drug interactions: Minimal; no dose adjustment needed with renal impairment 1 Patient counseling points: Can be taken with or without food, report unusual symptoms
18. Hydrochlorothiazide
Brand and generic name: Generic only (hydrochlorothiazide) Dosage forms: Oral tablets, capsules Pharmacologic category: Thiazide diuretic FDA-approved indications: Hypertension, edema Dosage and frequency: 12.5-50 mg once daily Mechanism of action: Inhibits sodium reabsorption in distal renal tubule 1 Contraindications: Anuria, sulfonamide hypersensitivity Adverse effects: Electrolyte imbalances, hyperuricemia, hyperglycemia 1 Drug interactions: Enhanced effects of other antihypertensives, decreased lithium excretion Patient counseling points: Take in morning to avoid nocturia, monitor electrolytes
19. Premarin (Conjugated estrogens)
Brand and generic name: Premarin (conjugated estrogens) Dosage forms: Oral tablets, vaginal cream Pharmacologic category: Estrogen FDA-approved indications: Menopausal symptoms, vulvar/vaginal atrophy, osteoporosis prevention Dosage and frequency: 0.3-1.25 mg daily Mechanism of action: Binds to estrogen receptors, replacing depleted endogenous estrogen Contraindications: Breast cancer, estrogen-dependent neoplasia, undiagnosed abnormal genital bleeding, thromboembolism Adverse effects: Nausea, breast tenderness, headache, increased risk of endometrial cancer, thromboembolism Drug interactions: Decreased effectiveness with CYP3A4 inducers Patient counseling points: Use lowest effective dose for shortest duration, report unusual bleeding
20. Risperdal (Risperidone)
Brand and generic name: Risperdal (risperidone) Dosage forms: Oral tablets, orally disintegrating tablets, oral solution, long-acting injection Pharmacologic category: Atypical antipsychotic FDA-approved indications: Schizophrenia, bipolar disorder, irritability associated with autism Dosage and frequency: 1-6 mg daily in 1-2 divided doses Mechanism of action: Antagonizes dopamine D2 and serotonin 5-HT2A receptors 5 Contraindications: Hypersensitivity to risperidone Adverse effects: Extrapyramidal symptoms, weight gain, hyperprolactinemia, sedation Drug interactions: Metabolized by CYP2D6 and CYP3A4; interactions with inhibitors/inducers 5 Patient counseling points: May take with or without food, monitor for movement disorders
21. Farxiga (Dapagliflozin)
Brand and generic name: Farxiga (dapagliflozin) Dosage forms: Oral tablets Pharmacologic category: SGLT2 inhibitor FDA-approved indications: Type 2 diabetes mellitus, heart failure, chronic kidney disease Dosage and frequency: 5-10 mg once daily Mechanism of action: Inhibits SGLT2 in proximal renal tubules, reducing glucose reabsorption 1 Contraindications: Severe renal impairment, dialysis, type 1 diabetes Adverse effects: Genital mycotic infections, urinary tract infections, volume depletion 1 Drug interactions: Increased risk of hypoglycemia with insulin or insulin secretagogues Patient counseling points: Take in morning, maintain hydration, monitor for genital infections
22. Dyazide/Maxzide (Triamterene-hydrochlorothiazide)
Brand and generic name: Dyazide/Maxzide (triamterene-hydrochlorothiazide) Dosage forms: Oral capsules, tablets Pharmacologic category: Potassium-sparing diuretic/thiazide diuretic combination FDA-approved indications: Hypertension, edema Dosage and frequency: 1-2 capsules/tablets daily Mechanism of action: Triamterene blocks sodium channels in distal tubule; hydrochlorothiazide inhibits sodium reabsorption 1 Contraindications: Anuria, severe renal impairment, hyperkalemia Adverse effects: Hyperkalemia, electrolyte imbalances, photosensitivity Drug interactions: Increased hyperkalemia risk with ACE inhibitors, ARBs, potassium supplements Patient counseling points: Take in morning, avoid potassium supplements, monitor electrolytes
23. Prometrium (Progesterone)
Brand and generic name: Prometrium (progesterone) Dosage forms: Oral capsules, vaginal gel/insert Pharmacologic category: Progestin FDA-approved indications: Secondary amenorrhea, prevention of endometrial hyperplasia Dosage and frequency: 200-400 mg daily Mechanism of action: Binds to progesterone receptors, inducing secretory changes in endometrium Contraindications: Breast cancer, thromboembolic disorders, undiagnosed vaginal bleeding Adverse effects: Drowsiness, dizziness, abdominal cramping, breakthrough bleeding Drug interactions: Decreased effect with CYP3A4 inducers Patient counseling points: May cause drowsiness, take oral form at bedtime with food
24. Seroquel (Quetiapine)
Brand and generic name: Seroquel (quetiapine) Dosage forms: Immediate-release and extended-release tablets Pharmacologic category: Atypical antipsychotic FDA-approved indications: Schizophrenia, bipolar disorder, major depressive disorder (adjunct) Dosage and frequency: 150-800 mg daily in 1-2 divided doses Mechanism of action: Antagonizes multiple neurotransmitter receptors including serotonin 5-HT2A and dopamine D2 6, 5 Contraindications: Hypersensitivity to quetiapine Adverse effects: Sedation, dizziness, weight gain, metabolic effects Drug interactions: Metabolized by CYP3A4; interactions with inhibitors/inducers 5 Patient counseling points: May cause drowsiness, monitor for metabolic changes, may take with or without food
25. Invokana (Canagliflozin)
Brand and generic name: Invokana (canagliflozin) Dosage forms: Oral tablets Pharmacologic category: SGLT2 inhibitor FDA-approved indications: Type 2 diabetes mellitus, diabetic kidney disease Dosage and frequency: 100-300 mg once daily Mechanism of action: Inhibits SGLT2 in proximal renal tubules, reducing glucose reabsorption 1 Contraindications: Severe renal impairment, dialysis, type 1 diabetes Adverse effects: Genital mycotic infections, urinary tract infections, volume depletion, increased risk of lower limb amputations 1 Drug interactions: Increased risk of hypoglycemia with insulin or insulin secretagogues Patient counseling points: Take before first meal of day, maintain hydration, monitor for foot problems
26. Aldactone (Spironolactone)
Brand and generic name: Aldactone (spironolactone) Dosage forms: Oral tablets Pharmacologic category: Potassium-sparing diuretic, aldosterone antagonist FDA-approved indications: Hypertension, heart failure, edema, hyperaldosteronism Dosage and frequency: 25-200 mg daily in 1-2 divided doses Mechanism of action: Competitively blocks aldosterone receptors Contraindications: Hyperkalemia, anuria, severe renal impairment Adverse effects: Hyperkalemia, gynecomastia, menstrual irregularities Drug interactions: Increased hyperkalemia risk with ACE inhibitors, ARBs, potassium supplements Patient counseling points: Monitor potassium levels, may take with food to reduce GI upset
27. Provera (Medroxyprogesterone)
Brand and generic name: Provera (medroxyprogesterone) Dosage forms: Oral tablets, injectable suspension Pharmacologic category: Progestin FDA-approved indications: Secondary amenorrhea, abnormal uterine bleeding, endometrial hyperplasia prevention Dosage and frequency: 2.5-10 mg daily for 5-10 days (oral); 150 mg every 3 months (injectable) Mechanism of action: Binds to progesterone receptors, inducing secretory changes in endometrium Contraindications: Breast cancer, thromboembolic disorders, undiagnosed vaginal bleeding Adverse effects: Weight gain, breast tenderness, irregular bleeding, mood changes Drug interactions: Decreased effect with CYP3A4 inducers Patient counseling points: Report unusual bleeding, may affect bone density with long-term use
28. Zyprexa (Olanzapine)
Brand and generic name: Zyprexa (olanzapine) Dosage forms: Oral tablets, orally disintegrating tablets, injectable Pharmacologic category: Atypical antipsychotic FDA-approved indications: Schizophrenia, bipolar disorder Dosage and frequency: 5-20 mg daily Mechanism of action: Antagonizes multiple neurotransmitter receptors including serotonin 5-HT2A and dopamine D2 6, 5 Contraindications: Hypersensitivity to olanzapine Adverse effects: Significant weight gain, sedation, metabolic effects (diabetes, dyslipidemia) Drug interactions: Metabolized by CYP1A2 and CYP2D6; interactions with inhibitors/inducers 5 Patient counseling points: Monitor weight and metabolic parameters, may take with or without food
The most important consideration when selecting medications is to prioritize those that reduce morbidity and mortality while maintaining quality of life. For conditions like diabetes, cardiovascular disease, and psychiatric disorders, medication selection should be guided by the most recent evidence on outcomes that matter most to patients.