High Risk Medication Alternative Table
High Risk Medication Alternative Table Description High Risk Medication Rationale for risk* Alternatives Anticholinergics brompheniramine3, Highly anticholinergic, clearance Allergy: levocetirizine, desloratadine, montelukast, carbinoxamine3, reduced with advanced age, and azelastine, intranasal steroid (e.g., fluticasone4), OTCs chlorpheniramine3, tolerance develops when used as such as cetirizine, loratadine, fexofenadine, or clemastine3, cyproheptadine1, hypnotic; greater risk of confusion, dry intranasal normal saline (member to pay out of dexbrompheniramine3, mouth, constipation, and other pocket) dexchlorpheniramine3, anticholinergic effects and toxicity. Cough: OTCs such as guaifenesin, dextromethorphan diphenhydramine (oral)3, (member to pay out of pocket) dimenhydrinate3, Anti-emetic: ondansetron-oral1, granisetron-oral1, doxylamine3, hydroxyzine1, aprepitant-oral1 meclizine, promethazine1, triprolidine3 benztropine (oral)1, Not recommended for prevention of carbidopa & levodopa, carbidopa & levodopa & trihexyphenidyl1 extrapyramidal symptoms with entacapone, ropinirole, pramipexole, amantadine antipsychotics; more-effective agents available for treatment of Parkinson's disease. Antithrombotics dipyridamole - oral short May cause orthostatic hypotension; dipyridamole & aspirin4, clopidogrel acting1 (does not apply to ER more effective alternatives available; combination with aspirin) intravenous form acceptable for use in cardiac stress testing. Anti-infective nitrofurantoin Potential for pulmonary toxicity; safer For UTI Treatment,
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