Guideline 16: Combining Medications in Older Patients

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The experts recommended close monitoring for side effects when using the combinations listed in the table below. More than a quarter of the experts considered the following combinations to be contraindicated: clozapine + carbamazepine (rated as contraindicated by 39% of the experts), ziprasidone + a tricyclic antidepressant (TCA) (rated as contraindicated by 26%), and a low-potency conventional antipsychotic + fluoxetine (rated as contraindicated by 27%). Certain combinations of medications caused the experts more concern (e.g., drugs that are potent inhibitors of CYP drug-metabolizing enzymes and thus have increased potential to cause drug-drug interactions).’ ‹