Version July 2025
| Drug/drug class | Adverse effect(s) |
| Anti-inflammatory medications | |
| Glucocorticoids | Sodium retention (particularly with fludrocortisone, hydrocortisone) |
| NSAIDs¶ | Sodium retention and peripheral vasocontriction; blunted response to diuretics and angiotensin converting enzyme inhibitors |
| Cardiovascular medications | |
| Class I antiarrhythmic agents*¶ | Negative inotropy; proarrhythmia; increased mortality with IA and IC agents in post-MI trials |
| Class III antiarrhythmic agents (included sotalol and ibutalide)*¶ | Proarrhythmia |
| Calcium channel blockers (other than amlodipine or felodipine)*¶ | Negative inotropy; neurohumoral activation |
| Minoxidil*¶ | Sodium retention; neurohumoral activation |
| Diabetes medications | |
| Metformin | Lactic acidosis |
| Thiazolidinediones¶ | Sodium retention |
| Phosphdiesterase inhibitors | |
| Anagrelide | Palpitations; tachycardia; sodium retention; induction or exacerbation of HF |
| Cilostazol | Ventricular tachyarrhythmias |
| Neurologic and psychiatric medications | |
| Amphetamines*¶ | Sympathetic agonist activity; hypertension; tachycardia; tachyarrhythmias |
| Carbamazepine | Negative inotropic effect; bradyarrhythmias |
| Clozapine | Development of myocarditis and cardiomyopathy |
| Ergot alkaloids (ergotamine, dihydroergotamine) | Sympathetic agonist activity; valve fibrosis |
| Pergolide (not available in the US) | Valve fibrosis |
| Tricyclic antidepressants | Negative inotropic effect; proarrhythmia |
| Miscellaneous | |
| Beta-2 agonists | Sympathetic agonist activity; tachyarrhythmias; hypokalemia |
| Trimethoprim-sulfamethoxazole | Risk of hyperkalemia or acute kidney injury when taken with ACE inhibitor or ARB Risk of hyperkalemia when taken with MRA |
| Itraconazole | Negative inotropic effect; also can increase serum digoxin concentrations |
| Licorice | Mineralocorticoid excess: sodium retention and hypokalemia |
| Sodium-containing preparations (eg, Fleet PhosPho soda) | |
| Sodium load QT-prolonging drugs (eg, haloperidol, erythromycin) | Proarrhythmia |
