Helpful Insights forPatients and Caregivers

Key Reminders

When starting a new medication, it is always important to share this information with your doctor and pharmacist.  While it may be safe with one medication, others may become toxic or less effective. They can provide more information regarding potentially harmful combinations and how to manage them.  For example, did you know these combinations could be dangerous if not carefully managed?

  • Lithium with NSAIDs (ibuprofen, naproxen) or certain blood pressure medications (lisinopril)
  • Clozapine and cigarette smoking
  • Benzodiazepine anti-anxiety medications (alprazolam, lorazepam) and opioid pain medications (hydrocodone, oxycodone, morphine)
  • Antacids and certain antipsychotics (chlorpromazine, fluphenazine)


  1. National Institute on Alcohol Abuse and Alcoholism (NIAAA): Visit to learn more
    • National Center for Complementary and Integrative Healthcare (NCCIH): Visit to learn more about complementary health information
    • Substance abuse and Mental Health Administration (SAMHSA): Call the national line for help at 1-800-622-HELP (4357)
    • Your local pharmacist or mental health provider


    1. Boden JM, Fergusson DM. Alcohol and depression. Addiction. 2011;106(5):906-14. DOI: 10.1111/j.1360-0443.2010.03351.x. PubMed PMID: 21382111.
    2. Sher L. Alcohol consumption and suicide. QJM. 2006;99(1):57-61. DOI: 10.1093/qjmed/hci146. PubMed PMID: 16287907.
    3. Breslow RA, Dong C, White A. Prevalence of alcohol-interactive prescription medication use among current drinkers: United States, 1999 to 2010. Alcohol Clin Exp Res. 2015;39(2):371-9. DOI: 10.1111/acer.12633. PubMed PMID: 25597432; PubMed Central PMCID: PMC4331237.
    4. Azofeifa A, Mattson ME, Schauer G, McAfee T, Grant A, Lyerla R. National Estimates of Marijuana Use and Related Indicators - National Survey on Drug Use and Health, United States, 2002-2014. Mmwr Surveill. Summ. 2016;65(11):1-28. DOI: 10.15585/mmwr.ss6511a1. PubMed PMID: 27584586.
    5. Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27. DOI: 10.1056/NEJMra1402309. PubMed PMID: 24897085.
    6. Gilbert CR, Baram M, and Cavarocchi NC. “Smoking Wet”: Respiratory Failure Related to Smoking Tainted Marijuana Cigarettes. Tex Heart Inst J. 2013; 40(1):64-7.
    7. Peters RJ, Kelder SH, Meshack A, Yacoubian GS, McCrimmons D, Ellis A. Beliefs and social norms about cigarettes or marijuana sticks laced with embalming fluid and phencyclidine (PCP): why youth use "fry". Subst Use Misuse. 2005;40(4):563-71. DOI: 10.1081/ja-200052426. PubMed PMID: 15830737.
    8. Henderson L, Yue QY, Bergquist C, Gerden B, Arlett P. St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol. 2002;54(4):349-56. DOI: 10.1046/j.1365-2125.2002.01683.x. PubMed PMID: 12392581; PubMed Central PMCID: PMC1874438.
    9. NIH Office of Dietary Supplements. Valerian: Fact Sheet for Health Professionals. Office of Dietary Supplements Web site. Accessed at on January 22, 2018.
    10. Flockhart DA. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: an update. J Clin Psychiatry. 2012;73 Suppl 1:17-24. DOI: 10.4088/JCP.11096su1c.03. PubMed PMID: 22951238.
    11. Saphris (asenapine) [package insert]. Allergan, Inc. Irvine, CA; 2017.
    12. Lithium carbonate [package insert]. Roxane Laboratories. Columbus, Ohio; 2011.