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Drug Interactions between anagrelide and Cope

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

aspirin anagrelide

Applies to: Cope (aspirin / caffeine) and anagrelide

MONITOR: Anagrelide and aspirin may potentiate each other's antiplatelet effects when they are coadministered. In two clinical studies with healthy subjects, the administration of single-dose anagrelide 1 mg and aspirin 900 mg or repeat dose once-daily anagrelide 1 mg with aspirin 75 mg resulted in greater antiplatelet aggregation effects than administration of aspirin alone. There were no effects on bleeding time, prothrombin time (PT), or activated partial thromboplastin time (aPTT) with the single-dose aspirin and anagrelide regimen. Major hemorrhages have been reported in some patients with essential thrombocythemia who received both aspirin and anagrelide.

MANAGEMENT: Before initiation of combination treatment, the risks and benefits should be assessed, especially in patients who have a high risk for hemorrhage and/or whose platelet counts are greater than 1000 x 10(9)/L.

References

  1. (2001) "Product Information. Agrylin (anagrelide)." Roberts Pharmaceutical Corporation
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  4. Cerner Multum, Inc. "Australian Product Information."
View all 4 references

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Moderate

caffeine anagrelide

Applies to: Cope (aspirin / caffeine) and anagrelide

MONITOR: Theoretically, coadministration with anagrelide may increase the plasma concentrations and the risk of toxicity of drugs that are substrates of CYP450 1A2. The proposed mechanism, based on in vitro data, is decreased clearance due to anagrelide-mediated inhibition of CYP450 1A2 metabolism.

MANAGEMENT: Until more information is available, caution is advised if anagrelide is used concomitantly with drugs that are substrates of CYP450 1A2, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever anagrelide is added to or withdrawn from therapy. Patients should be monitored for the development of adverse effects.

References

  1. (2001) "Product Information. Agrylin (anagrelide)." Roberts Pharmaceutical Corporation
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."

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Minor

aspirin caffeine

Applies to: Cope (aspirin / caffeine) and Cope (aspirin / caffeine)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6

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Drug and food interactions

Moderate

aspirin food

Applies to: Cope (aspirin / caffeine)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

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Minor

caffeine food

Applies to: Cope (aspirin / caffeine)

The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine. However, a well-conducted pharmacokinetic/pharmacodynamic study did not demonstrate this effect. The clinical significance of this potential interaction is unknown.

References

  1. (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
  2. Maish WA, Hampton EM, Whitsett TL, Shepard JD, Lovallo WR (1996) "Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics." Pharmacotherapy, 16, p. 1046-52

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Minor

aspirin food

Applies to: Cope (aspirin / caffeine)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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