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Drug Interactions between Effervescent Pain Relief and tirofiban

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

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Interactions between your drugs

Moderate

aspirin sodium bicarbonate

Applies to: Effervescent Pain Relief (aspirin/citric acid/sodium bicarbonate) and Effervescent Pain Relief (aspirin/citric acid/sodium bicarbonate)

MONITOR: Agents that cause urinary alkalinization can reduce serum salicylate concentrations in patients receiving anti-inflammatory dosages of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to increased urinary pH, resulting in increased renal salicylate clearance especially above urine pH of 7. This interaction is sometimes exploited in the treatment of salicylate toxicity.

MANAGEMENT: Patients treated chronically with urinary alkalinizers and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References

  1. Berg KJ "Acute acetylsalicylic acid poisoning: treatment with forced alkaline diuresis and diuretics." Eur J Clin Pharmacol 12 (1977): 111-6
  2. Prescott LF, Balali-Mood M, Critchley JA, Johnstone AF, Proudfoot AT "Diuresis or urinary alkalinisation for salicylate poisoning?" Br Med J (Clin Res Ed) 285 (1982): 1383-6
  3. Balali-Mood M, Prescott LF "Failure of alkaline diuresis to enhance diflunisal elimination." Br J Clin Pharmacol 10 (1980): 163-5
  4. Berg KJ "Acute effects of acetylsalicylic acid in patients with chronic renal insufficiency." Eur J Clin Pharmacol 11 (1977): 111-6
  5. Brouwers JRBJ, Desmet PAGM "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet 27 (1994): 462-85
View all 5 references

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Moderate

aspirin tirofiban

Applies to: Effervescent Pain Relief (aspirin/citric acid/sodium bicarbonate) and tirofiban

MONITOR: Although aspirin is routinely given with glycoprotein IIb/IIIa inhibitors, be cognizant of the increased risk of bleeding associated with this combination due to the additive inhibitory effects of salicylates on platelet function. Arterial puncture sites may be most problematic.

MANAGEMENT: It is recommended that these drugs be used together only when indicated by skilled personnel who are qualified and equipped to detect and treat bleeding complications. Patients should be closely monitored for signs of bleeding, especially at arterial puncture sites. Therapy should be discontinued immediately if serious or uncontrollable bleeding or thrombocytopenia occurs.

References

  1. "Product Information. ReoPro (abciximab)." Lilly, Eli and Company PROD (2001):
  2. "Product Information. Integrilin (eptifibatide)." Schering Corporation PROD (2001):
  3. Klinkhardt U, Kirchmaier CM, Westrup D, Graff J, Mahnel R, Breddin HK, Harder S "Ex vivo-in vitro interaction between aspirin, clopidogrel, and the glycoprotein IIb/IIIa inhibitors abciximab and SR121566A." Clin Pharmacol Ther 67 (2000): 305-13
  4. Hirsch J, Dalen J, Guyatt G, American College of Chest Physicians "The sixth (2000) ACCP guidelines for antithrombotic therapy for prevention and treatment of thrombosis. American College of Physicians." Chest 119(1 Suppl) (2001): 1S-2S
View all 4 references

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Drug and food interactions

Moderate

aspirin food

Applies to: Effervescent Pain Relief (aspirin/citric acid/sodium bicarbonate)

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

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Minor

aspirin food

Applies to: Effervescent Pain Relief (aspirin/citric acid/sodium bicarbonate)

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 "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 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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