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Drug Interactions between Heparin Sodium and YSP Aspirin

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

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Interactions between your drugs

Moderate

aspirin heparin

Applies to: YSP Aspirin (aspirin) and Heparin Sodium (heparin)

GENERALLY AVOID: Theoretically, the coadministration of nonsteroidal anti-inflammatory drugs (NSAIDs) and heparin or low molecular weight heparin (LMWH) may potentiate the risk of bleeding. NSAIDs interfere with platelet adhesion and aggregation and may prolong bleeding time in healthy individuals. While these effects are generally slight and of relatively short duration for most NSAIDs (except aspirin) at recommended dosages, they may be of pronounced clinical significance when combined with the inhibitory effects of heparin on the clotting cascade. However, little clinical data exist regarding an actual interaction. In a controlled, randomized prospective study, 60 patients undergoing total hip replacement received enoxaparin (40 mg subcutaneously 12 hours pre- and every 24 hours postoperatively for 10 days) and analgesia with either ketorolac tromethamine (30 mg IM on induction of anesthesia and every 24 hours postoperatively for 4 days) or an opioid plus acetaminophen. The authors reported no significant differences between the two groups for intraoperative blood loss, postoperative drainage, transfusion requirements, bruising, wound oozing, and leg swelling. However, there have been anecdotal reports of hemorrhagic complications in surgical patients treated with NSAIDs alone and in combination with a LMWH. In addition, NSAIDs are known to cause dose-related gastrointestinal bleeding, which may be complicated by anticoagulant therapy.

MANAGEMENT: Until further data are available, products containing NSAIDs, especially if given chronically or in high dosages, should preferably be avoided in patients receiving heparin or LMWH. Close clinical and laboratory observation for bleeding complications is recommended if concurrent therapy is necessary.

References

  1. Bang CJ, Riedel B, Talstad I, Berstad A "Interaction between heparin and acetylsalicylic acid on gastric mucosal and skin bleeding in humans." Scand J Gastroenterol 27 (1992): 489-94
  2. Walker AM "Predictors of bleeding during heparin therapy." JAMA 244 (1980): 1209-12
  3. Heiden D, Rodvien R, Mielke CH "Heparin bleeding, platelet dysfunction, and aspirin." JAMA 246 (1981): 330-1
  4. Theroux P, Ouimet H, McCans J, et al. "Aspirin, heparin, or both to treat acute unstable angina." N Engl J Med 319 (1988): 1105-6
  5. Weale AE, Warwick DJ, Durant N, Prothero D "Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?" Ann R Coll Surg Engl 77 (1995): 35-7
  6. Price AJ, Frcpath DO "Is there a clinical interaction between low molecular weight heparin and non-steroidal analgesics after total hip replacement?" Ann R Coll Surg Engl 77 (1995): 395
View all 6 references

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Drug and food interactions

Moderate

aspirin food

Applies to: YSP Aspirin (aspirin)

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: YSP Aspirin (aspirin)

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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