Skip to Content

Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) Disease Interactions

There are 18 disease interactions with Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide):

Major

Aluminum-containing antacids (applies to Arthritis Pain Formula) constipation

Major Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction, Intestinal Obstruction, Phosphate Imbalance

Aluminum containing antacids may produce constipation, which may lead to intestinal obstruction. Osteomalacia and hypophosphatemia may be produced in patients with renal dysfunction who are not receiving dialysis. Patients with renal dysfunction, intestinal obstruction, osteomalacia, or hypophosphatemia should use antacids with low or no aluminum content.

References

  1. "Product Information. Losospan (magaldrate)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Rolaids (dihydroxyaluminum sodium carbonate)." Warner Lambert Laboratories, Morris Plains, NJ.
  3. "Product Information. Amphojel (aluminum hydroxide)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Major

Aspirin (applies to Arthritis Pain Formula) coagulation

Major Potential Hazard, High plausibility. Applicable conditions: Coagulation Defect, Bleeding, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency

The use of aspirin is contraindicated in patients with significant active bleeding or hemorrhagic disorders such as hemophilia, von Willebrand's disease, or telangiectasia. Aspirin interferes with coagulation by irreversibly inhibiting platelet aggregation and prolonging bleeding time. The non-aceylated salicylates (i.e. salicylate salts such as sodium or magnesium salicylate) do not demonstrate these effects and may be appropriate substitutions in these patients. However, all salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially aspirin, should be administered with extreme caution in patients with hypoprothrombinemia, vitamin K deficiency, thrombocytopenia, thrombotic thrombocytopenic purpura, severe hepatic impairment, or anticoagulant use.

References

  1. Buerke M, Pittroff W, Meyer J, Darius H "Aspirin therapy: optimized platelet inhibition with different loading and maintenance doses." Am Heart J 130 (1995): 465-72
  2. Ferraris VA, Ferraris SP "Preoperative aspirin ingestion increases operative blood loss after coronary artery bypass grafting - update." Ann Thorac Surg 59 (1995): 1036-7
  3. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  4. Garg SK, Sarker CR "Aspirin-induced thrombocytopenia on an immune basis." Am J Med Sci 267 (1974): 129-32
  5. Patrono C "Aspirin as an antiplatelet drug." N Engl J Med 330 (1994): 1287-94
  6. "Product Information. Bayer aspirin (aspirin)." Bayer, West Haven, CT.
  7. Bochner F, Williams DB, Morris PM, Siebert DM, Lloyd JV "Pharmacokinetics of low-dose oral modified release, soluble and intravenous aspirin in man, and effects on platelet function." Eur J Clin Pharmacol 35 (1988): 287-94
  8. Hirsh J, Dalen JE, Fuster V, Harker LB, Patrono C, Roth G "Aspirin and other platelet-active drugs: the relationship among dose, effectiveness, and side effects." Chest 108 Suppl (1995): s247-57
  9. Colwell JA "Aspirin and risk of hemorrhagic stroke." JAMA 282 (1999): 731-2
  10. He J, Whelton PK, Vu B, Klag MJ "Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials." JAMA 280 (1998): 1930-35
  11. Moroz LA "Increased blood fibrinolytic activity after aspirin ingestion." N Engl J Med 296 (1977): 525-9
  12. Petty GW, Brown RD, Whisnant JP, Sicks JD, O'Fallon WM, Wiebers DO "Frequency of major complications of aspirin, warfarin, and intravenous heparin for secondary stroke prevention: a population study." Ann Intern Med 130 (1999): 14-22
  13. Sbarbaro JA, Bennett RM "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  14. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 14 references
Major

Calcium salts (applies to Arthritis Pain Formula) calcium- phosphate calcifications

Major Potential Hazard, High plausibility. Applicable conditions: Phosphate Imbalance

Elevated serum concentrations of calcium and phosphate can exceed the solubility level and result in calcium- phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Therapy with calcium should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Administration of oral calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. These complexes are eliminated in the feces. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

References

  1. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Major

Calcium salts (applies to Arthritis Pain Formula) cardiac contraction/conduction

Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias

Calcium is involved in cardiac muscle contraction and electrical impulse conduction. Therapy with calcium salt formulations (particularly IV) should be administered cautiously to patients with cardiac disease. Patients receiving cardiac glycosides and concomitant IV calcium may experience arrhythmias. Therapy with IV calcium should be administered slowly and at reduced dosages in patients with cardiac disease.

References

  1. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Major

Calcium salts (applies to Arthritis Pain Formula) malabsorption

Major Potential Hazard, High plausibility. Applicable conditions: Achlorhydria, Malabsorption Syndrome

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

References

  1. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
Major

Calcium salts (applies to Arthritis Pain Formula) renal dysfunction

Major Potential Hazard, High plausibility.

Absorption of oral calcium formulations may be altered and elimination of calcium by the kidney decreased with renal impairment. Hyperphosphatemia occurs during renal failure. Calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. Calcium carbonate can partially correct metabolic acidosis associated with chronic renal failure. Clinical monitoring of renal function and serum calcium and phosphate concentrations is necessary.

References

  1. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  2. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
Major

Calcium salts (applies to Arthritis Pain Formula) sarcoidosis

Major Potential Hazard, High plausibility.

Hypercalciuria, with or without hypercalcemia, may occasionally occur in patients with sarcoidosis. Elevated calcium levels may result from increased intestinal absorption of calcium, which is related to the extrarenal production of vitamin D by mononuclear phagocytes present within the sarcoid granuloma. Therapy with calcium salts should be administered cautiously and only if necessary in patients with sarcoidosis.

References

  1. "Product Information. Neo-Calglucon (calcium glubionate)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  2. "Product Information. Posture (calcium phosphate, triphasic)." Whitehall-Robbins, Madison, NJ.
  3. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Major

Laxatives (applies to Arthritis Pain Formula) inflammatory bowel disease

Major Potential Hazard, Moderate plausibility.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

References

  1. "Product Information. Fleet Bisacodyl Enema (bisacodyl)." Fleet, Lynchburg, VA.
  2. "Product Information. Dulcolax (bisacodyl)." Ciba Self-Medication Inc, Woodbridge, NJ.
Major

Laxatives (applies to Arthritis Pain Formula) intestinal obstruction disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Obstruction

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

References

  1. "Product Information. Kondremul (mineral oil)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Fleet Bisacodyl Enema (bisacodyl)." Fleet, Lynchburg, VA.
  3. "Product Information. Dulcolax (bisacodyl)." Ciba Self-Medication Inc, Woodbridge, NJ.
  4. "Product Information. Fleet Mineral Oil Enema (mineral oil)." Fleet, Lynchburg, VA.
  5. "Product Information. Fleet Babylax (glycerin)." Alcon Laboratorries Inc, Fort Worth, TX.
View all 5 references
Major

Magnesium salts (applies to Arthritis Pain Formula) renal dysfunction

Major Potential Hazard, High plausibility.

Magnesium is eliminated by the kidney. The serum concentration of magnesium is increased in patients with renal impairment. Magnesium toxicity includes CNS depression, muscular paralysis, respiratory depression, hypotension and prolonged cardiac conduction time. Disappearance of the patellar reflex is a useful clinical sign of magnesium intoxication. Therapy with magnesium should be administered cautiously and dosages should be modified in patients with compromised renal function. Clinical monitoring of serum magnesium levels is recommended.

References

  1. "Product Information. Mag-Ox 400 (magnesium oxide)." Blaine, Erlanger, KY.
  2. "Product Information. Uro-Mag (magnesium oxide)." Blaine, Erlanger, KY.
  3. "Product Information. Losospan (magaldrate)." Whitehall-Robbins, Madison, NJ.
  4. "Product Information. Slow-Mag (magnesium chloride)." Searle, Skokie, IL.
  5. "Product Information. Magonate (magnesium gluconate)." Fleming and Company, Fenton, MO.
View all 5 references
Major

NSAIDs (applies to Arthritis Pain Formula) asthma

Major Potential Hazard, High plausibility.

Approximately 10% of patients with asthma may have aspirin-sensitive asthma, characterized by nasal polyposis, pansinusitis, eosinophilia, and precipitation of asthma and rhinitis attacks after ingestion of aspirin. The use of aspirin in these patients has been associated with severe bronchospasm and fatal anaphylactoid reactions. Since cross-sensitivity has been noted between aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), therapy with any NSAID should be avoided in asthmatic patients with a history of aspirin or other NSAID sensitivity, and administered cautiously in all patients with preexisting asthma. Prior to initiating therapy with NSAIDs, patients should be questioned about previous allergic-type reactions to these agents. Salicylate salts, salsalate, salicylamide, and acetaminophen may be appropriate alternatives in patients with a history of NSAID-induced bronchospasm, since cross-sensitivity to these agents appears to be low. However, cross-sensitivity has been demonstrated occasionally with high dosages of these agents (e.g., acetaminophen >= 1000 mg), thus it may be appropriate to initiate therapy with low dosages and increase gradually. There is some evidence suggesting that COX-2 inhibitors may be safely used in patients with aspirin-sensitive asthma, although the labeling for these products contraindicate such use. If necessary, aspirin desensitization may also be attempted in some patients under medical surveillance.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. Stevenson DD, Simon RA "Lack of cross-reactivity between rofecoxib and aspirin in aspirin-sensitive patients with asthma." J Allerg Clin Immunol 108 (2001): 47-51
  4. "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
  5. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
  6. Stevenson DD, Hougham AJ, Schrank PJ, Goldlust MB, Wilson RR "Salsalate cross-sensitivity in aspirin-sensitive patients with asthma." J Allergy Clin Immunol 86 (1990): 749-58
  7. Settipane RA, Stevenson DD "Cross sensitivity with acetaminophen in aspirin-sensitive subjects with asthma." J Allergy Clin Immunol 84 (1989): 26-33
  8. "Product Information. Mobic (meloxicam)" Boehringer-Ingelheim, Ridgefield, CT.
  9. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  10. "Product Information. Clinoril (sulindac)." Merck & Co, Inc, West Point, PA.
  11. Lewis RV "Severe asthma after naproxen." Lancet 05/30/87 (1987): 1270
  12. Ayres JG, Fleming DM, Whittington RM "Asthma death due to ibuprofen." Lancet 05/09/87 (1987): 1082
  13. Carmona MJ, Blanca M, Garcia A, Fernandez S, Burgos F, Miranda A, Vega JM, Garcia J "Intolerance to piroxicam in patients with adverse reactions to nonsteroidal antiinflammatory drugs." J Allergy Clin Immunol 90 (1992): 873-9
  14. Shapiro N "Acute angioedema after ketorolac ingestion - report of case." J Oral Maxillofac Surg 52 (1994): 626-7
  15. Haddow GR, Riley E, Isaacs R, McSharry R "Ketorolac, nasal polyposis, and bronchial asthma: a cause for concern." Anesth Analg 76 (1993): 420-2
  16. Israel E, Fischer AR, Rosenberg MA, Lilly CM, Callery JC, Shapiro J, Cohn J, Rubin P, Drazen JM "The pivotal role of 5-lipoxygenase products in the reaction of aspirin-sensitive asthmatics to aspirin." Am Rev Respir Dis 148 (1993): 1447-51
  17. Cohen RD, Bateman ED, Potgieter PD "Near-fatal bronchospasm in an asthmatic patient following ingestion of flurbiprofen. A case report." S Afr Med J 61 (1982): 803
  18. "Product Information. Bextra (valdecoxib)." Pharmacia Corporation, Peapack, NJ.
  19. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical, Raritan, NJ.
  20. "Product Information. Relafen (nabumetone)." SmithKline Beecham, Philadelphia, PA.
  21. Schreuder G "Ketoprofen: possible idiosyncratic acute bronchospasm." Med J Aust 152 (1990): 332-3
  22. Zikowski D, Hord AH, Haddox JD, Glascock J "Ketorolac-induced bronchospasm." Anesth Analg 76 (1993): 417-9
  23. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  24. "Product Information. Nalfon (fenoprofen)." Xspire Pharma, Ridgeland, MS.
  25. Woessner KM, Simon RA, Stevenson DD "The safety of celecoxib in patients with aspirin-sensitive asthma." Arthritis Rheum 46 (2002): 2201-6
  26. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  27. Dahlen B, Szczeklik A, Murray HH "Celecoxib in patients with asthma and aspirin intolerance." N Engl J Med 344 (2000): 142
  28. "Product Information. Indocin (indomethacin)." Merck & Co, Inc, West Point, PA.
  29. "Product Information. Daypro (oxaprozin)." Searle, Skokie, IL.
  30. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  31. Lee TH "Mechanism of aspirin sensitivity." Am Rev Respir Dis 145 (1992): s34-6
  32. "Product Information. Celebrex (celecoxib)." Searle, Chicago, IL.
  33. Salberg DJ, Simon MR "Severe asthma induced by naproxen: a case report and review of the literature." Ann Allergy 45 (1980): 372-5
  34. "Product Information. Vioxx (rofecoxib)." Merck & Co, Inc, West Point, PA.
  35. Szczeklik A, Stevenson DD "Aspirin-induced asthma: Advances in pathogenesis and management." J Allerg Clin Immunol 104 (1999): 5-13
  36. Chan TY "Severe asthma attacks precipitated by NSAIDs." Ann Pharmacother 29 (1995): 199
  37. Nasser SMS, Lee TH "Aspirin-induced early and late asthmatic responses." Clin Exp Allergy 25 (1995): 1-3
  38. Lee TH "Mechanism of bronchospasm in aspirin-sensitive asthma." Am Rev Respir Dis 148 (1993): 1442-3
View all 38 references
Major

Salicylates (applies to Arthritis Pain Formula) GI toxicity

Major Potential Hazard, High plausibility. Applicable conditions: Peptic Ulcer, Duodenitis/Gastritis, Gastrointestinal Hemorrhage, Gastrointestinal Perforation, History - Peptic Ulcer, Alcoholism, Colitis/Enteritis (Noninfectious), Colonic Ulceration

Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.

References

  1. Lanas A, Serrano P, Bajador E, Esteva F, Benito R, Sainz R "Evidence of aspirin use in both upper and lower gastrointestinal perforation." Gastroenterology 112 (1997): 683-9
  2. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  3. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  4. Roderick PJ, Wilkes HC, Meade TW "The gastrointestinal toxicity of aspirin: an overview of randomised controlled trials." Br J Clin Pharmacol 35 (1993): 219-26
  5. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  6. Stalnikowiczdarvasi R "Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events: a critical analysis." J Clin Gastroenterol 21 (1995): 13-6
  7. Bergmann JF, Chassany O, Geneve J, Abiteboul M, Caulin C, Segrestaa JM "Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the gastroduodenal mucosa." Eur J Clin Pharmacol 42 (1992): 685-8
  8. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  9. Levy M, Miller DR, Kaufman DW, Siskind V, Schwingl P, Rosenberg L, Strom B, Shapiro S "Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics." Arch Intern Med 148 (1988): 281-5
  10. Sabesin SM, Boyce HW Jr, King CE, Mann JA, Ruoff G, Wall E "Comparative evaluation of gastrointestinal intolerance produced by plain and tri-buffered aspirin tablets." Am J Gastroenterol 83 (1988): 1220-5
  11. Wilcox CM, Shalek KA, Cotsonis G "Striking prevalence of over-the-counter nonsteroidal anti- inflammatory drug use in patients with upper gastrointestinal hemorrhage." Arch Intern Med 154 (1994): 42-6
  12. Silagy CA, McNeil JJ, Donnan GA, Tonkin AM, Worsam B, Campion K "Adverse effects of low-dose aspirin in a healthy elderly population." Clin Pharmacol Ther 54 (1993): 84-9
  13. Greenberg PD, Cello JP, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604
  14. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  15. Mehta S, Dasarathy S, Tandon RK, Mathur M, Malaviya AN "A prospective randomized study of the injurious effects of aspirin and naproxen on the gastroduodenal mucosa in patients with rheumatoid arthritis." Am J Gastroenterol 87 (1992): 996-1000
  16. Naschitz JE, Yeshurun D, Odeh M, Bassan H, Rosner I, Stermer E, Levy N "Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease." Am J Gastroenterol 85 (1990): 408-11
  17. Weil J, Colinjones D, Langman M, Lawson D, Logan R, Murphy M, Rawlins M, Vessey M, Wainwright P "Prophylactic aspirin and risk of peptic ulcer bleeding." BMJ 310 (1995): 827-30
  18. Graham DY, Smith JL "Aspirin and the stomach." Ann Intern Med 104 (1986): 390-8
  19. Prichard PJ, Kitchingman GK, Walt RP, Daneshmend TK, Hawkey CJ "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
View all 19 references
Major

Salicylates (applies to Arthritis Pain Formula) renal dysfunction

Major Potential Hazard, High plausibility.

Salicylate and its metabolites are eliminated almost entirely by the kidney. Therapy with salicylate drugs should be administered cautiously in patients with renal impairment, especially if it is severe. Reduced dosages may be necessary to avoid drug accumulation. Clinical monitoring of renal function is recommended during prolonged therapy, since the use of salicylate drugs has rarely been associated with renal toxicities, including elevations in serum creatinine, renal papillary necrosis, and acute tubular necrosis with renal failure. Most of the data have been derived from experience with aspirin but may apply to other salicylates as well. In patients with impaired renal function, aspirin has caused reversible and sometimes marked decreases in renal blood flow and glomerular filtration rate. Adverse renal effects have usually reversed rapidly following withdrawal of aspirin therapy.

References

  1. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  3. Whelton A "Renal effects of over-the-counter analgesics." J Clin Pharmacol 35 (1995): 454-63
  4. Wen SF, Parthasarathy R, Iliopoulos O, Oberley TD "Acute renal failure following binge drinking and nonsteroidal antiinflammatory drugs." Am J Kidney Dis 20 (1992): 281-5
  5. Maher JF "Analgesic nephropathy. Observations, interpretations, and perspective on the low incidence in America." Am J Med 76 (1984): 345-8
  6. Carmichael J, Shankel SW "Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function." Am J Med 78 (1985): 992-1000
  7. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  8. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  9. Riegger GA, Kahles HW, Elsner D, Kromer EP, Kochsiek K "Effects of acetylsalicylic acid on renal function in patients with chronic heart failure." Am J Med 90 (1991): 571-5
  10. Kimberly RP, Plotz PH "Aspirin-induced depression of renal function." N Engl J Med 296 (1977): 418-24
  11. Muther RS, Potter DM, Bennett WM "Aspirin-induced depression of glomerular filtration rate in normal humans: role of sodium balance." Ann Intern Med 94 (1981): 317-21
View all 11 references
Major

Salicylates (applies to Arthritis Pain Formula) Reye's syndrome

Major Potential Hazard, High plausibility. Applicable conditions: Influenza, Varicella-Zoster

The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.

References

  1. Belay ED, Bresee JS, Holman RC, Khan AS, Shahriari A, Schonberger LB "Reye's syndrome in the United States from 1981 through 1997." N Engl J Med 340 (1999): 1377-82
  2. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  3. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  4. American Academy of Pediatrics. Committee on Infectious Diseases; Peter G, ed. "Red BooK: Report of the Committee on Infectious Diseases. 24th" Grove Village, IL: American Academy of Pediatrics (1997):
  5. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  6. Epidemiology Office, Divisiion of Viral and Rickettsial Diseasses, Center for Infectious Diseases, Centers for Disease Control. "Leads from the MMWR. Reye syndrome surveillance--United States, 1987 and 1988." JAMA 261 (1989): 3520,
  7. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  8. Hasking GJ, Duggan JM "Encephalopathy from bismuth subsalicylate." Med J Aust 2 (1982): 167
  9. Behrman R, Kliegman R, Arvin A, Nelson W, eds. "Nelson Textbook of Pediatrics. 15th ed." Philadelphia, PA: W.B. Saunders Company (1996):
View all 9 references
Moderate

Salicylates (applies to Arthritis Pain Formula) anemia

Moderate Potential Hazard, Moderate plausibility.

Occult, often asymptomatic GI blood loss occurs quite frequently with the use of normal dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. Other salicylates reportedly cause little or no GI blood loss at usual dosages, but may do so at high dosages. Prolonged therapy with salicylates, particularly aspirin, should be administered cautiously in patients with or predisposed to anemia. Periodic monitoring of hematocrit is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

References

  1. Naschitz JE, Yeshurun D, Odeh M, Bassan H, Rosner I, Stermer E, Levy N "Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease." Am J Gastroenterol 85 (1990): 408-11
  2. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  3. Stalnikowiczdarvasi R "Gastrointestinal bleeding during low-dose aspirin administration for prevention of arterial occlusive events: a critical analysis." J Clin Gastroenterol 21 (1995): 13-6
  4. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  5. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  6. Prichard PJ, Kitchingman GK, Walt RP, Daneshmend TK, Hawkey CJ "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
  7. Greenberg PD, Cello JP, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604
  8. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
View all 8 references
Moderate

Salicylates (applies to Arthritis Pain Formula) dialysis

Moderate Potential Hazard, High plausibility. Applicable conditions: hemodialysis

Salicylate and its metabolites are readily removed by hemodialysis and, to a lesser extent, by peritoneal dialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  3. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
Moderate

Salicylates (applies to Arthritis Pain Formula) G-6-PD deficiency

Moderate Potential Hazard, Moderate plausibility.

Salicylates, particularly aspirin, may cause or aggravate hemolysis in patients with pyruvate kinase or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. However, this effect has not been clearly established. Until more data are available, therapy with salicylates should be administered cautiously in patients with G-6-PD deficiency. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

References

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  2. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  3. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
Moderate

Salicylates (applies to Arthritis Pain Formula) hepatotoxicity

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The use of salicylates has occasionally been associated with acute, reversible hepatotoxicity, primarily manifested as elevations of serum transaminases, alkaline phosphatase and/or, rarely, bilirubin. Hepatic injury consistent with chronic active hepatitis has also been reported in a few patients, which resulted rarely in encephalopathy or death. Salicylate-induced hepatotoxicity appears to be dependent on serum salicylate concentration (> 25 mg/dL) and has occurred most frequently in patients with juvenile arthritis, active systemic lupus erythematosus, rheumatic fever, or preexisting hepatic impairment. Therapy with salicylates, particularly when given in high dosages, should be administered cautiously in these patients, and periodic monitoring of liver function is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate. A dosage reduction may be necessary if liver function abnormalities develop and serum salicylate concentration exceeds 25 mg/dL, although serum transaminase elevations may sometimes be transient and return to pretreatment values despite continued therapy without dosage adjustment.

References

  1. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  2. Wolfe JD, Metzger AL, Goldstein RC "Aspirin hepatitis." Ann Intern Med 80 (1974): 74-6
  3. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  4. Patel DK, Hesse A, Ogunbona A, Notarianni LJ, Bennett PN "Metabolism of aspirin after therapeutic and toxic doses." Hum Exp Toxicol 9 (1990): 131-6
  5. Jorup-Ronstrom C, Beermann B, Wahlin-Boll E, Melander A, Britton S "Reduction of paracetamol and aspirin metabolism during viral hepatitis." Clin Pharmacokinet 11 (1986): 250-6
  6. Seaman WE, Ishak KG, Plotz PH "Aspirin-induced hepatotoxicity in patients with systemic lupus erythematosus." Ann Intern Med 80 (1974): 1-8
  7. Sbarbaro JA, Bennett RM "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  8. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 8 references

Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) drug interactions

There are 611 drug interactions with Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide) alcohol/food interactions

There are 4 alcohol/food interactions with Arthritis Pain Formula (aluminum hydroxide / aspirin / calcium carbonate / magnesium hydroxide)

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.