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Aspirin/omeprazole Disease Interactions

There are 12 disease interactions with aspirin / omeprazole.

Major

Aspirin (applies to aspirin/omeprazole) 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. Moroz LA "Increased blood fibrinolytic activity after aspirin ingestion." N Engl J Med 296 (1977): 525-9
  2. Garg SK, Sarker CR "Aspirin-induced thrombocytopenia on an immune basis." Am J Med Sci 267 (1974): 129-32
  3. Bennett RM, Sbarbaro JA "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  4. Morris PM, Lloyd JV, Bochner F, Siebert DM, Williams DB "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
  5. Patrono C "Aspirin as an antiplatelet drug." N Engl J Med 330 (1994): 1287-94
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. Ferraris SP, Ferraris VA "Preoperative aspirin ingestion increases operative blood loss after coronary artery bypass grafting - update." Ann Thorac Surg 59 (1995): 1036-7
  8. Buerke M, Darius H, Pittroff W, Meyer J "Aspirin therapy: optimized platelet inhibition with different loading and maintenance doses." Am Heart J 130 (1995): 465-72
  9. Harker LB, Hirsh J, Patrono C, Dalen JE, Fuster V, Roth G "Aspirin and other platelet-active drugs: the relationship among dose, effectiveness, and side effects." Chest 108 Suppl (1995): s247-57
  10. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  11. Vu B, He J, Klag MJ, Whelton PK "Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials." JAMA 280 (1998): 1930-35
  12. Wiebers DO, O'Fallon WM, Sicks JD, Brown RD, Whisnant JP, Petty GW "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. "Product Information. Bayer aspirin (aspirin)." Bayer, West Haven, CT.
  14. Colwell JA "Aspirin and risk of hemorrhagic stroke." JAMA 282 (1999): 731-2
View all 14 references
Major

NSAIDs (applies to aspirin/omeprazole) asthma

Major Potential Hazard, High plausibility.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in patients with history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs; severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps, severe potentially fatal bronchospasm, and/or intolerance to aspirin and other NSAIDs. Since cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, therapy with any NSAID should be avoided in patients with this form of aspirin sensitivity. NSAIDs should be used with caution in patients with preexisting asthma (without known aspirin sensitivity), and these patients should be monitored for changes in the signs and symptoms of asthma.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
  2. "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
  3. "Product Information. Indocin (indomethacin)." Merck & Company Inc (2002):
  4. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
  5. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
  6. "Product Information. Clinoril (sulindac)." Merck & Company Inc (2001):
  7. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
  8. "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
  9. "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
  10. "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
  11. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
  12. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
  13. "Product Information. Daypro (oxaprozin)." Searle (2001):
  14. "Product Information. Celebrex (celecoxib)." Searle (2001):
  15. "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
View all 15 references
Major

PPIs (applies to aspirin/omeprazole) C. diff

Major Potential Hazard, Moderate plausibility. Applicable conditions: Pseudomembranous Colitis, Diarrhea

Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

References

  1. "Product Information. Prilosec (omeprazole)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
  3. "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
  4. "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
  5. "Product Information. Protonix I.V. (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
  7. "Product Information. NexIUM I.V. (esomeprazole)." Astra-Zeneca Pharmaceuticals (2014):
  8. "Product Information. Esomeprazole Strontium (esomeprazole)." Amneal Pharmaceuticals (2014):
View all 8 references
Major

Salicylates (applies to aspirin/omeprazole) 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. Abiteboul M, Caulin C, Segrestaa JM, Bergmann JF, Chassany O, Geneve J "Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the gastroduodenal mucosa." Eur J Clin Pharmacol 42 (1992): 685-8
  2. Dasarathy S, Malaviya AN, Mehta S, Mathur M, Tandon RK "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
  3. Bassan H, Odeh M, Levy N, Yeshurun D, Stermer E, Naschitz JE, Rosner I "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
  4. Boyce HW Jr, King CE, Wall E, Mann JA, Sabesin SM, Ruoff G "Comparative evaluation of gastrointestinal intolerance produced by plain and tri-buffered aspirin tablets." Am J Gastroenterol 83 (1988): 1220-5
  5. Graham DY, Smith JL "Aspirin and the stomach." Ann Intern Med 104 (1986): 390-8
  6. Levy M, Schwingl P, Kaufman DW, Miller DR, Siskind V, Rosenberg L, Shapiro S, Strom B "Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics." Arch Intern Med 148 (1988): 281-5
  7. Prichard PJ, Walt RP, Daneshmend TK, Hawkey CJ, Kitchingman GK "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
  8. Roderick PJ, Meade TW, Wilkes HC "The gastrointestinal toxicity of aspirin: an overview of randomised controlled trials." Br J Clin Pharmacol 35 (1993): 219-26
  9. Cotsonis G, Shalek KA, Wilcox CM "Striking prevalence of over-the-counter nonsteroidal anti- inflammatory drug use in patients with upper gastrointestinal hemorrhage." Arch Intern Med 154 (1994): 42-6
  10. Silagy CA, McNeil JJ, Worsam B, Campion K, Donnan GA, Tonkin AM "Adverse effects of low-dose aspirin in a healthy elderly population." Clin Pharmacol Ther 54 (1993): 84-9
  11. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  12. Langman M, Colinjones D, Murphy M, Wainwright P, Lawson D, Logan R, Rawlins M, Vessey M, Weil J "Prophylactic aspirin and risk of peptic ulcer bleeding." BMJ 310 (1995): 827-30
  13. Allen ML, Dimarino AJ, Krum RP, Hermann GA, Savon JJ "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  14. 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
  15. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  16. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  17. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  18. Cello JP, Greenberg PD, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604
  19. Benito R, Bajador E, Sainz R, Serrano P, Esteva F, Lanas A "Evidence of aspirin use in both upper and lower gastrointestinal perforation." Gastroenterology 112 (1997): 683-9
View all 19 references
Major

Salicylates (applies to aspirin/omeprazole) 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. Kimberly RP, Plotz PH "Aspirin-induced depression of renal function." N Engl J Med 296 (1977): 418-24
  2. Kahles HW, Elsner D, Kromer EP, Riegger GA, Kochsiek K "Effects of acetylsalicylic acid on renal function in patients with chronic heart failure." Am J Med 90 (1991): 571-5
  3. Carmichael J, Shankel SW "Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function." Am J Med 78 (1985): 992-1000
  4. Oberley TD, Parthasarathy R, Iliopoulos O, Wen SF "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. Bennett WM, Muther RS, Potter DM "Aspirin-induced depression of glomerular filtration rate in normal humans: role of sodium balance." Ann Intern Med 94 (1981): 317-21
  7. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  8. Whelton A "Renal effects of over-the-counter analgesics." J Clin Pharmacol 35 (1995): 454-63
  9. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  10. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  11. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):
View all 11 references
Major

Salicylates (applies to aspirin/omeprazole) 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. Epidemiology Office, Center for Infectious Diseases, Centers for Disease Control., Divisiion of Viral and Rickettsial Diseasses "Leads from the MMWR. Reye syndrome surveillance--United States, 1987 and 1988." JAMA 261 (1989): 3520,
  2. Duggan JM, Hasking GJ "Encephalopathy from bismuth subsalicylate." Med J Aust 2 (1982): 167
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals (2001):
  4. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  5. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  6. Arvin A, Kliegman R, Nelson W, Behrman R, eds. "Nelson Textbook of Pediatrics." Philadelphia, PA: W.B. Saunders Company (1996):
  7. American Academy of Pediatrics. Committee on Infectious Diseases; Peter G, ed. "Red BooK: Report of the Committee on Infectious Diseases." Grove Village, IL: American Academy of Pediatrics (1997):
  8. Schonberger LB, Shahriari A, Bresee JS, Belay ED, Holman RC, Khan AS "Reye's syndrome in the United States from 1981 through 1997." N Engl J Med 340 (1999): 1377-82
  9. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):
View all 9 references
Moderate

Proton pump inhibitors (applies to aspirin/omeprazole) bone fractures

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Osteoporosis

Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.

References

  1. "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
  2. "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
  4. "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Omeprazole (omeprazole)." Mylan Pharmaceuticals Inc (2003):
  6. "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
View all 6 references
Moderate

Proton pump inhibitors (applies to aspirin/omeprazole) hypomagnesemia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Magnesium Imbalance

Symptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.

References

  1. "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
  2. "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
  4. "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Omeprazole (omeprazole)." Mylan Pharmaceuticals Inc (2003):
  6. "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
View all 6 references
Moderate

Salicylates (applies to aspirin/omeprazole) 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. Bassan H, Odeh M, Levy N, Yeshurun D, Stermer E, Naschitz JE, Rosner I "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. Prichard PJ, Walt RP, Daneshmend TK, Hawkey CJ, Kitchingman GK "Human gastric mucosal bleeding induced by low dose aspirin, but not warfarin." BMJ 298 (1989): 493-6
  3. Allen ML, Dimarino AJ, Krum RP, Hermann GA, Savon JJ "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  4. 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
  5. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  6. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  7. Marks RD "Aspirin use and fecal occult blood testing." Am J Med 100 (1996): 596-7
  8. Cello JP, Greenberg PD, Rockey DC "Asymptomatic chronic gastrointestinal blood loss in patients taking aspirin or warfarin for cardiovascular disease." Am J Med 100 (1996): 598-604
View all 8 references
Moderate

Salicylates (applies to aspirin/omeprazole) 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 (2001):
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  3. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):
Moderate

Salicylates (applies to aspirin/omeprazole) 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 (2001):
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham (2001):
  3. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):
Moderate

Salicylates (applies to aspirin/omeprazole) 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. Seaman WE, Ishak KG, Plotz PH "Aspirin-induced hepatotoxicity in patients with systemic lupus erythematosus." Ann Intern Med 80 (1974): 1-8
  2. Goldstein RC, Metzger AL, Wolfe JD "Aspirin hepatitis." Ann Intern Med 80 (1974): 74-6
  3. Bennett RM, Sbarbaro JA "Aspirin hepatotoxicity and disseminated intravascular coagulation." Ann Intern Med 86 (1977): 183-5
  4. Beermann B, Wahlin-Boll E, Melander A, Britton S, Jorup-Ronstrom C "Reduction of paracetamol and aspirin metabolism during viral hepatitis." Clin Pharmacokinet 11 (1986): 250-6
  5. Hesse A, Notarianni LJ, Ogunbona A, Bennett PN, Patel DK "Metabolism of aspirin after therapeutic and toxic doses." Hum Exp Toxicol 9 (1990): 131-6
  6. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  7. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc (2001):
  8. "Product Information. Rexolate (sodium thiosalicylate)." Hyrex Pharmaceuticals (2001):
View all 8 references

Aspirin/omeprazole drug interactions

There are 480 drug interactions with aspirin / omeprazole.

Aspirin/omeprazole alcohol/food interactions

There are 2 alcohol/food interactions with aspirin / omeprazole.


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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.