Diclofenac ophthalmic Disease Interactions
There are 2 disease interactions with diclofenac ophthalmic:
Nsaids (Includes Diclofenac ophthalmic) ↔ Asthma
Severe Potential Hazard, High plausibility
Applies to: Asthma
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.
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals, East Hanover, NJ.
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
- "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
Ophthalmic Nsaids (Includes Diclofenac ophthalmic) ↔ Platelet Inhibition
Moderate Potential Hazard, Low plausibility
Applies to: Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Bleeding, Vitamin K Deficiency
Topically applied nonsteroidal anti-inflammatory drugs (NSAIDs) are systemically absorbed, with the potential for producing rare but clinically significant systemic effects. NSAIDs have been shown to reversibly inhibit platelet adhesion and aggregation and may slightly prolong bleeding time in healthy individuals. These effects may be more pronounced in patients with underlying hemostatic abnormalities. Thrombocytopenia has also been reported rarely during NSAID use. Therapy with ocular NSAIDs should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment.
- Thwaites BK, Nigus DB, Bouska GW, Mongan PD, Ayala EF, Merrill GA "Intravenous ketorolac tromethamine worsens platelet function during knee arthroscopy under spinal anesthesia." Anesth Analg 82 (1996): 1176-81
- Camba L, Joyner MV "Acute thrombocytopenia following ingestion of indomethacin." Acta Haematol 71 (1984): 350-2
- "Product Information. Voltaren (diclofenac)." Ciba Vision Ophthalmics, Duluth, GA.
diclofenac ophthalmic drug Interactions
There are 116 drug interactions with diclofenac ophthalmic
Drug Interaction Classification
|Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|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.|
|No information available.|
Do not stop taking any medications without consulting your healthcare provider.
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