Drug Interactions between Alka-Seltzer Extra Strength and ticagrelor
This report displays the potential drug interactions for the following 2 drugs:
- Alka-Seltzer Extra Strength (aspirin/citric acid/sodium bicarbonate)
- ticagrelor
Interactions between your drugs
aspirin sodium bicarbonate
Applies to: Alka-Seltzer Extra Strength (aspirin/citric acid/sodium bicarbonate) and Alka-Seltzer Extra Strength (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
- Berg KJ (1977) "Acute acetylsalicylic acid poisoning: treatment with forced alkaline diuresis and diuretics." Eur J Clin Pharmacol, 12, p. 111-6
- Prescott LF, Balali-Mood M, Critchley JA, Johnstone AF, Proudfoot AT (1982) "Diuresis or urinary alkalinisation for salicylate poisoning?" Br Med J (Clin Res Ed), 285, p. 1383-6
- Balali-Mood M, Prescott LF (1980) "Failure of alkaline diuresis to enhance diflunisal elimination." Br J Clin Pharmacol, 10, p. 163-5
- Berg KJ (1977) "Acute effects of acetylsalicylic acid in patients with chronic renal insufficiency." Eur J Clin Pharmacol, 11, p. 111-6
- Brouwers JRBJ, Desmet PAGM (1994) "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet, 27, p. 462-85
aspirin ticagrelor
Applies to: Alka-Seltzer Extra Strength (aspirin/citric acid/sodium bicarbonate) and ticagrelor
ADJUST DOSE: Use of high maintenance dosages of aspirin may decrease the effectiveness of ticagrelor in preventing thrombotic events in patients with acute coronary syndromes. The underlying biological mechanism has not been established. Data from PLATO, a large, randomized, double-blind efficacy and safety comparison study with clopidogrel, suggest that the efficacy of ticagrelor is associated with aspirin dosage during maintenance therapy. Patients who received a low maintenance dosage (75 to 150 mg daily) of aspirin benefited more than those who received a high maintenance dosage (above 300 mg daily). Because data for the high maintenance dosages of aspirin do not provide conclusive evidence of efficacy of ticagrelor relative to clopidogrel, the dosage of aspirin should be limited during maintenance dual antiplatelet therapy with ticagrelor. In drug interaction studies, coadministration of ticagrelor with aspirin did not have any effect on the plasma levels of ticagrelor or its active metabolite.
MANAGEMENT: Following the initial loading dose (usually 325 mg) of aspirin, a daily maintenance dose of 75 to 100 mg is recommended by the manufacturer to be used with ticagrelor.
References
- (2011) "Product Information. Brilinta (ticagrelor)." Astra-Zeneca Pharmaceuticals
Drug and food interactions
aspirin food
Applies to: Alka-Seltzer Extra Strength (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
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
aspirin food
Applies to: Alka-Seltzer Extra Strength (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
- Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6
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
Report options
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 interaction information available. |
Further information
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