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Drug Interactions between aspirin / butalbital / caffeine and evening primrose

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

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Interactions between your drugs

Minor

aspirin caffeine

Applies to: aspirin / butalbital / caffeine and aspirin / butalbital / caffeine

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)
  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6
Minor

aspirin evening primrose

Applies to: aspirin / butalbital / caffeine and evening primrose

Theoretically, use of borage or evening primrose oil with anticoagulants or antiplatelet aggregation drugs may increase the risk of bleeding in some patients. In one study, 12 hyperlipidemic males took gamma linolenic acid 240 mg and linolenic acid 2200 mg (both main components of borage and evening primrose oil) daily for 4 months. After 4 months on this supplementation and compared to baseline, platelet aggregation decreased by 50% when platelets were aggregated with adenosine diphosphate (ADP), and by 60% with adrenaline. Also, in the same study platelet thromboxane B2 levels were reduced by 54% as compared to placebo. However, another study suggests platelet aggregation in healthy patients may not be affected by borage oil supplementation. Until further information is available, clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bruising, red or brown urine, or red or black stools.

References (5)
  1. Kathy Wedig, Jeffrey Whitsett (2008) "Down the Primrose Path: Petechiae in a Neonate Exposed to Herbal Remedy for Parturition." J Pediatr, 10, p. 2
  2. Guivernau M, Meza N, Barja P, Roman O (1994) "Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production." Prostaglandins Leukot Essent Fatty Acids, 51, p. 311-6
  3. N. A. Michael Eskin (2008) "Borage and evening primrose oil." European Journal of Lipid Science and Technology, 110, p. 1
  4. Bard JM, Luc G, Jude B, et al. (1997) "A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers." Fundam Clin Pharmacol, 11, p. 143-4
  5. Asadi-Samani M, Bahmani M, Rafieian-Kopaei M (2014) "The chemical composition, botanical characteristic and biological activities of Borago officinalis: a review." Asian Pac J Trop Med, 7S1, S22-8

Drug and food interactions

Major

butalbital food

Applies to: aspirin / butalbital / caffeine

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Moderate

aspirin food

Applies to: aspirin / butalbital / caffeine

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)
  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
Minor

caffeine food

Applies to: aspirin / butalbital / caffeine

The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine. However, a well-conducted pharmacokinetic/pharmacodynamic study did not demonstrate this effect. The clinical significance of this potential interaction is unknown.

References (2)
  1. (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
  2. Maish WA, Hampton EM, Whitsett TL, Shepard JD, Lovallo WR (1996) "Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics." Pharmacotherapy, 16, p. 1046-52
Minor

aspirin food

Applies to: aspirin / butalbital / caffeine

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)
  1. 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

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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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