Drug Interactions between aspirin / caffeine / dihydrocodeine and aspirin / pentazocine
This report displays the potential drug interactions for the following 2 drugs:
- aspirin/caffeine/dihydrocodeine
- aspirin/pentazocine
Interactions between your drugs
pentazocine dihydrocodeine
Applies to: aspirin / pentazocine and aspirin / caffeine / dihydrocodeine
GENERALLY AVOID: Concomitant use of opioids with other central nervous system (CNS) depressants including mixed agonist-antagonist or partial agonist opioids may result in profound sedation, respiratory depression, coma, and death. The risk of hypotension may also be increased. On the other hand, mixed agonist-antagonist or partial agonist opioids can reduce the pharmacologic effects of other opioid agonists. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their opioid regimen following the addition of a mixed agonist-antagonist or partial agonist opioid.
MANAGEMENT: The use of opioids in conjunction with other CNS depressants including mixed agonist-antagonist or partial agonist opioids should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary (e.g., when initiating a switch from one opioid to the other), the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Additional caution is advisable when a mixed agonist-antagonist or partial agonist opioid is added to an existing opioid regimen, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the mixed agonist-antagonist or partial agonist opioid. A dosage adjustment for one or both drugs may be required.
References
- Moldenhauer CC, Roach GW, Finlayson DC, et al. (1985) "Nalbuphine antagonism of ventilatory depression following high-dose fentanyl anesthesia." Anesthesiology, 62, p. 647-50
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- Strain EC, Preston KL, Liebson IA, Bigelow GE (1993) "Precipitated withdrawal by pentazocine in methadone-maintained volunteers." J Pharmacol Exp Ther, 267, p. 624-34
- (2001) "Product Information. Nubain (nalbuphine)." Endo Laboratories LLC
- (2001) "Product Information. Buprenex (buprenorphine)." Reckitt and Colman Pharmaceuticals Inc
- (2001) "Product Information. Talwin NX (pentazocine)." Sanofi Winthrop Pharmaceuticals
- (2001) "Product Information. Stadol (butorphanol)." Allscrips Pharmaceutical Company
- (2001) "Product Information. Dalgan (dezocine)." Astra-Zeneca Pharmaceuticals
- (2002) "Product Information. Suboxone (buprenorphine-naloxone)." Reckitt and Colman Pharmaceuticals Inc
- (2002) "Product Information. Subutex (buprenorphine)." Reckitt and Colman Pharmaceuticals Inc
- (2010) "Product Information. Butrans (buprenorphine)." Purdue Pharma LP
aspirin caffeine
Applies to: aspirin / caffeine / dihydrocodeine and aspirin / pentazocine and aspirin / caffeine / dihydrocodeine
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
Drug and food interactions
pentazocine food
Applies to: aspirin / pentazocine
MONITOR: Smoking tobacco may decrease the plasma concentrations and effects of pentazocine by enhancing its metabolic clearance.
MANAGEMENT: The possibility of reduced therapeutic effects of pentazocine should be considered in smokers.
References
- Miller LG (1989) "Recent developments in the study of the effects of cigarette smoking on clinical pharmacokinetics and clinical pharmacodynamics." Clin Pharmacokinet, 17, p. 90-108
- D'Arcy PF (1984) "Tobacco smoking and drugs: a clinically important interaction?" Drug Intell Clin Pharm, 18, p. 302-7
- (2006) "Product Information. Talacen (acetaminophen-pentazocine)." Sanofi-Synthelabo Inc
aspirin food
Applies to: aspirin / caffeine / dihydrocodeine and aspirin / pentazocine
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
pentazocine food
Applies to: aspirin / pentazocine
GENERALLY AVOID: Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.
MANAGEMENT: Concomitant use of opioid analgesics with ethanol should be avoided.
References
- Linnoila M, Hakkinen S (1974) "Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving." Clin Pharmacol Ther, 15, p. 368-73
- Sturner WQ, Garriott JC (1973) "Deaths involving propoxyphene: a study of 41 cases over a two-year period." JAMA, 223, p. 1125-30
- Girre C, Hirschhorn M, Bertaux L, et al. (1991) "Enhancement of propoxyphene bioavailability by ethanol: relation to psychomotor and cognitive function in healthy volunteers." Eur J Clin Pharmacol, 41, p. 147-52
- Levine B, Saady J, Fierro M, Valentour J (1984) "A hydromorphone and ethanol fatality." J Forensic Sci, 29, p. 655-9
- Sellers EM, Hamilton CA, Kaplan HL, Degani NC, Foltz RL (1985) "Pharmacokinetic interaction of propoxyphene with ethanol." Br J Clin Pharmacol, 19, p. 398-401
- Carson DJ (1977) "Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases." Lancet, 1, p. 894-7
- Rosser WW (1980) "The interaction of propoxyphene with other drugs." Can Med Assoc J, 122, p. 149-50
- Edwards C, Gard PR, Handley SL, Hunter M, Whittington RM (1982) "Distalgesic and ethanol-impaired function." Lancet, 2, p. 384
- Kiplinger GF, Sokol G, Rodda BE (1974) "Effect of combined alcohol and propoxyphene on human performance." Arch Int Pharmacodyn Ther, 212, p. 175-80
caffeine food
Applies to: aspirin / caffeine / dihydrocodeine
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
- (1995) "Grapefruit juice interactions with drugs." Med Lett Drugs Ther, 37, p. 73-4
- 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
aspirin food
Applies to: aspirin / caffeine / dihydrocodeine and aspirin / pentazocine
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
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Nonsteroidal anti-inflammatories
Therapeutic duplication
The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category:
- aspirin/caffeine/dihydrocodeine
- aspirin/pentazocine
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
Cyclooxygenase inhibitors
Therapeutic duplication
The recommended maximum number of medicines in the 'cyclooxygenase inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'cyclooxygenase inhibitors' category:
- aspirin/caffeine/dihydrocodeine
- aspirin/pentazocine
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
See also
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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