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Drug Interactions between aspirin / caffeine / dihydrocodeine and obeticholic acid

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

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Interactions between your drugs

Moderate

caffeine obeticholic acid

Applies to: aspirin / caffeine / dihydrocodeine and obeticholic acid

MONITOR: Coadministration with obeticholic acid may increase the plasma concentrations of drugs that are substrates of the CYP450 1A2 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 1A2 activity by obeticholic acid and its glycine and taurine conjugates. When a single 200 mg dose of caffeine (a probe CYP450 1A2 substrate) was administered with obeticholic acid 10 mg once daily, caffeine peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 6% and 42%, respectively.

MANAGEMENT: Caution is advised when obeticholic acid is prescribed with drugs that undergo metabolism by CYP450 1A2, particularly those with a narrow therapeutic range such as theophylline or tizanidine. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever obeticholic acid is added to or withdrawn from therapy.

References (1)
  1. (2016) "Product Information. Ocaliva (obeticholic acid)." Intercept Pharmaceuticals, Inc.
Minor

aspirin caffeine

Applies to: aspirin / caffeine / dihydrocodeine 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 (1)
  1. 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

Moderate

aspirin food

Applies to: aspirin / caffeine / dihydrocodeine

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 / 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 (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 / 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 (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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