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Drug Interactions between aspirin / omeprazole and Charcocaps

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

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Interactions between your drugs

Moderate

aspirin charcoal

Applies to: aspirin / omeprazole and Charcocaps (charcoal)

GENERALLY AVOID: Charcoal may reduce the absorption of many drugs and can absorb enterohepatically circulated drugs. Clinical utility may be the reduction either of the effects or of the toxicity of many drugs. Activated charcoal may adsorb any therapeutic agents administered while it is in the gastrointestinal tract.

MANAGEMENT: The regular ingestion of charcoal should be avoided by patients requiring maintenance medications. If concomitant use is necessary, the dosage or route of administration may need to be altered.

References

  1. Decker WJ, Shpall RA, Corby DG (1969) "Inhibition of aspirin absorption by activated charcoal and apomorphine." Clin Pharmacol Ther, 10, p. 710-3
  2. Knadler MP, Bergstrom RF, Callaghan JT, Obermeyer BD, Rubin A (1987) "Absorption studies of the H2-blocker nizatidine." Clin Pharmacol Ther, 42, p. 514-20
  3. Wing LM, Miners JO, Birkett DJ, et al. (1984) "Lidocaine disposition: sex differences and effects of cimetidine." Clin Pharmacol Ther, 35, p. 695-701
  4. Scheufler E, Bos I (1983) "Influence of peroral charcoal on pharmacokinetics and intestinal toxicity of intravenously given methotrexate." Arch Int Pharmacodyn Ther, 261, p. 180-5
  5. Gadgil SD, Damle SR, Advani SH, Vaidya AB (1982) "Effect of activated charcoal on the pharmacokinetics of high-dose methotrexate." Cancer Treat Rep, 66, p. 1169-71
  6. Park GD, Spector R, Goldberg MJ, Johnson GF (1986) "Expanded role of charcoal therapy in the poisoned and overdosed patient." Arch Intern Med, 146, p. 969-73
  7. Watson WA (1987) "Factors influencing the clinical efficacy of activated charcoal." Drug Intell Clin Pharm, 21, p. 160-6
  8. Kivisto KT, Neuvonen PJ (1990) "The effect of cholestyramine and activated charcoal on glipizide absorption." Br J Clin Pharmacol, 30, p. 733-6
  9. Dolgin JG, Nix DE, Sanchez J, Watson WA (1991) "Pharmacokinetic simulation of the effect of multiple-dose activated charcoal in phenytoin poisoning: report of two pediatric cases." DICP, 25, p. 646-9
  10. Rowden AM, Spoor JE, Bertino JS, Jr (1990) "The effect of activated charcoal on phenytoin pharmacokinetics." Ann Emerg Med, 19, p. 1144-7
  11. Farrar HC, Herold DA, Reed MD (1993) "Acute valproic acid intoxication: enhanced drug clearance with oral-activated charcoal." Crit Care Med, 21, p. 299-301
  12. Howard CE, Roberts RS, Ely DS, Moye RA (1994) "Use of multiple-dose activated charcoal in phenytoin toxicity." Ann Pharmacother, 28, p. 201-3
  13. Chernish SM, Wolen RL, Rodda BE (1972) "Adsorption of propoxyphene hydrochloride by activated charcoal." Clin Toxicol, 5, p. 317-29
  14. Glab WN, Corby DG, Decker WJ, Coldiron VR (1982) "Decreased absorption of propoxyphene by activated charcoal." J Toxicol Clin Toxicol, 19, p. 129-38
  15. Karkkainen S, Neuvonen PJ (1985) "Effect of oral charcoal and urine pH on dextropropoxyphene pharmacokinetics." Int J Clin Pharmacol Ther Toxicol, 23, p. 219-25
  16. Wakabayashi Y, Maruyama S, Hachimura K, Ohwada T (1994) "Activated charcoal interrupts enteroenteric circulation of phenobarbital." J Toxicol Clin Toxicol, 32, p. 419-24
  17. Reed MD (1988) "Oral activated charcoal therapy." Am J Emerg Med, 6, p. 318
  18. Neuvonen PJ (1982) "Clinical pharmacokinetics of oral activated charcoal in acute intoxications." Clin Pharmacokinet, 7, p. 465-89
  19. Naveau S, Bonhomme L, Preaux N, Chaput JC (1991) "A pure charcoal suspension for colonoscopic tattoo." Gastrointest Endosc, 37, p. 624-5
  20. Ilkhanipour K, Yealy DM, Krenzelok EP (1993) "Activated charcoal surface area and its role in multiple-dose charcoal therapy." Am J Emerg Med, 11, p. 583-5
  21. Saetta JP (1993) "Gastric decontaminating procedures: is it time to call a stop?" J R Soc Med, 86, p. 396-9
  22. Orisakwe OE (1994) "Activated charcoal: is failure to use it negligence or ignorance?" South Med J, 87, p. 165-8
  23. Herrington AM, Clifton GD (1995) "Toxicology and management of acute drug ingestions in adults." Pharmacotherapy, 15, p. 182-200
  24. Bonuccelli U, Piccini P, Del Dotto P, Pavese N, D'Antonio P, Muratorio A (1992) "Apomorphine test in de novo Parkinson's disease." Funct Neurol, 7, p. 295-8
  25. (2001) "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals
View all 25 references

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Minor

aspirin omeprazole

Applies to: aspirin / omeprazole and aspirin / omeprazole

Coadministration with proton pump inhibitors may decrease the oral bioavailability of aspirin and other salicylates. The interaction has been studied with omeprazole and aspirin, although data are conflicting. In one study, pretreatment with omeprazole (20 mg/day for 2 days) in 11 healthy volunteers led to a significant and progressively greater reduction in the mean serum salicylate level at 30, 60, and 90 minutes after administration of aspirin (650 mg single dose). The investigators suggest that acid suppression may reduce the lipophilic nature of aspirin, thereby adversely affecting its absorption from the gastrointestinal tract. Another study found no effect of omeprazole pretreatment (20 mg/day for 4 days) on plasma salicylate and aspirin levels, skin bleeding times, or antiplatelet effect of low-dose aspirin (125 mg single dose) in 14 healthy volunteers. However, these results do not exclude the possibility that omeprazole might interfere with the analgesic, antipyretic, or anti-inflammatory effects of aspirin, which has been demonstrated in rats.

Proton pump inhibitors may enhance the release rate of salicylates from enteric-coated formulations due to premature disruption of the coating and intragastric release of the drug secondary to an increase in gastric pH. In eight healthy volunteers, omeprazole pretreatment (20 mg/day for 4 days) did not affect the bioavailability of salicylate from uncoated aspirin tablets but significantly increased the absorption rate of salicylate from enteric-coated sodium salicylate tablets. The clinical significance of this interaction is unknown. Theoretically, it may increase the risk of gastric adverse effects associated with salicylates.

References

  1. Nefesoglu FZ, Ayanoglu-Dulger G, Ulusoy NB, Imeryuz N (1998) "Interaction of omeprazole with enteric-coated salicylate tablets." Int J Clin Pharmacol Ther, 36, p. 549-53
  2. Anand BS, Sanduja SK, Lichetenberger LM (1999) "Effect of omeprazole on the bioavailability of aspirin: a randomized controlled study on healthy volunteers." Gastroenterology, 116, A371
  3. Inarrea P, Esteva F, Cornudella R, Lanas A (2000) "Omeprazole does not interfere with the antiplatelet effect of low-dose aspirin in man." Scand J Gastroenterol, 35, p. 242-6

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Drug and food interactions

Moderate

aspirin food

Applies to: aspirin / omeprazole

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

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Minor

aspirin food

Applies to: aspirin / omeprazole

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

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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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