Drug Interactions between aspirin / omeprazole and Skelid
This report displays the potential drug interactions for the following 2 drugs:
- aspirin/omeprazole
- Skelid (tiludronate)
Interactions between your drugs
aspirin tiludronate
Applies to: aspirin / omeprazole and Skelid (tiludronate)
ADJUST DOSING INTERVAL: Aspirin has been reported to decrease the bioavailability of tiludronate by up to 50% when taken two hours after tiludronate. The mechanism of the interaction is unknown.
MANAGEMENT: Aspirin should be taken two hours before or two hours after tiludronate.
References
- "Product Information. Skelid (tiludronate)." Sanofi Winthrop Pharmaceuticals
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
- 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
- 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
- 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
Drug and food interactions
tiludronate food
Applies to: Skelid (tiludronate)
ADJUST DOSING INTERVAL: Food significantly decreases the bioavailability of tiludronate. The manufacturer reports up to a 90% decrease in bioavailability when administered with or 2 hours after a standard breakfast. Clinical efficacy, however, was demonstrated when tiludronate was taken 2 hours before or after meals.
MANAGEMENT: Tiludronate should be administered with 6 to 8 ounces of plain water at least 2 hours before or 2 hours after food.
References
- "Product Information. Skelid (tiludronate)." Sanofi Winthrop Pharmaceuticals
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
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
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
- 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
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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