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Drug Interactions between aspirin / pravastatin and ticlopidine

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

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Interactions between your drugs

Moderate

aspirin ticlopidine

Applies to: aspirin / pravastatin and ticlopidine

GENERALLY AVOID: Ticlopidine may potentiate the effect of aspirin on collagen-induced platelet aggregation. Other salicylates that also inhibit platelet aggregation may be similarly impacted. An increased risk of bleeding should be anticipated, especially in patients with a history of gastrointestinal (GI) ulceration or bleeding. Conversely, aspirin does not alter the ticlopidine-mediated inhibition of adenosine diphosphate-induced platelet aggregation.

MANAGEMENT: The safety of concomitant use of ticlopidine with aspirin or other platelet-inhibiting salicylates has not been established. Ticlopidine labeling recommends against long-term coadministration with aspirin. However, ticlopidine (250 mg twice daily) may be given with antiplatelet dosages of aspirin for up to 30 days following successful coronary artery stent implantation to reduce the risk of blood clots forming inside the stent. Close monitoring for bleeding complications, particularly GI bleeding, is advised during treatment.

References (1)
  1. (2001) "Product Information. Ticlid (ticlopidine)." Syntex Laboratories Inc

Drug and food interactions

Moderate

ticlopidine food

Applies to: ticlopidine

ADJUST DOSING INTERVAL: The bioavailability and gastrointestinal tolerance of ticlopidine is enhanced by food.

MANAGEMENT: Patients may be advised to take ticlopidine with meals.

References (1)
  1. (2001) "Product Information. Ticlid (ticlopidine)." Syntex Laboratories Inc
Moderate

aspirin food

Applies to: aspirin / pravastatin

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
Moderate

pravastatin food

Applies to: aspirin / pravastatin

MONITOR: Concomitant use of statin medication with substantial quantities of alcohol may increase the risk of hepatic injury. Transient increases in serum transaminases have been reported with statin use and while these increases generally resolve or improve with continued therapy or a brief interruption in therapy, there have been rare postmarketing reports of fatal and non-fatal hepatic failure in patients taking statins. Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at increased risk for hepatic injury. Active liver disease or unexplained transaminase elevations are contraindications to statin use.

MANAGEMENT: Patients should be counseled to avoid substantial quantities of alcohol in combination with statin medications and clinicians should be aware of the increased risk for hepatotoxicity in these patients.

References (9)
  1. (2001) "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb
  2. (2001) "Product Information. Zocor (simvastatin)." Merck & Co., Inc
  3. (2001) "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals
  4. (2001) "Product Information. Lipitor (atorvastatin)." Parke-Davis
  5. (2002) "Product Information. Altocor (lovastatin)." Andrx Pharmaceuticals
  6. (2003) "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  8. Cerner Multum, Inc. "Australian Product Information."
  9. (2010) "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic)
Minor

aspirin food

Applies to: aspirin / pravastatin

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.

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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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