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Drug Interactions between Azdone and lecanemab

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

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Interactions between your drugs

Major

aspirin lecanemab

Applies to: Azdone (aspirin / hydrocodone) and lecanemab

MONITOR CLOSELY: Coadministration with drugs that can affect hemostasis such as anticoagulants, antiplatelet agents, and thrombolytics may potentiate the risk of bleeding complications observed with amyloid beta-directed antibody therapy. Use of monoclonal antibodies directed against aggregated forms of beta amyloid such as aducanumab, donanemab, and lecanemab has been associated with amyloid related imaging abnormalities (ARIA) with hemosiderin deposition (ARIA-H), including microhemorrhage, superficial siderosis, and intracerebral hemorrhage greater than 1 cm in diameter, the latter of which can be fatal. Based on limited clinical trial data, concomitant use of these monoclonal antibodies with an antithrombotic medication (aspirin, other antiplatelet agents, or anticoagulants) does not appear to significantly increase the risk of ARIA-H or intracerebral hemorrhage compared to use without an antithrombotic medication or placebo with an antithrombotic medication. However, the majority of antithrombotic exposures in trial patients were to aspirin only; therefore, no definitive conclusions regarding safety concerns can be drawn. In addition, patients with known risk factors for intracerebral hemorrhage were excluded from clinical trials.

MANAGEMENT: Due to the risk of potentially fatal intracerebral hemorrhage, caution and close monitoring are recommended with the use of antithrombotic or thrombolytic agents in patients receiving amyloid beta-directed antibody therapy, particularly those with risk factors for ARIA and intracerebral hemorrhage such as apolipoprotein E epsilon 4 carriers (approximately 15% of patients with Alzheimer's disease are apoE epsilon 4 homozygotes) or patients with baseline radiographic findings suggestive of cerebral amyloid angiopathy (e.g., evidence of prior intracerebral hemorrhage greater than 1 cm in diameter, at least two cerebral microhemorrhages, cortical superficial siderosis, vasogenic edema, diffuse white matter disease) or other lesions (e.g., aneurysm, vascular malformation). Because ARIA with edema (ARIA-E) can cause focal neurologic deficits that may mimic an ischemic stroke, clinicians should consider whether such symptoms could be due to ARIA-E before giving thrombolytic therapy in patients being treated with an amyloid beta-directed antibody.

References (3)
  1. (2023) "Product Information. Leqembi (lecanemab)." Eisai Inc, 1
  2. (2024) "Product Information. Kisunla (donanemab)." Lilly, Eli and Company
  3. (2023) "Product Information. Aduhelm (aducanumab)." Biogen Idec Inc

Drug and food interactions

Major

HYDROcodone food

Applies to: Azdone (aspirin / hydrocodone)

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including hydrocodone. 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.

GENERALLY AVOID: Consumption of alcohol while taking some sustained-release formulations of hydrocodone may cause rapid release of the drug, resulting in high systemic levels of hydrocodone that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. In study subjects, the rate of absorption of hydrocodone from an extended-release formulation was found to be affected by coadministration with 40% alcohol in the fasted state, as demonstrated by an average 2.4-fold (up to 3.9-fold in one subject) increase in hydrocodone peak plasma concentration and a decrease in the time to peak concentration. Alcohol also increased the extent of absorption by an average of 1.2-fold (up to 1.7-fold in one subject).

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of hydrocodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of hydrocodone by certain compounds present in grapefruit. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.

MANAGEMENT: Patients taking sustained-release formulations of hydrocodone should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as hydrocodone should not be combined with alcohol. Patients should also avoid consumption of grapefruit or grapefruit juice during treatment with hydrocodone.

References (1)
  1. (2013) "Product Information. Zohydro ER (hydrocodone)." Zogenix, Inc
Moderate

aspirin food

Applies to: Azdone (aspirin / hydrocodone)

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

aspirin food

Applies to: Azdone (aspirin / hydrocodone)

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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