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Drug Interactions between balsalazide and hydrocodone / ibuprofen

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

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Interactions between your drugs

Moderate

ibuprofen balsalazide

Applies to: hydrocodone / ibuprofen and balsalazide

MONITOR: Coadministration of 5-aminosalicylate with other nephrotoxic agents may increase the risk and severity of renal impairment due to additive effects on the kidney. The use of 5-aminosalicylate or its prodrugs has been associated with rare reports of renal impairment including minimal change nephropathy, acute and chronic interstitial nephritis, and renal failure. Animal studies have also shown the kidney to be the major target organ of 5-aminosalicylate toxicity. Renal lesions including granular and hyaline casts, tubular degeneration, tubular dilation, renal infarct, papillary edema, papillary necrosis, tubular necrosis, interstitial fibrosis, and interstitial nephritis have been observed with large doses.

MANAGEMENT: Caution is advised when 5-aminosalicylate preparations are prescribed to patients who have recently received or are receiving treatment with other potentially nephrotoxic agents (e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function should be evaluated prior to and during 5-aminosalicylate therapy.

References (4)
  1. Novis BH, Korzets Z, Chen P, Bernheim J (1988) "Nephrotic syndrome after treatment with 5-aminosalicylic acid." Br Med J (Clin Res Ed), 296, p. 1442
  2. "Product Information. Canasa (mesalamine)." Axcan Pharma US Inc
  3. (2022) "Product Information. Lialda (mesalamine)." Shire US Inc
  4. Schreiber S. Hamling J, Zehnter E, et al. (1997) "Renal tubular dysfunction in patients with inflammatory bowel disease treated with aminosalicylate." Gut, 40, p. 761-6

Drug and food interactions

Major

HYDROcodone food

Applies to: hydrocodone / ibuprofen

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

ibuprofen food

Applies to: hydrocodone / ibuprofen

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

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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