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Drug Interactions between clopidogrel and Sudafed 12 Hour Pressure+Pain

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

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Interactions between your drugs

Moderate

naproxen clopidogrel

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine) and clopidogrel

MONITOR: The coadministration of clopidogrel with naproxen resulted in occult gastrointestinal blood loss in healthy volunteers. The mechanism has not been described, but may be due to additive platelet inhibition. The coadministration of nonsteroidal anti-inflammatory drugs (NSAIDs) and clopidogrel should be undertaken with extreme caution. Additionally, some NSAIDs are substrates for the CYP450 isoenzyme 2C9. Clopidogrel inhibits this isoenzyme and therefore may lead to decreased metabolism of these NSAIDs. The clinical magnitude of this interaction is not known.

MANAGEMENT: Close observation for increased NSAID toxicity is recommended if these agents are coadministered with clopidogrel. Patients should also be advised to promptly report any signs of GI bleeding to their caregiver, including pain, swelling, dizziness, weakness, bloody or coffee-ground emesis, or red or black stools, and to avoid any over-the-counter NSAID products.

References

  1. (2001) "Product Information. Plavix (clopidogrel)." Bristol-Myers Squibb

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Drug and food interactions

Moderate

naproxen food

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine)

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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Moderate

pseudoephedrine food

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
View all 7 references

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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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