Drug Interactions between clove and Zee-Seltzer Antacid and Pain Reliever

MONITOR: Agents that cause urinary alkalinization can reduce serum salicylate concentrations in patients receiving anti-inflammatory dosages of aspirin or other salicylates. The mechanism involves reduction in salicylate renal tubular reabsorption due to increased urinary pH, resulting in increased renal salicylate clearance especially above urine pH of 7. This interaction is sometimes exploited in the treatment of salicylate toxicity.

MANAGEMENT: Patients treated chronically with urinary alkalinizers and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

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Clove and clove oil may potentiate the effects of anticoagulants and other drugs that may affect hemostasis such as platelet inhibitors, thrombolytic agents, and nonsteroidal anti-inflammatory drugs, possibly increasing the risk of bleeding. Eugenol, the active constituent of clove and clove oil, has been shown to be an inhibitor of platelet activity. However, bleeding complications and interactions with hematologic agents have not been reported. Moreover, pharmacologic effects may be highly variable due to inconsistencies in formulation and potency of commercial herbal products. Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients who have used clove and clove oil extensively prior to receiving treatment with anticoagulants or other drugs that may affect hemostasis, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

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