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Drug Interactions between Demadex and Pravigard Pac

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

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Interactions between your drugs

Minor

aspirin torsemide

Applies to: Pravigard Pac (aspirin / pravastatin) and Demadex (torsemide)

Salicylates in anti-inflammatory dosages may blunt the diuretic and natriuretic response to loop diuretics. The interaction has been demonstrated in patients with ascites secondary to liver cirrhosis and in normal volunteers. Investigators theorize that salicylates may inhibit the renal effects of loop diuretics that are mediated by prostaglandins, including increases in sodium excretion, renal blood flow, and plasma renin activity. Since renal prostaglandins are believed to play a major role in the maintenance of renal blood flow and glomerular filtration rate in cirrhotics with ascites, the interaction may be particularly important in this population. No clinical interventions are generally required, but the possibility of a potential interaction should be considered in patients with ascites treated with a loop diuretic and salicylate or salicylate-related product.

References

  1. Kaufman J, Hamburger R, Matheson J, Flamenbaum W "Bumetanide-induced diuresis and natriuresis: effect of prostaglandin synthetase inhibition." J Clin Pharmacol 21 (1981): 663-7
  2. Salerno F, Lorenzano E, Maggi A, Badalamenti S, Minuz P, Degan M, Chinea B, Scotti A "Effects of imidazole-salicylate on renal function and the diuretic action of furosemide in cirrhotic patients with ascites." J Hepatol 19 (1993): 279-84
  3. Bartoli E, Arras S, Faedda R, Soggia G, Satta A, Olmeo NA "Blunting of furosemide diuresis by aspirin in man." J Clin Pharmacol 20 (1980): 452-8
  4. Tobert MB, Ostaszewski T, Reger B, Meisinger MA, Cook TJ "Diflunisal-furosemide interaction." Clin Pharmacol Ther 27 (1980): 289-90
  5. Planas R, Arroyo V, Rimola A, Perez-Ayuso RM, Rodes J "Acetylsalicylic acid suppresses the renal hemodynamic effect and reduces the diuretic action of furosemide in cirrhosis with ascites." Gastroenterology 84 (1983): 247-52
  6. Wilson TW, McCauley FA, Wells HD "Effects of low-dose aspirin on responsses to furosemide." J Clin Pharmacol 26 (1986): 100-5
  7. Valette H, Apoil E "Interaction between salicylate and two loop diuretics." Br J Clin Pharmacol 8 (1979): 592-4
View all 7 references

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Drug and food interactions

Moderate

aspirin food

Applies to: Pravigard Pac (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. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Moderate

pravastatin food

Applies to: Pravigard Pac (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

  1. "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb PROD (2001):
  2. "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
  3. "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals PROD (2001):
  4. "Product Information. Lipitor (atorvastatin)." Parke-Davis PROD (2001):
  5. "Product Information. Altocor (lovastatin)." Andrx Pharmaceuticals (2002):
  6. "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. Cerner Multum, Inc. "Australian Product Information." O 0
  9. "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
View all 9 references

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Minor

aspirin food

Applies to: Pravigard Pac (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. Yoovathaworn KC, Sriwatanakul K, Thithapandha A "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 71-6

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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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