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Drug Interactions between diflunisal and indomethacin

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

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Interactions between your drugs

Major

indomethacin diflunisal

Applies to: indomethacin and diflunisal

GENERALLY AVOID: Concomitant administration of diflunisal may increase serum indomethacin concentrations by up to two- to threefold and increase the risk of toxicity such as gastrointestinal and central nervous system side effects. The mechanism is unknown, but may involve competition for the same metabolic and secretory pathways, and/or inhibition of glucuronidation by diflunisal. The renal clearance of indomethacin and its conjugate are also significantly reduced. Fatal gastrointestinal hemorrhage has been reported.

MANAGEMENT: The manufacturer recommends that this combination should be avoided.

References

  1. Eriksson LO, Wahlin-Boll E, Liedholm H, et al. (1989) "Influence of chronic diflunisal treatment on the plasma levels, metabolism and excretion of indomethacin." Eur J Clin Pharmacol, 37, p. 7-15
  2. (2001) "Product Information. Dolobid (diflunisal)." Merck & Co., Inc
  3. Van Hecken A, Verbesselt R, Tjandra-Maga TB, De Schepper PJ (1989) "Pharmacokinetic interaction between indomethacin and diflunisal." Eur J Clin Pharmacol, 36, p. 507-12
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Cerner Multum, Inc. "Australian Product Information."
View all 5 references

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Drug and food interactions

Moderate

indomethacin food

Applies to: indomethacin

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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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Nonsteroidal anti-inflammatories

Therapeutic duplication

The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category:

  • diflunisal
  • indomethacin

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

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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