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Drug Interactions between EC-Naprosyn and turmeric

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

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Interactions between your drugs

Moderate

naproxen turmeric

Applies to: EC-Naprosyn (naproxen) and turmeric

MONITOR: Turmeric may potentiate the bleeding risk associated with drugs that interfere with platelet function or coagulation. In vitro data suggest that curcumin, an active constituent of turmeric, may inhibit platelet-activating factor and platelet aggregation. Isolated case reports have also described increases in INR following initiation of turmeric-containing products in patients treated with a vitamin K antagonist such as warfarin. However, pharmacologic effects of turmeric preparations may be highly variable due to inconsistencies in formulation and potency of commercial herbal products.

MANAGEMENT: Caution is advised when turmeric-containing products are used concomitantly with drugs that affect hemostasis such as anticoagulants, antiplatelet agents, nonsteroidal anti-inflammatory drugs, serotonin reuptake inhibitors, and thrombolytic agents. Clinical and laboratory observation for hematologic complications is recommended.

References (4)
  1. Heck AM, DeWitt BA, Lukes AL (2000) "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm, 57, 1221-7; quiz 1228-30
  2. Abebe W (2002) "Herbal medication: potential for adverse interactions with analgesic drugs." J Clin Pharm Ther, 27, p. 391-401
  3. Yang X, Thomas DP, Zhang X, et al. (2006) "Curcumin inhibits platelet-derived growth factor-stimulated vascular smooth muscle cell function and injury-induced neointima formation." Arterioscler Thromb Vasc Biol, 26, p. 85-90
  4. New Zealand Medicines and Medical Devices Safety Authority (2022) Medsafe Monitoring Communication: Beware turmeric/curcumin containing products can interact with warfarin. https://medsafe.govt.nz/safety/EWS/2018/Turmeric.asp

Drug and food interactions

Moderate

naproxen food

Applies to: EC-Naprosyn (naproxen)

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
Moderate

naproxen food

Applies to: EC-Naprosyn (naproxen)

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

References (4)
  1. (2024) "Product Information. Cytisine (cytisinicline)." Consilient Health Ltd
  2. jeong sh, Newcombe D, sheridan j, Tingle M (2015) "Pharmacokinetics of cytisine, an a4 b2 nicotinic receptor partial agonist, in healthy smokers following a single dose." Drug Test Anal, 7, p. 475-82
  3. Vaughan DP, Beckett AH, Robbie DS (1976) "The influence of smoking on the intersubject variation in pentazocine elimination." Br J Clin Pharmacol, 3, p. 279-83
  4. Zevin S, Benowitz NL (1999) "Drug interactions with tobacco smoking: an update" Clin Pharmacokinet, 36, p. 425-38

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.

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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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