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Drug Interactions between famotidine / ibuprofen and levamlodipine

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

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Interactions between your drugs

Moderate

ibuprofen levamlodipine

Applies to: famotidine / ibuprofen and levamlodipine

MONITOR: Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to be related to an alteration of vascular tone, which is dependent on prostacyclins and other vasodilatory prostanoids. When a nonsteroidal anti-inflammatory drug (NSAID) is added to the regimen of a patient who is already taking a calcium channel blocker, increased blood pressure may result. Also, the clinician should be aware that the risk of hypotension is increased when NSAIDs are withdrawn from the regimen.

MANAGEMENT: Monitoring for altered blood pressure control is recommended.

References (9)
  1. Ring ME, Corrigan JJ, Fenster PE (1986) "Effects of oral diltiazem on platelet function: alone and in combination with "low dose" aspirin." Thromb Res, 44, p. 391-400
  2. Altman R, Scazziota A, Dujovne C (1988) "Diltiazem potentiates the inhibitory effect of aspirin on platelet aggregation." Clin Pharmacol Ther, 44, p. 320-5
  3. Cremer KF, Pieper JA, Joyal M, Mehta J (1984) "Effects of diltiazem, dipyridamole, and their combination on hemostasis." Clin Pharmacol Ther, 36, p. 641-4
  4. Minuz P, Pancera P, Ribul M, et al. (1995) "Amlodipine and haemodynamic effects of cyclo-oxygenase inhibition." Br J Clin Pharmacol, 39, p. 45-50
  5. Houston MC, Weir M, Gray J, et al. (1995) "The effects of nonsteroidal anti-inflammatory drugs on blood pressures of patients with hypertension controlled by verapamil." Arch Intern Med, 155, p. 1049-54
  6. Deleeuw PW (1996) "Nonsteroidal anti-inflammatory drugs and hypertension: the risks in perspective." Drugs, 51, p. 179-87
  7. "Product Information. DurAct (bromfenac)." Wyeth-Ayerst Laboratories
  8. (2001) "Product Information. Arthrotec (diclofenac-misoprostol)." Searle
  9. Zanchetti A, Hansson L, Leonetti G, et al. (2002) "Low-dose aspirin does not interfere with the blood pressure-lowering effects of antihypertensive therapy." J Hypertens, 20, p. 1015-1022
Minor

ibuprofen famotidine

Applies to: famotidine / ibuprofen and famotidine / ibuprofen

H2 antagonists may alter the pharmacokinetic disposition of some nonsteroidal anti-inflammatory drugs (NSAIDs), resulting in increased or decreased plasma concentrations. Data have been varied, even for the same NSAID. The mechanism may involve inhibition of metabolism, changes in gastric pH resulting in altered absorption, and/or reduced urinary elimination of the affected NSAIDs. Statistically significant changes have been small and of limited clinical significance when interactions have been observed.

References (5)
  1. Said SA, Foda AM (1989) "Influence of cimetidine on the pharmacokinetics of piroxicam in rat and man." Arzneimittelforschung, 39, p. 790-2
  2. Scavone JM, Greenblatt DJ, Matlis R, Harmatz JS (1986) "Interaction of oxaprozin with acetaminophen, cimetidine, and ranitidine." Eur J Clin Pharmacol, 31, p. 371-4
  3. (2001) "Product Information. Daypro (oxaprozin)." Searle
  4. "Product Information. DurAct (bromfenac)." Wyeth-Ayerst Laboratories
  5. Cerner Multum, Inc. "UK Summary of Product Characteristics."

Drug and food interactions

Moderate

ibuprofen food

Applies to: famotidine / ibuprofen

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
Minor

famotidine food

Applies to: famotidine / ibuprofen

H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.

References (1)
  1. Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM (1990) "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol, 38, p. 165-9

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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