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Drug Interactions between famotidine / ibuprofen and peanut allergen powder

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

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Interactions between your drugs

Major

ibuprofen peanut allergen extract

Applies to: famotidine / ibuprofen and peanut allergen powder

GENERALLY AVOID: Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) may pose a greater risk of more serious systemic reactions, including anaphylaxis, to immunotherapy with peanut allergen extract. The precise mechanism by which NSAIDs can induce or augment anaphylaxis has not been established, but may involve enhanced allergen absorption due to increased gastrointestinal permeability related to inhibition of prostaglandin synthesis by NSAIDs. Another proposed mechanism involves a direct impact on the IgE activation of mast cells and basophils, resulting in enhanced degranulation and release of chemical mediators such as histamine, prostaglandins, leukotrienes, and thromboxane.

MANAGEMENT: Immunotherapy with peanut allergen extract may not be appropriate in patients receiving NSAIDs due to the potential for increased risk of anaphylaxis. Alternatives to NSAIDs or temporarily withholding the immunotherapy should be considered. Otherwise, close monitoring for anaphylaxis or other allergic reactions is advised if coadministration cannot be avoided.

References (3)
  1. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  2. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
  3. Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
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

Major

peanut allergen extract food

Applies to: peanut allergen powder

ADJUST DOSING INTERVAL: Coadministration of peanut allergen extract with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. In addition, according to product labeling, administration of peanut allergen extract during a fasting state may potentiate the risk of allergic reactions, including anaphylaxis. The exact mechanism has not been elucidated.

MANAGEMENT: To minimize the risk of allergic reactions, including anaphylaxis, some authorities recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract. If alcohol cannot be avoided, withholding or decreasing peanut allergen dosage should be considered. Peanut allergen extract should also be administered with an evening meal and not within 2 hours of bedtime.

References (3)
  1. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  2. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
  3. Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
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.

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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

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