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Drug Interactions between famotidine / ibuprofen and prazosin

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

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Interactions between your drugs

Moderate

ibuprofen prazosin

Applies to: famotidine / ibuprofen and prazosin

MONITOR: Nonsteroidal anti-inflammatory drugs (NSAIDs) may decrease the antihypertensive effect of prazosin. The proposed mechanism is NSAID-induced inhibition of prostaglandin synthesis. Data are available for indomethacin. A similar interaction is expected with other NSAIDs.

MANAGEMENT: The patient's blood pressure should be monitored during coadministration, and the dosage adjusted as necessary.

References (2)
  1. Rubin P, Jackson G, Blaschke T (1980) "Studies on the clinical pharmacology of prazosin. II: The influence of indomethacin and of propranolol on the action and disposition of prazosin." Br J Clin Pharmacol, 10, p. 33-9
  2. Radack KL, Deck CC, Bloomfield SS (1987) "Ibuprofen interferes with the efficacy of antihypertensive drugs: a randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen." Ann Intern Med, 107, p. 628-35
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
Moderate

prazosin food

Applies to: prazosin

GENERALLY AVOID: The concurrent use of ethanol and alpha-1 adrenergic blockers may cause increased hypotensive effects. Patients with aldehyde dehydrogenase deficiencies (primarily Asians) may be at a higher risk of this interaction. The mechanism has not been determined. Data exist for prazosin and other alpha adrenergic blockers are expected to interact also. In addition, any patients taking alpha adrenergic blockers may experience excessive orthostatic hypotension with ethanol ingestion, due to ethanol's unopposed vasodilatory effects in the presence of alpha adrenergic blockade.

MANAGEMENT: Patients who develop a flushing reaction after ethanol ingestion (indicates a possible aldehyde dehydrogenase deficiency) should be advised to avoid ethanol or limit their intake. All patients should be warned about the possibility of orthostatic hypotension with concurrent ethanol use.

References (2)
  1. Kawano Y, Abe H, Kojima S, Takishita S, Omae T (2000) "Interaction of alcohol and an a1-blocker on ambulatory blood pressure in patients with essential hypertension." Am J Hypertens, 13, p. 307-12
  2. (2002) "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc
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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