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Drug Interactions between feverfew and Halfprin

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

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Interactions between your drugs

Minor

aspirin feverfew

Applies to: Halfprin (aspirin) and feverfew

Theoretically, feverfew extracts may potentiate the effects of anticoagulants, platelet inhibitors, and thrombolytic agents, possibly increasing the risk of bleeding. In vitro studies have shown feverfew to interfere with hemostasis and platelet aggregation by neutralizing platelet sulfhydryl groups as well as preventing prostaglandin synthesis. However, bleeding complications and interactions with hematologic agents have not been reported. Moreover, pharmacologic effects may be highly variable due to inconsistencies in formulation and potency of commercial herbal products. Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients who have used feverfew extensively prior to receiving anticoagulation, antiplatelet, or thrombolytic therapy, the potential for an interaction should be considered. Clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References

  1. Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
  2. 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
  3. Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W (1987) "Extracts of feverfew may inhibit platelet behavior via neutralization of sulphydryl groups." J Pharm Pharmacol, 39, p. 459-65
  4. Groenewegen WA, Heptinstall S (1990) "A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro." J Pharm Pharmacol, 42, p. 553-7
  5. Biggs MJ, Johnson ES, Persaud NP, Ratclife DM (1982) "Platelet aggregation in patients using feverfew for migraine." Lancet, 2, p. 776
  6. Heptinstall S, White A, Williamson L, Mitchell JR (1985) "Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes." Lancet, 1, p. 1071-2
View all 6 references

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Drug and food interactions

Moderate

aspirin food

Applies to: Halfprin (aspirin)

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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Minor

aspirin food

Applies to: Halfprin (aspirin)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A (1986) "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet, 11, p. 71-6

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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.