Drug Interactions between Flanax Pain Reliever and potassium bicarbonate / sodium bicarbonate

MONITOR: Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) with potassium salts may increase the risk of hyperkalemia. NSAIDs may produce potassium retention by reducing renal synthesis of prostaglandin E and impairing the renin-angiotensin system.

MANAGEMENT: Closely monitor potassium levels in patients receiving both potassium salts and NSAID therapy, especially those with renal impairment, diabetes, older age, severe or worsening heart failure, dehydration, or concomitant therapy with other agents that increase serum potassium (e.g., beta-blockers, cyclosporine, heparin, tacrolimus, and trimethoprim). Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat.

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Antacids and some oral aluminum, calcium, or magnesium containing preparations may decrease the gastrointestinal absorption of enteric-coated naproxen, which requires an acidic environment for dissolution. The proposed mechanism is an increase in gastric pH (i.e. decreased gastric acidity) produced by antacids. In patients treated with antacids, the possibility of a reduced or subtherapeutic response to enteric-coated naproxen should be considered. Concomitant use of these drugs is generally not recommended. Aluminum hydroxide and some magnesium-containing antacids have also been reported to reduce the absorption of regular naproxen. The interaction may be minimized by separating the times of administration by at least 2 hours.

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