Drug Interactions between heparin flush and Synalgos-DC

MONITOR: Concomitant use of heparin flush and drugs that interfere with platelet function or coagulation or drugs that commonly cause thrombocytopenia may potentiate the risk of bleeding complications. Although uncommon, inadvertent anticoagulation resulting in hemorrhagic events may occur with heparin flushes, particularly during repeated or excessive use or administration of higher concentration flush solutions.

MANAGEMENT: Caution and monitoring (e.g., platelet counts, hematocrits, tests for occult blood in stools) are advised when heparin flushes are given to patients receiving systemic anticoagulants, platelet inhibitors, antithrombotic agents, thrombolytics, or drugs with known risks of thrombocytopenia or bleeding. An unexplained fall in hematocrit, fall in blood pressure, or any other unexplained symptom should lead to serious consideration of a hemorrhagic event.

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.