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Drug Interactions between Lortab ASA and turmeric

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

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Interactions between your drugs

Moderate

aspirin turmeric

Applies to: Lortab ASA (aspirin / hydrocodone) and turmeric

MONITOR: Turmeric may potentiate the bleeding risk associated with drugs that interfere with platelet function or coagulation. In vitro data suggest that curcumin, an active constituent of turmeric, may inhibit platelet-activating factor and platelet aggregation. Isolated case reports have also described increases in INR following initiation of turmeric-containing products in patients treated with a vitamin K antagonist such as warfarin. However, pharmacologic effects of turmeric preparations may be highly variable due to inconsistencies in formulation and potency of commercial herbal products.

MANAGEMENT: Caution is advised when turmeric-containing products are used concomitantly with drugs that affect hemostasis such as anticoagulants, antiplatelet agents, nonsteroidal anti-inflammatory drugs, serotonin reuptake inhibitors, and thrombolytic agents. Clinical and laboratory observation for hematologic complications is recommended.

References

  1. 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
  2. Abebe W (2002) "Herbal medication: potential for adverse interactions with analgesic drugs." J Clin Pharm Ther, 27, p. 391-401
  3. Yang X, Thomas DP, Zhang X, et al. (2006) "Curcumin inhibits platelet-derived growth factor-stimulated vascular smooth muscle cell function and injury-induced neointima formation." Arterioscler Thromb Vasc Biol, 26, p. 85-90
  4. New Zealand Medicines and Medical Devices Safety Authority (2022) Medsafe Monitoring Communication: Beware turmeric/curcumin containing products can interact with warfarin. https://medsafe.govt.nz/safety/EWS/2018/Turmeric.asp
View all 4 references

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Drug and food interactions

Major

HYDROcodone food

Applies to: Lortab ASA (aspirin / hydrocodone)

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including hydrocodone. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

GENERALLY AVOID: Consumption of alcohol while taking some sustained-release formulations of hydrocodone may cause rapid release of the drug, resulting in high systemic levels of hydrocodone that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. In study subjects, the rate of absorption of hydrocodone from an extended-release formulation was found to be affected by coadministration with 40% alcohol in the fasted state, as demonstrated by an average 2.4-fold (up to 3.9-fold in one subject) increase in hydrocodone peak plasma concentration and a decrease in the time to peak concentration. Alcohol also increased the extent of absorption by an average of 1.2-fold (up to 1.7-fold in one subject).

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of hydrocodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of hydrocodone by certain compounds present in grapefruit. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.

MANAGEMENT: Patients taking sustained-release formulations of hydrocodone should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as hydrocodone should not be combined with alcohol. Patients should also avoid consumption of grapefruit or grapefruit juice during treatment with hydrocodone.

References

  1. (2013) "Product Information. Zohydro ER (hydrocodone)." Zogenix, Inc

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Moderate

aspirin food

Applies to: Lortab ASA (aspirin / hydrocodone)

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: Lortab ASA (aspirin / hydrocodone)

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.

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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