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Drug Interactions between Noctiva and Saleto-800

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

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Moderate

ibuprofen desmopressin

Applies to: Saleto-800 (ibuprofen) and Noctiva (desmopressin)

MONITOR: The antidiuretic response to vasopressin or desmopressin may be potentiated by certain drugs, including nonsteroidal anti-inflammatory agents, selective serotonin reuptake inhibitors, tricyclic/tetracyclic antidepressants, carbamazepine, chlorpropamide, chlorpromazine, clofibrate, eslicarbazepine, fludrocortisone, haloperidol, lamotrigine, oxcarbazepine, urea, and some antineoplastic agents (e.g., vinca alkaloids, cisplatin, cyclophosphamide). These drugs can occasionally cause fluid retention, in some cases secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Coadministration with vasopressin or desmopressin may, therefore, increase the risk of water intoxication and/or hyponatremia. Seizure and coma in association with severe hyponatremia have been reported during concomitant use of desmopressin and imipramine or ibuprofen. In addition, indomethacin may prolong the effects of vasopressin on cardiac index and systemic vascular resistance. The elderly may be particularly susceptible.

MANAGEMENT: Caution is advised when vasopressin or desmopressin is used in combination with drugs that can cause fluid retention or SIADH. Some authorities recommend adjusting vasopressin dosage as needed. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly. Patients should be advised to seek medical attention if they develop signs and symptoms of water intoxication or hyponatremia such as anorexia, nausea, vomiting, headache, malaise, lethargy, irritability, difficulty concentrating, memory impairment, confusion, weakness, muscle spasm, unsteadiness (which may lead to falls), anuria, and weight gain. Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated; therefore, early treatment is important to help prevent progression to seizures, coma, respiratory arrest, and death.

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  158. Kimura T, Shoju M, et al. (1995) "Chlorpropamide-induced ADH release, hyponatremia and central pontine myelinolysis in diabetes mellitus." Tohoku J Exp Med, 177, p. 303-13
  159. Guay DR (2010) Hyponatremia associated with selective serotonin reuptake inhibitors. http://www.ascp.com/publications/tcp/2000/feb/cr_hypo.shtml
  160. Adlakha A, Manocha AP, Bechard DL (1991) "Imipramine-induced syndrome of inappropriate antidiuretic hormone secretion." South Med J, 84, p. 1507-9
  161. Agrawal NK, Rastogi A, Goyal R, Singh SK (2007) "Sertraline-induced hyponatremia in the elderly." CJEM, 9, p. 415
  162. Ritch PS (1988) "Cis-dichlorodiammineplatinum II-induced syndrome of inappropriate secretion of antidiuretic hormone." Cancer, 61, p. 448-50
  163. Levin L, Sealy R, Barron J (1982) "Syndrome of inappropriate antidiuretic hormone secretion following cis-dichlorodiammineplatinum II in a patient with malignant thymoma." Cancer, 50, p. 2279-82
  164. Littlewood TJ, Smith AP (1984) "Syndrome of inappropriate antidiuretic hormone secretion due to treatment of lung cancer with cisplatin." Thorax, 39, p. 636-7
  165. Iyer AV, Krasnow SH, Dufour DR, Arcenas AS (2003) "Sodium-wasting nephropathy caused by cisplatin in a patient with small-cell lung cancer." Clin Lung Cancer, 5, p. 187-9
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  168. Moses AM, Howanitz J, van Gemert M, Miller M (1973) "Clofibrate-induced antidiuresis." J Clin Invest, 52, p. 535-42
  169. O'Regan S, Carson S, Chesney RW, Drummond KN (1977) "Electrolyte and acid-base disturbances in the management of leukemia." Blood, 49, p. 345-53
  170. McCarron M, Wright GD, Roberts SD (1995) "Water intoxication after low dose cyclophosphamide." BMJ, 311, p. 292
  171. Harlow PJ, DeClerck YA, Shore NA, Ortega JA, Carranza A, Heuser E (1979) "A fatal case of inappropriate ADH secretion induced by cyclophosphamide therapy." Cancer, 44, p. 896-8
  172. Kato A, Sugiura T, Yamamoto T, et al. (2008) "Water intoxication induced by low-dose oral cyclophosphamide in a patient with anti-neutrophil cytoplasmic antibody-related glomerulonephritis." NDT Plus, 1, p. 286-8
  173. Jayachandran NV, Chandrasekhara PK, Thomas J, Agrawal S, Narsimulu G (2009) "Cyclophosphamide-associated complications: we need to be aware of SIADH and central pontine myelinolysis." Rheumatology, 48, p. 89-90
  174. Lazarevic V, Hagg E, Wahlin A (2007) "Hiccups and severe hyponatremia associated with high-dose cyclophosphamide in conditioning regimen for allogeneic stem cell transplantation." Am J Hematol, 82, p. 88
  175. DeFronzo RA, Colvin OM, Braine H, Robertson GL, Davis PJ (1974) "Proceedings: cyclophosphamide and the kidney." Cancer, 33, p. 483-91
  176. Munro AH, Crompton GK (1972) "Inappropriate antidiuretic hormone secretion in oat-cell carcinoma of bronchus. Aggravation of hyponatraemia by intravenous cyclophosphamide." Thorax, 27, p. 640-2
  177. Bourgeois JA (2005) "Reversible hyponatremia and venlafaxine." Psychosomatics, 46, p. 495-6
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Drug and food interactions

Moderate

ibuprofen food

Applies to: Saleto-800 (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. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

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Minor

desmopressin food

Applies to: Noctiva (desmopressin)

Food may decrease the rate and extent of absorption of desmopressin following oral administration. In 16 healthy, nonsmoking volunteers, administration of a single 400 mcg oral dose of desmopressin concomitantly with a standardized meal (27% fat) resulted in a 52% decrease in the peak plasma concentration (Cmax) of desmopressin and a 43% decrease in systemic exposure (AUC) compared to administration in the fasting state. The Cmax and AUC were still reduced by 46% and 41%, respectively, when desmopressin was administered 1.5 hours after eating. Both feeding regimens prolonged the time to reach peak plasma concentration (Tmax) from 1 hour to 1.5 hours. However, the pharmacodynamic effects of desmopressin were not affected as assessed by urine volume and osmolality for at least 4 hours postdose. The degree of antidiuresis was similar in the absence of food and when the drug was taken with or 1.5 hours after eating. These findings would suggest a fairly minor clinical impact of the interaction in most patients, especially since oral desmopressin is intended for administration at bedtime. Nevertheless, the possibility of food effects should be considered before increasing the dose whenever a diminution of effect is noted. A significant interaction is not expected to occur with the sublingual formulation, since absorption occurs primarily in the oral mucosa, pharynx, and esophagus.

References

  1. (2001) "Product Information. DDAVP (desmopressin)." Rhone Poulenc Rorer
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink

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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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