Combunox (ibuprofen / oxycodone) and Alcohol / Food Interactions
There are 3 alcohol/food/lifestyle interactions with Combunox (ibuprofen / oxycodone) which include:
oxyCODONE ↔ food
Major Food Interaction
Consumer information for this interaction is not currently available.
GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including oxycodone. 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: Grapefruit juice may increase the plasma concentrations of oxycodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of oxycodone by certain compounds present in grapefruit, resulting in decreased formation of metabolites noroxycodone and noroxymorphone and increased formation of oxymorphone due to a presumed shifting of oxycodone metabolism towards the CYP450 2D6-mediated route. In 12 healthy, nonsmoking volunteers, administration of a single 10 mg oral dose of oxycodone hydrochloride on day 4 of a grapefruit juice treatment phase (200 mL three times a day for 5 days) increased mean oxycodone peak plasma concentration (Cmax), systemic exposure (AUC) and half-life by 48%, 67% and 17% (from 3.5 to 4.1 hours), respectively, compared to administration during an equivalent water treatment phase. Grapefruit juice also decreased the metabolite-to-parent AUC ratio of noroxycodone by 44% and that of noroxymorphone by 45%. In addition, oxymorphone Cmax and AUC increased by 32% and 56%, but the metabolite-to-parent AUC ratio remained unchanged. Pharmacodynamic changes were modest and only self-reported performance was significantly impaired after grapefruit juice. Analgesic effects were not affected.
MANAGEMENT: Patients should not consume alcoholic beverages or use drug products that contain alcohol during treatment with oxycodone. Any history of alcohol or illicit drug use should be considered when prescribing oxycodone, and therapy initiated at a lower dosage if necessary. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Due to a high degree of interpatient variability with respect to grapefruit juice interactions, patients treated with oxycodone may also want to avoid or limit the consumption of grapefruit and grapefruit juice.
- Nieminen TH, Hagelberg NM, Saari TI, et al "Grapefruit juice enhances the exposure to oral oxycodone." Basic Clin Pharmacol Toxicol 107 (2010): 782-8
High Blood Pressure (Hypertension)
Severe Potential Hazard, Moderate plausibility
NSAIDs - fluid retention
Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure. Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
- Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics." Arch Intern Med 158 (1998): 1108-12
- Lewis RV, Toner JM, Jackson PR, Ramsay LE "Effects of indomethacin and sulindac on blood pressure of hypertensive patients." Br Med J 292 (1986): 934-5
- "Product Information. Daypro (oxaprozin)." Searle, Skokie, IL.
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
- Agnholt J, Andreasen F "The effect of ibuprofen therapy on water and electrolyte balance." Acta Med Scand 212 (1982): 65-9
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
- Johnson AG, Nguyen TV, Day RO "Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis." Ann Intern Med 121 (1994): 289-300
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma, Ridgeland, MS.
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
- "Product Information. Celebrex (celecoxib)." Searle, Chicago, IL.
- "Product Information. Anaprox (naproxen)." Roche Laboratories, Nutley, NJ.
- "Product Information. Mobic (meloxicam)" Boehringer-Ingelheim, Ridgefield, CT.
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
- Heynen G "Toleration and safety of piroxicam." Eur J Rheumatol Inflamm 8 (1987): 86-93
- "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
- Van Den Ouweland FA, Gribnau FW, Meyboom RH "Congestive heart failure due to nonsteroidal anti-inflammatory drugs in the elderly." Age Ageing 17 (1988): 8-16
- Gurwitz JH, Everitt DE, Monane M, et al "The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons." J Gerontol A Biol Sci Med Sci 51 (1996): m74-9
- "Product Information. Clinoril (sulindac)." Merck & Co, Inc, West Point, PA.
- "Product Information. Vioxx (rofecoxib)." Merck & Co, Inc, West Point, PA.
- Willkens RF "Worldwide clinical safety experience with diclofenac." Semin Arthritis Rheum 2 Suppl 1 (1985): 105-10
- "Product Information. Indocin (indomethacin)." Merck & Co, Inc, West Point, PA.
- Brooks CD, Linet OI, Schellenberg D, Turner LF, Defesche CL, Teoh KW, Johnson JH, Assenzo JR "Clinical safety of flurbiprofen." J Clin Pharmacol 30 (1990): 342-51
- Petersson I, Nilsson G, Hansson B-G, Hedner T "Water intoxication associated with non-steroidal anti-inflammatory drug therapy." Acta Med Scand 221 (1987): 221-3
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical, Raritan, NJ.
- "Product Information. Relafen (nabumetone)." SmithKline Beecham, Philadelphia, PA.
- Easton PA, Koval A "Hypertensive reaction with sulindac." Can Med Assoc J 122 (1980): 1273-4
- Buckley MM, Brogden RN "Ketorolac. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 39 (1990): 86-109
- "Product Information. Bextra (valdecoxib)." Pharmacia Corporation, Peapack, NJ.
High Blood Pressure (Hypertension)
Moderate Potential Hazard, Moderate plausibility
NSAIDs - hypertension
NSAIDs including topicals can lead to the onset of new hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events. Blood pressure should be monitored closely during NSAID therapy and throughout the course of therapy.
Combunox (ibuprofen / oxycodone) drug Interactions
There are 1140 drug interactions with Combunox (ibuprofen / oxycodone)
Combunox (ibuprofen / oxycodone) disease Interactions
There are 30 disease interactions with Combunox (ibuprofen / oxycodone) which include:
- Impaired Gi Motility
- Infectious Diarrhea
- Liver Disease
- Renal Dysfunction
- Fluid Retention
- Gi Toxicity
- Renal Toxicities
- Acute Alcohol Intoxication
- Drug Dependence
- Intracranial Pressure
- Respiratory Depression
- Gastrointestinal Obstruction
- Adrenal Insufficiency
- Biliary Spasm
- Seizure Disorders
- Urinary Retention
- Heart Failure
- Platelet Aggregation Inhibition
Drug Interaction Classification
|No information available.|
Do not stop taking any medications without consulting your healthcare provider.