Drug Interaction Report

GENERALLY AVOID: The risk of bleeding associated with glycoprotein IIb/IIIa inhibitors is increased in the presence of nonsteroidal anti-inflammatory agents due to additive inhibitory effects on platelet function. Arterial puncture sites may be most problematic. Data are available for abciximab.

MANAGEMENT: It is recommended that these drugs be used together only when indicated by skilled personnel who are qualified and equipped to detect and treat bleeding complications.

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.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.