Drug Interaction Report

MONITOR CLOSELY: Coadministration of plasminogen with anticoagulants, antiplatelets, or other agents that interfere with normal coagulation may prolong or worsen bleeding from active lesions and wounds. Plasminogen deficiency type 1 is characterized by the formation of fibrin-rich lesions on mucous membranes. Replacement therapy temporarily corrects plasminogen deficiency and reduces or resolves extravascular fibrinous lesions, which may prolong or worsen bleeding from any active lesion (disease-related or not), including GI bleeding, hemoptysis, epistaxis, vaginal bleeding, or hematuria. Clinical data are currently lacking.

MANAGEMENT: Caution is advised if plasminogen is used in patients taking anticoagulants, antiplatelets, or other agents that interfere with normal coagulation. Clinical and laboratory monitoring are recommended for 4 hours after infusion. If a patient develops any GI bleeding or bleeding from any other site that persists longer than 30 minutes, seek emergency care and discontinue plasminogen immediately.

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.