Drug Interaction Report

GENERALLY AVOID: Large, anti-inflammatory doses of salicylates may inhibit the uricosuric effect of probenecid. The mechanism of interaction has not been established. In contrast, low, daily antiplatelet doses do not seem to interact. In a study of 11 patients with gouty arthritis receiving a stable dosage of probenecid for at least three months, no significant effects on serum levels or 24-hour urinary excretion of uric acid were observed during coadministration with enteric-coated aspirin 325 mg/day, taken simultaneously with probenecid or 6 hours after.

MANAGEMENT: Large doses of salicylates should be avoided in patients who require probenecid for the treatment of hyperuricemia or gout. However, occasional use of low dosages for analgesia or daily use of cardioprotective dosages should generally not be a concern.

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

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.