drug to drug interactions involving NSAIDs
| Drug Affected | NSAID Implicated | Effect |
|---|---|---|
| Warfarin | NSAIDs that inhibit COX-1 | Inhibits metabolism of warfarin; increases risk of bleeding owing to inhibition of platelet function and gastric mucosal damage |
| Sulfonylurea | High-dose salicylate | Potentiates hypoglycemia |
| Beta-blocker | All PG-inhibiting NSAIDs | Blunts hypotensive but not negative chronotropic or inotropic effect |
| Hydralazine Prazosin Angiotensin-converting enzyme inhibitor | All PG-inhibiting NSAIDsAll PG-inhibiting NSAIDsAll PG-inhibiting NSAIDs | Loss of hypotensive effectsLoss of hypotensive effectsLoss of hypotensive effects |
| Diuretics | All PG-inhibiting NSAIDs | Loss of natriuretic, diuretic, hypotensive effects of furosemide Loss of natriuretic effect of spironolactone Loss of hypotensive but not natriuretic or diuretic effects of thiazide |
| Phenytoin | Most NSAIDs | Displaces phenytoin from plasma protein, reducing total concentration for the same active concentration |
| Lithium | Most NSAIDs | Increases plasma lithium level |
| Digoxin | Most NSAIDs | May increase digoxin levels |
| Aminoglycosides | Most NSAIDs | May increase aminoglycoside level |
| Methotrexate | Most NSAIDs | May increase methotrexate plasma concentration |
| Cholestyramine | Most NSAIDs | Anion exchange resin binds NSAIDs in gut, ↓absorption |
| Sodium valproate | ASA | Inhibits valproate metabolism, increasing plasma valproate concentration |
| Probenecid | Most NSAIDs | Reduces metabolism and renal clearance of NSAIDs |
