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 |