Non-steroidal anti-inflammatories drug interactions

Dupuis L, Loren G, Shore A, Silverman ED, Laxer RM. Methotrexate non-steroidal anti-inflammatory drug interaction in children with arthritis. J Rheumat 1990 17 1469-1473. 

Ragheb M.The clinical significance of lithium non-steroidal anti-inflammatory drug interactions. J Clin Psychopharmacol 1990 10 350-354. 

Toxic effects of lithium can be fatal. Early signs of lithium toxicity are vomiting and severe diarrhoea followed by tremor, ataxia, renal impairment and convulsions. Many non-steroidal anti-inflammatory drugs interact with lithium to increase its plasma... 

Diclofenac is a non-steroidal anti-inflammatory drug. NSAIDs interact with both angiotensin-converting enzyme inhibitors, such as enalapril, and beta-adrenoceptor blockers, such as atenolol, resulting in antagonism to the hypotensive reaction, leading to a hypertensive reaction. NSAIDs interact with... 

M. E. Jones, B. C. Sallustio, Y. Purdie, and E J. Meffin, Enantioselective disposition of 2-arylpropionic acid non-steroidal anti-inflammatory drugs. II. 2-Phenylpropionic acid binding, /. Pharmacol. Exp Ther., 238 288 (1986). R. A. O Reilly, W. E Trager, C. H. Motley, and W. Howald, Stereoselective interaction of phenylbutazone with (12C/13C) warfarin pseudoracemates in man, /. Cfm. Invest., 65 746 (1980). 

Constantopoulos A. Colitis induced by interaction of cyclosporine A and non-steroidal anti-inflammatory drugs. Pediatr Int 1999 41(2) 184-6. 

The role of Helicobacter pylori Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) account for nearly all gastroduodenal ulcers and serious ulcer complications, but the interaction between infection with H. pylori and the use of NSAIDs in the pathogenesis of NSAID-induced gastropathy is controversial. In fact, studies that have examined these two susceptibility factors have yielded conflicting results about whether H. pylori infection increases the risk of toxicity in NSAID users, has no effect, or may even be protective (70-72). 

Shah SJ, Bhandarkar SD, Satoskar RS. Drug interaction between chlorpropamide and non-steroidal anti-inflammatory drugs, ibuprofen and phenylbutazone. Int J Clin Pharmacol Ther Toxicol 1984 22(9) 470-2. 

Several non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to interfere with the natriuretic effects of thiazides (SED-11, 423). A similar interaction is seen with tenidap, an antiarthritic cytokine modulating drug (46). The salt-retaining properties of the NSAIDs probably play the central role in this interaction. 

Another example of drug-drug interaction occurs when non-steroidal anti-inflammatory drugs are... 

The OAT proteins play a critical role in the excretion and detoxification of a wide variety of drugs, toxins, hormones and neurotransmitter metabolites. A number of common non-steroid anti-inflammatory drugs (NSAID), including acetyl salicylate and salicylate, acetaminophen, diclofenac, ibuprofen, ketoprofen, indomethacin, and naproxen, are substrates of one or more OAT isoforms, so that there can be significant interactions between NSAlDs and other drugs. The 3-lactam antibiotics (penicillins, cephalosporins and penems) and the antiviral nucleosides adefovir, cidofovir,... 

A potentially dangerous interaction may occur between fluvoxamine and warfarin. There is a 65% increase in plasma warfarin concentration and a significant prolongation of prothrombin time. The selective serotonin reuptake inhibitors (SSRIs) increase the risk of upper gastrointestinal bleeding, and this effect is potentiated by the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin. There are anecdotal reports of bleeding disorder with the concomitant use of nicoumalone (a coumarin derivate), ibuprofen, and warfarin. 

Children given antipyretic doses of aspirin co-administered with valproate were found to exhibit a decrease in protein binding and an inhibition of the metabolism of valproate. The common use of aspirin should alert to the need for caution if these drugs are co-administered. Interaction with other non-steroidal anti-inflammatory drugs (NSAIDs) may not be so prominent. 

Andersson T, Bredberg E, Lagerstrom P-0, Naesdal J, Wilson I. Lack of drug-drug interaction between three different non-steroidal anti-inflammatory drugs and omeprazole. EurJ Clin Pharmacol (1998) 54, 399-404. 

A1 Balia S, AlMomenAK,AlArfajH,Al SugairS, Gader AMA. Interaction between nabumetone — a new non-steroidal anti-inflammatory drug — and the haemostatic system ex vivo. Haemostasis (1990) 20,270-5. 

Favre L, Glasson PH, Riondel A, Vallotton MB. Interaction of diuretics and non-steroidal anti-inflammatory drugs in man. Clin Sci (1983) 64, 407-15. 

Weil J, LangmanMJS, WainwrightP, Lawson DH, Rawlins M, Logan RFA, Brown TP, Ves-sey MP, Murphy M, Colin-Jones DG. Peptic ulcer bleeding accessory risk factors and interactions widi non-steroidal anti-inflammatory drugs. Gut (2000) 46, 27-31. 

The classical non-steroidal anti-inflammatory drugs, except acetylsalicylic acid, bind competitively to cyclooxygenases (Fig. 5.86). Usually, a very strong ionic bond to Arg-120 is formed. Additional lipophilic interactions at the site of the channel narrowing or in the active pocket enhance the binding further, so that arachidonic acid can no longer access this pocket. [158]... 

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