NSAIDs Propranolol

Administration of zafirlukast and aspirin increases plasma levels of zafirlukast, When zafirlukast is administered with warfarin, there is an increased effect of the anti coagulant. Administration of zafirlukast and theophylline or erythromycin may result in a decreased level of zafirlukast. Administration of montelukast with other drugs has not revealed any adverse responses. Administration of montelukast with aspirin and NSAIDs is avoided in patients with known aspirin sensitivity. Administration of zileuton with propranolol increases the activity or the propranolol with theophylline increases serum theophylline levels and with warfarin may increase prothrombin time (PT). A prothrombin blood test should be done regularly in the event dosages of warfarin need to be decreased. 

Furazolidone Metronidazole Minocycline Paromomycin Polymyxin B Salicylates and NSAIDs Loop diuretics Antitumor agents Miscellaneous Morphine Penicillamine Pentazocine Propranolol Propoxyphene... 

Because of the availability of PK information on each enantiomer, the illustrative examples below have been taken from racemic NSAIDs such as ibuprofen, ketoprofen, flurbiprofen, and etodolac, and from racemic cardiovascular drugs such as propranolol, propafenone, nicardipine, and verapamil. However, the principles and logic presented below are applicable to wide ranges of racemic drugs. 

There is evidence that most NSAIDs can increase blood pressure in patients taking antihypertensives, although some studies have not found the increase to be clinically relevant In various small studies, indometacin reduced the antihypertensive effects of the beta biockers. There is some evidence that piroxicam usually interacts similarly. Ibuprofen and naproxen have reduced the effect of beta blockers in some small studies but not others. Two isolated cases of hypertension have been reported with naproxen and ibuprofen in patients treated with propranolol and pindolol, respectively. Celecoxib, but not rofecoxib, inhibits the metabolism of metoprolol. Limited information su ests that normally di-... 

Case-control (1993) 133 cases 133 controls Hydrochlorothiazide, furosemide, methyidopa, propranolol Ibuprofen (30% of cases) Indometacin (22%) Naproxen (18%) Sulindac (13%) SBP was about 5 mmHg higher (not statistically significant) in those on NSAIDs, but DBP did not differ. Findings the same if indometacin users removed. 4... 

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