FDA advises about potential attenuation of anti-platelet effect of low-dose aspirin with concomitant use of ibuprofen
FDA recently released an information sheet advising healthcare professionals about a potential pharmacodynamic interaction between low-dose aspirin (81 mg/d) and ibuprofen 400 mg when they are dosed concomitantly. This interaction may attenuate aspirin's anti-platelet cardioprotective effect in patients taking aspirin for secondary prevention of myocardial infarction.
FDA recently released an information sheet advising healthcare professionals about a potential pharmacodynamic interaction between low-dose aspirin (81 mg/d) and ibuprofen 400 mg when they are dosed concomitantly. This interaction may attenuate aspirin's anti-platelet cardioprotective effect in patients taking aspirin for secondary prevention of myocardial infarction.
Although the clinical implications of the interaction have not been evaluated in clinical end point studies, some unpublished trials involving single-dose ibuprofen 400 mg have demonstrated through measurements of thromboxane B2 (TXB2) levels and studies of platelet activation that ibuprofen ingested within 30 minutes of taking immediate-release aspirin may interfere with aspirin's antiplatelet activity. The possible mechanism for the interference may be the competitive inhibition of the acetylation site of cyclooxygenase (COX) in the platelet. Similar interference also has been observed when a single dose of ibuprofen has been taken 8 hours before aspirin or sooner.
Occasional use of ibuprofen by patients likely carries a minimal risk of the interaction, according to FDA, because of aspirin's long-lasting anti-platelet effects when taken daily.
FDA also said that it could not issue recommendations at this time about the effects of chronic ibuprofen doses of <400 mg or >400 mg, nor about the effects of ibuprofen on enteric-coated low-dose aspirin because clear data for those situations are not available.
FDA recommends that other nonselective OTC NSAIDs should be viewed as having potential to interfere with the antiplatelet effect of low-dose aspirin unless proven otherwise. In addition, analgesics such as acetaminophen that do not interfere with the antiplatelet effect of low-dose aspirin should be considered for populations at high risk for cardiovascular events.
SOURCES US Food and Drug Administration. Concomitant use of ibuprofen and aspirin: potential for attenuation of the anti-platelet effect of aspirin. Washington, DC: US Food and Drug Administration; September 8, 2006. Available at: http:// http://www.fda.gov/cder/drug/infopage/ibuprofen/science_paper.htm. Accessed November 1, 2006.
US Food and Drug Administration. New information for healthcare professionals: Concomitant use of ibuprofen and aspirin. Washington, DC: US Food and Drug Administration; September 2006. Available at: http:// http://www.fda.gov/cder/drug/infosheets/hcp/ibuprofen_aspirinhcp.htm. Accessed November 1, 2006.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
