التداخل بين بوتالبيتال وأسبرين وكافيين وكودايين وفلودروكورتيزون

Aspirin — increased ulcerogenic effect; decreased pharmacologic effect of aspirin.

Rarely salicylate toxicity may occur in patients who discontinue steroids after concurrent high-dose aspirin therapy.

Monitor salicylate levels or the therapeutic effect for which aspirin is given; adjust salicylate dosage accordingly if effect is altered (see PRECAUTIONS, General ).

Barbiturates, phenytoin, or rifampin —increased metabolic clearance of fludrocortisone acetate because of the induction of hepatic enzymes.

If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids.

Examples: Ketorolac, ibuprofen, naproxen, diclofenac Corticosteroids Clinical Impact: In patients receiving concomitant corticosteroids and chronic use of aspirin, withdrawal of corticosteroids may result in salicylism because corticosteroids enhance renal clearance of salicylates and their withdrawal is followed by return to normal rates of renal clearance.

Adrenal Insufficiency : If diagnosed, treat with physiologic replacement of corticosteroids, and wean patient off the opioid.

Wean the patient off of the opioid to allow adrenal function to recover and continue corticosteroid treatment until adrenal function recovers.