التداخل بين ديكلوفيناك وميزوبروستول وسولينداك

…defects [see Warnings and Precautions (5.1) and Use in Specific Populations (8.1) ] • In the setting of coronary artery bypass graft (CABG) surgery [see Warnings and Precautions (5.2) ] • Active gastrointestinal bleeding [see Warnings and Precautions (5.3) ] • History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.

• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs ( 4 )

• Avoid administration of more than one NSAID at a time.

Exacerbation of Asthma Related to Aspirin Sensitivity A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps; severe, potentially fatal bronchospasm; and/or intolerance to aspirin and other NSAIDs.

Because cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, diclofenac sodium/misoprostol is contraindicated in patients with this form of aspirin sensitivity [see Contraindications (4) ] .

Sulindac should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.

This symptom complex typically occurs in asthmatic patients who experience rhinitis with or without nasal polyps, or who exhibit severe, potentially fatal bronchospasm after taking aspirin or other NSAIDs (see CONTRAINDICATIONS and PRECAUTIONS – Preexisting Asthma ).

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.In these patients, administration of a non-steroidal anti-inflammatory drug may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation.

Cyclosporine Administration of non-steroidal anti-inflammatory drugs concomitantly with cyclosporine has been associated with an increase in cyclosporine-induced toxicity, possibly due to decreased synthesis of renal prostacyclin.

As with other non-steroidal anti-inflammatory drugs, borderline elevations of one or more liver tests without any other signs and symptoms may occur in up to 15% of patients taking NSAIDs including sulindac.