Aspirin and dipyridamole interactions
Aspirin and dipyridamole (Aggrenox), an antiplatelet agent has 218 documented interactions across the FDA labels and fact sheets we index: 28 major, 171 moderate, 17 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (28)
- Acetazolamidecarbonic anhydrase inhibitorMajor
Caution is advised for patients receiving concomitant high-dose aspirin and acetazolamide, as anorexia, tachypnea, lethargy, metabolic acidosis, coma, and death have been reported. (Acetazolamide label, Warnings)
…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants • a history of traumatic or repeated epidural or spinal punctures • a history of spinal deformity… (Apixaban label, Boxed warning)
- Bismuth subsalicylatesalicylateMajor
Do not take if you are allergic to salicylates (including aspirin) taking other salicylate products Do not use if you have an ulcer a bleeding problem bloody or black stool Ask a doctor before use if you have fever mucus in the stool Ask a doctor or pharmacist before use if you are taking any drug for diabetes gout arthritis anticoagulation (thinning the blood)… (Bismuth subsalicylate label, Warnings)
• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Celecoxib label, Contraindications)
- DabigatrananticoagulantMajor
…the risk of developing epidural or spinal hematomas in these patients include: use of indwelling epidural catheters concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants a history of traumatic or repeated epidural or spinal punctures a history of spinal deformity… (Dabigatran label, Boxed warning)
Diclofenac Potassium is contraindicated in the following patients: Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to diclofenac or any components of the drug product [see Warnings and Precautions (5.7 , 5.9 )] History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Diclofenac label, Contraindications)
- Dimethyl fumarateimmunosuppressantMajor
Serious Gastrointestinal Reactions Serious gastrointestinal reactions, including perforation, ulceration, hemorrhage, and obstruction, some with fatal outcomes, have been reported in the postmarketing setting with the use of fumaric acid esters, including TECFIDERA, with or without concomitant aspirin use. (Dimethyl fumarate label, Warnings and precautions)
- EdoxabananticoagulantMajor
…the risk of developing epidural or spinal hematomas in these patients include: use of indwelling epidural catheters concomitant use of other drugs that affect hemostasis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants a history of traumatic or repeated epidural or spinal punctures a history of spinal deformity… (Edoxaban label, Boxed warning)
- EnoxaparinanticoagulantMajor
…the risk of developing epidural or spinal hematomas in these patients include: Use of indwelling epidural catheters Concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, and other anticoagulants A history of traumatic or repeated epidural or spinal punctures A history of spinal deformity… (Enoxaparin label, Boxed warning)
Etodolac tablets should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Etodolac label, Contraindications)
- FondaparinuxanticoagulantMajor
…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants • a history of traumatic or repeated epidural or spinal puncture • a history of spinal deformity… (Fondaparinux label, Boxed warning)
CALDOLOR is contraindicated in the following patients: Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to ibuprofen or any components of the drug product [ see Warnings and Precautions ( 5.7 , 5.9 ) ] History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Ibuprofen label, Contraindications)
INDOCIN is contraindicated in the following patients: Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to indomethacin or any components of the drug product [ see Warnings and Precautions ( 5.7 , 5.9 ) ] History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Indomethacin label, Contraindications)
Anticoagulants and Antiplatelets Ticagrelor Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)
CONCOMITANT USE WITH NSAIDs Ketorolac tromethamine is CONTRAINDICATED in patients currently receiving aspirin or NSAIDs because of the cumulative risk of inducing serious NSAID-related side effects. (Ketorolac label, Boxed warning)
The combined use of two or more prostaglandins, or prostaglandin analogs including XELPROS is not recommended. (Latanoprost label, Drug interactions)
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Meloxicam label, Contraindications)
- Menthol and methyl salicylatesalicylateMajor
Warnings For external use only Allergy alert: do not use if you are allergic to salicylates (including aspirin) unless directed by a doctor. (Menthol and methyl salicylate label, Warnings)
Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (Methotrexate label, Warnings and precautions)
- Misoprostolprostaglandin analogMajor
MISOPROSTOL SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) (see CONTRAINDICATIONS , WARNINGS , and PRECAUTIONS ). (Misoprostol label, Boxed warning)
Patients with known aspirin sensitivity should continue to avoid aspirin or non-steroidal anti-inflammatory agents while taking SINGULAIR ( 5.4 ). (Montelukast label, Warnings and precautions)
Nabumetone tablets should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Nabumetone label, Contraindications)
Naproxen Suspension is contraindicated in the following patients: Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen or any components of the drug product [ see Warnings and Precautions ( 5.7 , 5.9 ) ] History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. (Naproxen label, Contraindications)
Additional risk factors for bleeding include: body weight <60 kg, propensity to bleed, concomitant use of medications that increase the risk of bleeding (e.g . , warfarin, heparin, fibrinolytic therapy, chronic use of nonsteroidal anti-inflammatory drugs [NSAIDs]) [see Warnings and Precautions (5.1) ] . (Prasugrel label, Boxed warning)
- RiociguatvasodilatorMajor
Phosphodiesterase Inhibitors Concomitant administration of Adempas with specific PDE-5 inhibitors (such as sildenafil, tadalafil, or vardenafil) or nonspecific PDE-5 inhibitors (such as dipyridamole or theophylline) is contraindicated [see Dosage and Administration (2.6), Drug Interactions ( 7.1 ) and Clinical Pharmacology ( 12.2 )]. (Riociguat label, Contraindications)
…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants • a history of traumatic or repeated epidural or spinal punctures • a history of spinal deformity… (Rivaroxaban label, Boxed warning)
- Sumatriptan and naproxentriptanMajor
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Sumatriptan and naproxen label, Contraindications)
WARNING: BLEEDING RISK • BRILINTA, like other antiplatelet agents, can cause significant, sometimes fatal bleeding ( 5.1 , 6.1 ). (Ticagrelor label, Boxed warning)
Moderate interactions (171)
- AcarboseantidiabeticModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- AdapaleneretinoidModerate
Particular caution should be exercised in using preparations containing sulfur, resorcinol, or salicylic acid in combination with Adapalene Cream, 0.1%. (Adapalene label, Drug interactions)
Alcohol Warning Because aspirin and extended-release dipyridamole capsules contains aspirin, counsel patients who consume three or more alcoholic drinks every day about the bleeding risks involved with chronic, heavy alcohol use while taking aspirin. (Aspirin and dipyridamole label, Warnings and precautions)
Aspirin In clinical studies, the incidence of upper gastrointestinal adverse events was increased in patients receiving concomitant therapy with daily doses of alendronate sodium greater than 10 mg and aspirin-containing products. (Alendronate label, Drug interactions)
- AliskirenantihypertensiveModerate
…part on the activity of the RAAS (e.g., patients with renal artery stenosis, severe heart failure, post-myocardial infarction or volume depletion) or patients receiving ARB, ACEI or nonsteroidal anti-inflammatory drug (NSAID), including selective Cyclooxygenase-2 inhibitors (COX-2 inhibitors), therapy may be at particular risk for developing acute renal failure… (Aliskiren label, Warnings and precautions)
- Amiloridepotassium-sparing diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Patients whose renal function may depend in part on the activity of the RAS (e.g., patients with renal artery stenosis, severe heart failure, post-myocardial infarction or volume depletion) or who are on Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) or ARBs may be at particular risk of developing acute renal failure on amlodipine and benazepril hydrochloride. (Amlodipine and benazepril label, Warnings and precautions)
- Atenololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Azilsartanangiotensin II receptor blocker (ARB)Moderate
Non-steroidal Anti-Inflammatory Agents, including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) In patients who are elderly, volume-depleted (including those on diuretic therapy), or who have compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including azilsartan,… (Azilsartan label, Drug interactions)
- BenazeprilACE inhibitorModerate
NSAIDS: Increased risk of renal impairment and loss of antihypertensive efficacy ( 7.3 ) (Benazepril label, Drug interactions)
- Bisoprololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Bisoprolol and hydrochlorothiazidebeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- BrivaracetamanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Bumetanideloop diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- CanagliflozinSGLT2 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Candesartanangiotensin II receptor blocker (ARB)Moderate
NSAIDS use may lead to increased risk of renal impairment and loss of antihypertensive effect ( 7 ). (Candesartan label, Drug interactions)
- Cannabidiol (prescription)anticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- CaptoprilACE inhibitorModerate
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase – 2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including captopril, may result in deterioration… (Captopril label, Drug interactions)
- CarbamazepineanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Carisoprodolmuscle relaxantModerate
Low dose aspirin also showed an induction effect on CYP2C19. (Carisoprodol label, Drug interactions)
- Carvedilolbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- CenobamateanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Chlorthalidonethiazide diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- CiprofloxacinfluoroquinoloneModerate
NSAIDs Use with caution Non-steroidal anti-inflammatory drugs (but not acetyl salicylic acid) in combination of very high doses of quinolones have been shown to provoke convulsions in pre-clinical studies and in postmarketing. (Ciprofloxacin label, Drug interactions)
- CitalopramSSRIModerate
Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk. (Citalopram label, Warnings and precautions)
- ClobazambenzodiazepineModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- ClonazepambenzodiazepineModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Clopidogrelantiplatelet agentModerate
Risk factors for bleeding include concomitant use of other drugs that increase the risk of bleeding (e.g., anticoagulants, antiplatelet agents, and chronic use of NSAIDs) [see Drug Interactions (7.4 , 7.5 , 7.6 , 7.7) ]. (Clopidogrel label, Warnings and precautions)
- CyclosporineimmunosuppressantModerate
In addition, concomitant use of NSAIDs with cyclosporine, particularly in the setting of dehydration, may potentiate renal dysfunction. (Cyclosporine label, Drug interactions)
- DapagliflozinSGLT2 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Deferasiroxiron supplementModerate
The risk of GI hemorrhage may be increased when administering Exjade in combination with drugs that have ulcerogenic or hemorrhagic potential, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, oral bisphosphonates, or anticoagulants. (Deferasirox label, Warnings and precautions)
- DesmopressinModerate
…Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)
- DesvenlafaxineSNRIModerate
Examples NSAIDs, aspirin, and warfarin Drugs that are Primarily Metabolized by CYP2D6 Clinical Impact Concomitant use of PRISTIQ increases C max and AUC of a drug primarily metabolized by CYP2D6 which may increase the risk of toxicity of the CYP2D6 substrate drug [see Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Drug interactions)
- DexamethasonecorticosteroidModerate
Monitor for toxicity when aspirin is used in conjunction with HEMADY in hypoprothrombinemia. (Dexamethasone label, Drug interactions)
- Divalproex (valproate)anticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Donepezilcholinesterase inhibitorModerate
Therefore, patients should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, e.g., those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). (Donepezil label, Warnings and precautions)
- Dorzolamidecarbonic anhydrase inhibitorModerate
High-Dose Salicylate Therapy Although acid-base and electrolyte disturbances were not reported in the clinical trials with dorzolamide hydrochloride ophthalmic solution, these disturbances have been reported with oral carbonic anhydrase inhibitors and have, in some instances, resulted in drug interactions (e.g., toxicity associated with high-dose salicylate therapy). (Dorzolamide label, Drug interactions)
- Dorzolamide and timololcarbonic anhydrase inhibitorModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveModerate
Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)
- DulaglutideGLP-1 receptor agonistModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- DuloxetineSNRIModerate
Inform patients about the risk of increased bleeding associated with the concomitant use of CYMBALTA and NSAIDs, aspirin, or other drugs that affect coagulation [see Drug Interactions ( 7.4 )] . (Duloxetine label, Warnings and precautions)
- EmpagliflozinSGLT2 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Empagliflozin and metforminSGLT2 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Emtricitabine and tenofovirantiretroviralModerate
Individuals taking tenofovir prodrugs who have impaired renal function and those taking nephrotoxic agents including non-steroidal anti-inflammatory drugs are at increased risk of developing renal-related adverse reactions. (Emtricitabine and tenofovir label, Warnings and precautions)
- EnalaprilACE inhibitorModerate
In patients who are elderly, volume-depleted (as on diuretic therapy), or with compromised renal function, use with NSAIDs, including selective COX-2 inhibitors, may result in deterioration of renal function, including renal failure. (Enalapril label, Drug interactions)
- Eplerenonealdosterone antagonistModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- EscitalopramSSRIModerate
Increased Risk of Bleeding: Concomitant use of nonsteroidal anti-inflammatory drugs, aspirin, other antiplatelet drugs, warfarin and other anticoagulants may increase risk ( 5.7 , 7) (Escitalopram label, Warnings and precautions)
- EslicarbazepineanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Esmololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Ethacrynic acidloop diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- EthosuximideanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- ExenatideGLP-1 receptor agonistModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Febuxostatxanthine oxidase inhibitorModerate
Consider use of prophylactic low-dose aspirin therapy in patients with a history of CV disease. (Febuxostat label, Warnings and precautions)
- FelbamateanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Fluconazoleazole antifungalModerate
Non-steroidal anti-inflammatory drugs The C max and AUC of flurbiprofen were increased by 23% and 81%, respectively, when coadministered with fluconazole compared to administration of flurbiprofen alone. (Fluconazole label, Drug interactions)
- FludrocortisonecorticosteroidModerate
Aspirin — increased ulcerogenic effect; decreased pharmacologic effect of aspirin. (Fludrocortisone label, Drug interactions)
- FluoxetineSSRIModerate
Use with NSAIDs, aspirin, warfarin, or other drugs that affect coagulation may potentiate the risk of gastrointestinal or other bleeding ( 5.7 ) (Fluoxetine label, Warnings and precautions)
- FluvoxamineSSRIModerate
Other Drugs Affecting Hemostasis: Increased risk of bleeding with concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation ( 5.8 , 5.10 ). (Fluvoxamine label, Warnings and precautions)
- Furosemideloop diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- GabapentinanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Galantaminecholinesterase inhibitorModerate
Therefore, patients should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those with an increased risk for developing ulcers, e.g., those with a history of ulcer disease or patients using concurrent nonsteroidal anti-inflammatory drugs (NSAIDS). (Galantamine label, Warnings and precautions)
- Ginkgo bilobaHerbal and supplementModerate
Ginkgo may increase bleeding risk when taken with anticoagulant or antiplatelet medicines. (NCCIH, Ginkgo)
- GlimepiridesulfonylureaModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- GlipizidesulfonylureaModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- GlyburidesulfonylureaModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Glyburide and metforminsulfonylureaModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- GriseofulvinantifungalModerate
Serum salicylate concentrations may be decreased when griseofulvin is given concomitantly with salicylates. (Griseofulvin label, Drug interactions)
- HeparinanticoagulantModerate
Risk factors for bleeding include the use of other drugs that increase the risk of bleeding (e.g., anticoagulants, antiplatelet agents, heparin, anagrelide, fibrinolytic therapy, and chronic use of NSAIDs) [see Drug Interactions ( 7.1 )]. (Aspirin and dipyridamole label, Warnings and precautions)
- Hydrochlorothiazidethiazide diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- HydrocortisonecorticosteroidModerate
Concurrent administration of corticosteroids with non-steroidal anti-inflammatory drugs (NSAIDS) may increase the risk of gastrointestinal adverse reactions. (Hydrocortisone label, Warnings and precautions)
- IbandronatebisphosphonateModerate
Use caution when co-prescribing aspirin/nonsteroidal anti-inflammatory drugs that may worsen gastrointestinal irritation. (Ibandronate label, Drug interactions)
- Icosapent ethylomega-3 fatty acidModerate
The incidence of bleeding was greater in patients receiving concomitant antithrombotic medications, such as aspirin, clopidogrel, or warfarin. (Icosapent ethyl label, Warnings and precautions)
- Indapamidethiazide diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Insulin aspartinsulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Insulin degludecinsulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Insulin detemirinsulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Insulin glargineinsulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Insulin lisproinsulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Insulin regular (human)insulinModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Irbesartanangiotensin II receptor blocker (ARB)Moderate
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and COX-2 inhibitors: Increased risk of renal impairment. (Irbesartan label, Drug interactions)
- Ketoconazoleazole antifungalModerate
Anticoagulants and Antiplatelet Drugs rivaroxaban cilostazol, coumarins, dabigatran Cilostazol: Concomitant administration of single doses of cilostazol 100 mg and ketoconazole 400 mg approximately doubled cilostazol concentrations and altered (increase/decrease) the concentrations of the active metabolites of cilostazol. (Ketoconazole label, Drug interactions)
- Labetalolbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- LacosamideanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- LamotrigineanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- LevetiracetamanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- LevofloxacinfluoroquinoloneModerate
Non-Steroidal Anti-Inflammatory Drugs The concomitant administration of a non-steroidal anti-inflammatory drug with a fluoroquinolone, including Levofloxacin in 5% Dextrose Injection, may increase the risk of CNS stimulation and convulsive seizures [see Warnings and Precautions (5.4) ]. (Levofloxacin label, Drug interactions)
- LevomilnacipranSNRIModerate
Inform patients about the increased risk of bleeding associated with the concomitant use of FETZIMA and NSAIDs, aspirin, or other drugs that affect coagulation [see Drug Interactions ( 7.1 )] . (Levomilnacipran label, Warnings and precautions)
- Levonorgestrel and ethinyl estradioloral contraceptiveModerate
Other Drugs Clinical effect Concomitant use of CHCs may decrease systemic exposure of acetaminophen, morphine, salicylic acid, and temazepam. (Levonorgestrel and ethinyl estradiol label, Drug interactions)
- Levothyroxinethyroid hormoneModerate
An initial increase in serum FT 4 is followed by return of FT 4 to normal levels with sustained therapeutic serum salicylate concentrations, although total T 4 levels may decrease by as much as 30%. (Levothyroxine label, Drug interactions)
- LinagliptinDPP-4 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Liothyroninethyroid hormoneModerate
An initial increase in serum FT4 is followed by return of FT4 to normal levels with sustained therapeutic serum salicylate concentrations, although total T4 levels may decrease by as much as 30%. (Liothyronine label, Drug interactions)
- LiraglutideGLP-1 receptor agonistModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- LisinoprilACE inhibitorModerate
NSAIDS: Increased risk of renal impairment and loss of antihypertensive efficacy ( 7.3 ) (Lisinopril label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Lithiumserotonergic drugModerate
• Diuretics, NSAID, renin-angiotensin system antagonists, or metronidazole may increase lithium serum concentrations. (Lithium label, Drug interactions)
- Losartanangiotensin II receptor blocker (ARB)Moderate
NSAIDs: Increased risk of renal impairment and reduced diuretic, natriuretic, and antihypertensive effects. (Losartan label, Drug interactions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- MesalaminesalicylateModerate
Nephrotoxic Agents including NSAIDs: Increased risk of nephrotoxicity; monitor for changes in renal function and mesalamine-related adverse reactions. (Mesalamine label, Drug interactions)
- MetforminbiguanideModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- MethylprednisolonecorticosteroidModerate
Nonsteroidal anti-inflammatory drugs (NSAIDs) : Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects. (Methylprednisolone label, Drug interactions)
- Metolazonethiazide diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Metoprololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- MoexiprilACE inhibitorModerate
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDS, including selective COX-2 inhibitors, with ACE inhibitors, including moexipril, may result in deterioration… (Moexipril label, Drug interactions)
- MoxifloxacinfluoroquinoloneModerate
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Although not observed with moxifloxacin in preclinical and clinical trials, the concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone may increase the risks of CNS stimulation and convulsions [see Warnings and Precautions ( 5.4 ), and Patient Counseling Information ( 17 )]. (Moxifloxacin label, Drug interactions)
- Nadololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Nebivololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- NiacinModerate
Aspirin Concomitant aspirin may decrease the metabolic clearance of nicotinic acid. (Niacin label, Drug interactions)
- Nifedipinedihydropyridine calcium channel blockerModerate
…diverticulosis, and inflammatory bowel disease), hypomotility disorders (e.g., constipation, gastroesophageal reflux disease, ileus, obesity, hypothyroidism, and diabetes) and concomitant medications (e.g., H 2 -histamine blockers, opiates, nonsteroidal anti-inflammatory drugs, laxatives, anticholinergic agents, levothyroxine, and neuromuscular blocking agents). (Nifedipine label, Warnings)
- NintedanibModerate
Use OFEV with caution when treating patients with recent abdominal surgery, previous history of diverticular disease or receiving concomitant corticosteroids or NSAIDs. (Nintedanib label, Warnings and precautions)
- NizatidineH2 blockerModerate
In patients given very high doses (3,900 mg) of aspirin daily, increases in serum salicylate levels were seen when nizatidine, 150 mg b.i.d., was administered concurrently. (Nizatidine label, Drug interactions)
- Norgestimate and ethinyl estradioloral contraceptiveModerate
COCs have been shown to decrease plasma concentrations of acetaminophen, clofibric acid, morphine, salicylic acid, temazepam and lamotrigine. (Norgestimate and ethinyl estradiol label, Drug interactions)
- OfloxacinfluoroquinoloneModerate
Non Steroidal Anti-Inflammatory Drugs The concomitant administration of a non-steroidal anti-inflammatory drug with a quinolone, including ofloxacin, may increase the risk of CNS stimulation and convulsive seizures (see WARNINGS and PRECAUTIONS , General ). (Ofloxacin label, Drug interactions)
- Olmesartanangiotensin II receptor blocker (ARB)Moderate
NSAID use may lead to increased risk of renal impairment and loss of antihypertensive effect ( 7.2 ). (Olmesartan label, Drug interactions)
- OxcarbazepineanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- ParoxetineSSRIModerate
Drugs that Interfere with Hemostasis (e.g., NSAIDs, Aspirin, and Warfarin) Altered anticoagulant effects, including increased bleeding, have been reported when SSRIs are concomitantly administered with NSAIDs, aspirin, warfarin. or other drugs that affect coagulation. (Paroxetine label, Drug interactions)
- PentoxifyllinemethylxanthineModerate
DRUG INTERACTIONS Bleeding has been reported in patients treated with pentoxifylline extended-release tablets with or without concomitant NSAIDs, anticoagulants, or platelet aggregation inhibitors. (Pentoxifylline label, Drug interactions)
- PerampanelanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- PerindoprilACE inhibitorModerate
NSAID use may lead to increased risk of renal impairment and loss of antihypertensive effect. (Perindopril label, Drug interactions)
- PhenobarbitalbarbiturateModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Phentermine and topiramateCNS stimulantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- PhenytoinanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Pindololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- PioglitazonethiazolidinedioneModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Pioglitazone and metforminthiazolidinedioneModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Potassium chloridepotassium supplementModerate
Nonsteroidal anti-inflammatory drugs: Monitor for hyperkalemia ( 7.3 ) (Potassium chloride label, Drug interactions)
- PrednisolonecorticosteroidModerate
NSAIDS, including aspirin and salicylates: Concomitant use of aspirin or other non-steroidal anti-inflammatory agents and corticosteroids increases the risk of gastrointestinal side effects. (Prednisolone label, Drug interactions)
- PrednisonecorticosteroidModerate
NSAIDs including aspirin and salicylates: Increased risk of gastrointestinal side effects. (Prednisone label, Drug interactions)
- PregabalinanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- PrimidoneanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Propranololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- QuinaprilACE inhibitorModerate
Non-steroidal anti-inflammatory agents including selective cyclooxygenase-2 inhibitors (COX-2 inhibitors) In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including quinapril, may result in deterioration… (Quinapril label, Drug interactions)
- RamiprilACE inhibitorModerate
NSAIDS use may lead to increased risk of renal impairment and loss of antihypertensive effect (7.6). mTOR inhibitor or neprilysin inhibitor use may increase angioedema risk (7.7). (Ramipril label, Drug interactions)
- RepaglinidemeglitinideModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Rivastigminecholinesterase inhibitorModerate
Monitor patients using rivastigmine tartrate for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, e.g., those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). (Rivastigmine label, Warnings and precautions)
- RufinamideanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Sacubitril and valsartanangiotensin II receptor blocker (ARB)Moderate
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): May lead to increased risk of renal impairment. (Sacubitril and valsartan label, Drug interactions)
- SemaglutideGLP-1 receptor agonistModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- SertralineSSRIModerate
Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.3 ) (Sertraline label, Warnings and precautions)
- SitagliptinDPP-4 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Sitagliptin and metforminDPP-4 inhibitorModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- Sotalolbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Spironolactonealdosterone antagonistModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- TadalafilPDE5 inhibitorModerate
When administered in combination with aspirin, tadalafil 20 mg did not prolong bleeding time, relative to aspirin alone. (Tadalafil label, Warnings and precautions)
- Telmisartanangiotensin II receptor blocker (ARB)Moderate
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors): In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including telmisartan, may… (Telmisartan label, Drug interactions)
- TiagabineanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Timololbeta blockerModerate
Beta Blockers The hypotensive effects of beta blockers may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- TirzepatideGLP-1 receptor agonistModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- TofacitinibimmunosuppressantModerate
Promptly evaluate patients treated with XELJANZ/XELJANZ XR who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs) and who present with new onset abdominal symptoms for early identification of gastrointestinal perforation [see Adverse Reactions (6.1) ] . (Tofacitinib label, Warnings and precautions)
- TopiramateanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Torsemideloop diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- TrandolaprilACE inhibitorModerate
Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with ACE inhibitors, including trandolapril, may result in deterioration… (Trandolapril label, Drug interactions)
- TrazodoneantidepressantModerate
Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Trazodone label, Warnings and precautions)
- TriamcinolonecorticosteroidModerate
Nonsteroidal anti-inflammatory drugs (NSAIDs): Concomitant use of aspirin (or other nonsteroidal anti-inflammatory drugs) and corticosteroids increases the risk of gastrointestinal side effects. (Triamcinolone label, Drug interactions)
- Triamterenepotassium-sparing diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- UpadacitinibimmunosuppressantModerate
Monitor RINVOQ/RINVOQ LQ-treated patients who may be at risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis and those taking concomitant medications including NSAIDs or corticosteroids). (Upadacitinib label, Warnings and precautions)
- Valproic acidanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- Valsartanangiotensin II receptor blocker (ARB)Moderate
Non-Steroidal Anti-Inflammatory Drug (NSAID) use may lead to increased risk of renal impairment and loss of antihypertensive effect ( 7.2 ) (Valsartan label, Drug interactions)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Diuretics The effectiveness of diuretics in patients with underlying renal or cardiovascular disease may be diminished by the concomitant administration of aspirin due to inhibition of renal prostaglandins, leading to decreased renal blood flow and salt and fluid retention. (Aspirin and dipyridamole label, Drug interactions)
- VardenafilPDE5 inhibitorModerate
There is no clinical evidence of any additive prolongation of the bleeding time when vardenafil is administered with aspirin. (Vardenafil label, Warnings and precautions)
- VenlafaxineSNRIModerate
Patients should be cautioned about the increased risk of bleeding associated with the concomitant use of Venlafaxine Extended Release Tablets and NSAIDs, aspirin, or other drugs that affect coagulation. (Venlafaxine label, Warnings and precautions)
- Verapamilcalcium channel blockerModerate
Aspirin In a few reported cases, coadministration of verapamil with aspirin has led to increased bleeding times greater than observed with aspirin alone. (Verapamil label, Drug interactions)
- VigabatrinanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
- VilazodoneSSRIModerate
Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.3 ) (Vilazodone label, Warnings and precautions)
- Vitamin EVitamin and mineralModerate
Vitamin E can inhibit platelet aggregation and vitamin K-dependent clotting, increasing bleeding risk with anticoagulant and antiplatelet drugs. (NIH Office of Dietary Supplements, Vitamin E)
- Voriconazoleazole antifungalModerate
NSAIDs Non-Steroidal Anti-Inflammatory Drug including. ibuprofen and diclofenac (CYP2C9 Inhibition) Increased Frequent monitoring for adverse reactions and toxicity related to NSAIDs. (Voriconazole label, Drug interactions)
- VortioxetineantidepressantModerate
Inform patients about the increased risk of bleeding when TRINTELLIX is coadministered with NSAIDs, aspirin, or other drugs that affect coagulation or bleeding. (Vortioxetine label, Warnings and precautions)
- WarfarinanticoagulantModerate
Aspirin can displace warfarin from protein binding sites, leading to prolongation of both the prothrombin time and the bleeding time. (Aspirin and dipyridamole label, Drug interactions)
- Zafirlukastleukotriene receptor antagonistModerate
Coadministration of zafirlukast (40 mg/day) with aspirin (650 mg four times daily) resulted in mean increased plasma levels of zafirlukast by approximately 45%. (Zafirlukast label, Precautions)
- ZonisamideanticonvulsantModerate
Anticonvulsants Salicylic acid can displace protein-bound phenytoin and valproic acid, leading to a decrease in the total concentration of phenytoin and an increase in serum valproic acid levels. (Aspirin and dipyridamole label, Drug interactions)
Minor mentions (17)
- Buspironeserotonergic drugMinor
Therapeutic levels of aspirin, desipramine, diazepam, flurazepam, ibuprofen, propranolol, thioridazine, and tolbutamide had only a limited effect on the extent of binding of buspirone to plasma proteins (see CLINICAL PHARMACOLOGY ). (Buspirone label, Drug interactions)
- DroxidopasympathomimeticMinor
(tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity [see Contraindications ( 4 )]. (Droxidopa label, Warnings and precautions)
- Finasteride5-alpha reductase inhibitorMinor
…angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically significant adverse interactions. (Finasteride label, Drug interactions)
- Fish oil (omega-3)Herbal and supplementMinor
Omega-3 supplements may mildly prolong bleeding time; the combination with anticoagulants such as warfarin warrants monitoring, though clinically significant bleeding has not been consistently shown. (NIH Office of Dietary Supplements, Omega-3 Fatty Acids)
- FosinoprilACE inhibitorMinor
Angiotensin Converting Enzyme (ACE) Inhibitors Because of the indirect effect of aspirin on the renin-angiotensin conversion pathway, the hyponatremic and hypotensive effects of ACE inhibitors may be diminished by concomitant administration of aspirin. (Aspirin and dipyridamole label, Drug interactions)
- Garlic (supplement)Herbal and supplementMinor
Garlic supplements may increase bleeding risk with anticoagulants such as warfarin. (NCCIH, Garlic)
- InfliximabimmunosuppressantMinor
In RA, concomitant medications besides MTX were nonsteroidal anti-inflammatory agents (NSAIDs), folic acid, corticosteroids and/or narcotics. (Infliximab label, Drug interactions)
- IsotretinoinretinoidMinor
Although the overall incidence of tartrazine sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity. (Isotretinoin label, Warnings and precautions)
- IvermectinMinor
Antihistamines and/or aspirin have been used for most mild to moderate cases. (Ivermectin label, Warnings)
- LorazepambenzodiazepineMinor
(tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity [see Contraindications ( 4 )] . (Lorazepam label, Warnings and precautions)
- Nicardipinedihydropyridine calcium channel blockerMinor
In Vitro Interaction The plasma protein binding of nicardipine was not altered when therapeutic concentrations of furosemide, propranolol, dipyridamole, warfarin, quinidine, or naproxen were added to human plasma in vitro. (Nicardipine label, Drug interactions)
- Penicillin Gpenicillin antibioticMinor
These drugs include: aspirin, phenylbutazone, sulfonamides, indomethacin, thiazide diuretics, furosemide and ethacrynic acid. (Penicillin G label, Drug interactions)
- Prazosinalpha blockerMinor
…tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however), and quinidine; and (6) analgesics, antipyretics and anti-inflammatories–propoxyphene, aspirin, indomethacin, and phenylbutazone. (Prazosin label, Drug interactions)
- Pyridostigminecholinesterase inhibitorMinor
Cholinesterase Inhibitors Dipyridamole may counteract the anticholinesterase effect of cholinesterase inhibitors, thereby potentially aggravating myasthenia gravis. (Aspirin and dipyridamole label, Drug interactions)
- RisedronatebisphosphonateMinor
Aspirin/Nonsteroidal Anti-Inflammatory Drugs In the Phase 3 study comparing Risedronate sodium delayed-release 35 mg once-a-week immediately following breakfast and risedronate sodium 5 mg daily, 18% of NSAID users (any use) in both groups developed upper gastrointestinal adverse reactions. (Risedronate label, Drug interactions)
- TocilizumabimmunosuppressantMinor
Concomitant Drugs for Treatment of Adult Indications In RA patients, population pharmacokinetic analyses did not detect any effect of methotrexate (MTX), non-steroidal anti-inflammatory drugs or corticosteroids on tocilizumab clearance. (Tocilizumab label, Drug interactions)
- Treprostinilprostaglandin analogMinor
Bronchospasm Like other inhaled prostaglandins, Tyvaso may cause acute bronchospasm. (Treprostinil label, Warnings and precautions)
No significant interaction reported (2)
- OseltamivirantiviralNo interaction
…Clinically Significant Drug Interaction with TAMIFLU No dose adjustments are needed for either oseltamivir or the concomitant drug when coadministering oseltamivir with amoxicillin, acetaminophen, aspirin, cimetidine, antacids (magnesium and aluminum hydroxides and calcium carbonates), rimantadine, amantadine, or warfarin [see Clinical Pharmacology (12.3) ] . (Oseltamivir label, Drug interactions)
- SildenafilPDE5 inhibitorNo interaction
In humans, sildenafil has no effect on bleeding time when taken alone or with aspirin. (Sildenafil label, Warnings and precautions)
Check Aspirin and dipyridamole against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.