Analgesics, Antipyretics (cont.)
Drug interactions and NSAIDs
NSAIDs reduce the blood pressure-lowering effects of certain high blood pressure (antihypertensive) medications, including:
- thiazide diuretics such as hydrochlorothiazide (Dyazide, Maxzide);
- beta-blockers such as propranolol (Inderal, Inderal LA), atenolol (Inderal, Tenormin), and metoprolol (Lopressor);
- angiotensin receptor antagonists such as enalapril (Vasotec), lisinopril (Zestril; Prinivil), benazepril (Lotensin), quinapril (Accupril), ramipril (Altace), and captopril (Capoten); and
- some medications that act on the brain, such as clonidine (Catapres).
NSAIDs reduce blood flow to the kidneys and reduce the action of diuretics and decrease the elimination of lithium (Eskalith) and methotrexate (Rheumatrex).
NSAIDs also decrease the ability of the blood to clot and can increase the risk of bleeding. When used with other drugs that also increase bleeding risk (for example, warfarin [Coumadin]), there is an increased likelihood of serious bleeding or complications of bleeding. Therefore, individuals who are taking drugs that reduce the ability of blood to clot should avoid the prolonged use of NSAIDs.
What about overdoses of pain relievers and fever reducers?
The American Association of Poison Control Centers reported that of all overdoses of OTC products, 66% involved acetaminophen, 19% involved ibuprofen, and 15% involved aspirin.
Aspirin overdose can occur with as little as 150 mg/kg (10,000 mg or 10 grams in the average sized male) as a single dose, or 90 mg/kg per day for at least two consecutive days. Symptoms of toxicity due to aspirin include:
- tiredness,
- ringing in the ears,
- rapid breathing,
- seizures, vomiting,
- bleeding, and
- coma.
Large doses of acetaminophen rarely cause serious problems in children. In adults, as little as 10 grams can damage the liver and the kidneys.
Overdoses of ibuprofen rarely produce important problems. Nausea, vomiting, stomach pain, tiredness, and dizziness are the most common symptoms of large doses of ibuprofen. Rarely, coma may occur.
Source:medicinenet.com
