Interactions
Look
at the following tables to see what drugs interact with analgesic medications.
Nonopioids
The table below lists some of the possible interactions that drugs may have with nonopioid analgesics:
|
These nonopioids |
may interact with ... |
to cause... |
|---|---|---|
|
Salicylates |
Acetaminophen |
renal toxicity |
| Oral anticoagulatants (Warfarin) | bleeding/hemorrage | |
| Probenecid | interference with uricosuric effects of probencid (aspirin has this effect) | |
| Methotrexate | inhibition of renal excretion of methotrexate, resulting in hepatotoxicity & bone marrow suppression | |
| Alcohol | increased GI irritation & bleeding | |
| Hypoglycemic medications | hypoglyemia (higher doses of aspirin with insulin may have this effect) | |
|
NSAIDs |
tricyclic antidepressants |
increased effect of antidepressant due to decreased clearance from body |
| Lithium | increased serum / plasma lithium concentrations and reduced renal lithium excretion, causing possible lithium toxicity | |
| Digoxin | increased effects of digoxin, which may cause toxicity | |
| Salicylates | decreased anti-inflammatory effect of these drugs & may also increase risk of GI ulceration & bleeding | |
| Cyclosporin | increased risk & severity of renal impairment | |
| Corticosteroids | increased risk of GI ulceration & bleeding | |
| Loop diuretics | decreased diuretic effect | |
|
Use of any of these drugs with NSAIDs for longer than 3 days may lead to a decrease in the antihypertensive effect of these drugs and/or an increased risk of impaired kidney function. | |
|
Acetaminophen |
Isoniazid |
increased hepatoxic effects of acetaminophen |
|
increased risk of hepatotoxicity, while theanalgesic/ antipyretic effectiveness of acetaminophen may be decreased. | |
Opioids
The table below lists some of the possible interactions that opioid analgesics may have with other drugs:
|
Opioids interact with... |
to cause... |
|---|---|
|
drugs that produce CNS effects, such as
|
greatly increased pharmacologic effect (sedation & respiratory depression)
Note: Because of this effect, opiods must be used caution, if at all. |
|
Meperidine |
CNS excitation, hypertension & hypotension (opioids interact with MAO inhibitors) |
 |
 |
 |