Etodolac 2care4 Tương tác

Risk related to hyperkalemia: Certain drugs or therapeutic classes are likely to promote the occurrence of hyperkalaemia: Potassium salts, hyperkalaemic diuretics, converting enzyme inhibitors, angiotensin II antagonists, non-steroidal anti-inflammatory drugs, heparins (low molecular weight or unfractionated), immunosuppressants such as ciclosporin or tacrolimus, trimethoprim. The combination of these drugs increases the risk of hyperkalaemia. This risk is particularly high with potassium-sparing diuretics, especially when they are combined with each other or with potassium salts, while the combination of an ACE inhibitor and an NSAID has a lower risk.
To know the risks and levels of constraints specific to hyperkalaemic drugs, it is advisable to refer to the interactions specific to each substance.
However, some medications such as trimethoprim, are not the subject of specific interactions with regard to this risk. Nevertheless, they can act as contributing factors when combined with other drugs such as those mentioned previously.
Simultaneous administration of etodolac with the following products requires careful monitoring of the patient's clinical and biological status.
Combinations not recommended: Oral anticoagulants: Increased risk of bleeding from oral anticoagulant (aggression of the gastroduodenal mucosa by NSAIDs). NSAIDs may potentiate the effects of anticoagulants, such as warfarin.
If the association cannot be avoided, close clinical and biological monitoring.
Other NSAIDs: Increased risk of ulcerogenic and gastrointestinal bleeding.
Acetylsalicylic acid at anti-inflammatory doses (≥1 g per dose and/or ≥3 g per day), and at analgesic or antipyretic doses (≥500 mg per dose and/or <3 g per day): Increased risk of ulceration and gastrointestinal bleeding.
Unfractionated heparins, low molecular weight heparins and related (at curative doses and/or in the elderly): Increased risk of bleeding (inhibition of platelet function and aggression of the gastroduodenal mucosa by NSAIDs).
If the association cannot be avoided, close clinical (and biological for unfractionated heparins) monitoring.
Lithium: Increase in lithium which can reach toxic values (decrease in renal excretion of lithium). If the combination cannot be avoided, closely monitor the lithium and adapt the lithium dosage during the combination and after stopping the nonsteroidal anti-inflammatory drug.
Methotrexate used at doses greater than or equal to 20 mg/week: Increased haematological toxicity of methotrexate (decreased renal clearance of methotrexate by anti-inflammatory drugs).
Pemetrexed (patients with low to moderate renal function, creatinine clearance between 45 mL/min and 80 mL/min): Risk of increased toxicity of pemetrexed (decreased renal clearance by NSAIDs).
Combinations subject to precautions for use: Ciclosporin, tacrolimus: Risk of addition of nephrotoxic effects, especially in the elderly.
Monitor renal function at the start of treatment with NSAIDs.
Diuretics, ACE inhibitors, angiotensin II receptor antagonists: Acute renal failure in patients at risk (elderly and/or dehydrated subject) by reduction in glomerular filtration (inhibition of vasodilator prostaglandins by NSAIDs).
Moreover, reduction of the antihypertensive effect.
Hydrate the patient; Look at the kidney function at the start of the treatment.
Methotrexate used at doses less than or equal to 20 mg/week: Increased haematological toxicity of methotrexate (decreased renal clearance of methotrexate by anti-inflammatory drugs).
Weekly control of the blood count during the first weeks of the association.
Increased monitoring in the event of impairment (even slight) of renal function, as well as in the elderly.
Pemetrexed (patients with normal kidney function): Risk of increased toxicity of pemetrexed (decreased renal clearance by NSAIDs).
Biological monitoring of the renal function.
Associations to consider: Acetylsalicylic acid at anti-aggregation doses (from 50 mg to 375 mg per day in 1 or more doses): Increased risk of ulceration and gastrointestinal bleeding.
Glucocorticoids (except hydrocortisone in replacement therapy): Increased risk of gastrointestinal ulceration and bleeding.
Antiplatelet drugs and serotonin reuptake inhibitors (SSRIs): Increased risk of gastrointestinal bleeding.
Unfractionated heparins, low molecular weight heparins (preventive doses): Increased risk of bleeding.
Beta-blockers (except esmolol): Reduction of the antihypertensive effect (inhibition of vasodilating prostaglandins by NSAIDs and water and sodium retention with pyrazole NSAIDs).
Deferasirox: Increased risk of ulcerogenic and digestive bleeding.