Momentact Analgesico Tương tác

Risk of hyperkalaemia: Risk related to hyperkalaemia.
Certain drugs or therapeutic classes are likely to promote the onset of hyperkalaemia: potassium salts, hyperkalaemic diuretics, angiotensin-converting enzyme inhibitors, angiotensin II inhibitors, 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, for example, is at a lower risk as soon as as long as the recommended precautions are implemented.
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, certain substances, 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 ibuprofen with the following products requires rigorous monitoring of the patient's clinical and biological status: Combination contraindications: Mifamurtide: At high doses of NSAIDs, risk of reduce efficacy of mifamurtide.
Combination not recommended: Other NSAIDs: Increased risk of ulcerogenic and digestive bleeding.
Aspirin at anti-inflammatory doses (≥1g per dose and/or ≥3g per day) or at analgesic/antipyretic doses (≥500 mg per dose and/or <3 g per day): Increased risk of ulcerogenic and digestive bleeding.
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.
Heparins (in curative doses and/or in the elderly): Increased risk of bleeding (aggression of the gastroduodenal mucosa by NSAIDs).
If the association cannot be avoided, close clinical monitoring.
Lithium: Increase in lithium in plasma which can reach toxic values (decreased 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 NSAID.
Methotrexate used at doses greater than 20 mg/week: Increased toxicity, in particular haematological, of methotrexate (decreased renal clearance of methotrexate by anti-inflammatories).
Nicorandil: Increased risk of ulcerogenic and digestive bleeding.
Pemetrexed (in case of weak to moderate kidney function): Risk of increased toxicity of pemetrexed (decreased renal clearance by NSAIDs).
Combinations subject to precautions for use: Aminosides: NSAIDs may reduce the excretion of aminoglycosides.
Antibiotics from the quinolone group: The combination with non-steroidal anti-inflammatory drugs (NSAIDs) is likely to increase the risk of seizures.
Ciclosporin, tacrolimus: Risk of addition of nephrotoxic effects, especially in the elderly. Monitor renal function at the start of treatment with NSAIDs.
Cobimetinib: Increased risk of bleeding.
Clinical monitoring.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists: Causes acute renal failure in patients with risk factors (elderly patients, dehydrated, taking diuretics, impaired renal function) due to reduced glomerular filtration levels (NSAIDs inhibit the vasodilator effect of prostaglandins). This impact is usually reversible. Moreover, the combination of NSAIDs with diuretics, ACE-converting enzyme inhibitors, and angiotensin II receptor inhibitors also reduces the antihypertensive effect.
Patients should be adequately hydrated and should be monitored for kidney function after initiation of concurrent treatment and periodic follow-up thereafter.
Hypoglycemia: Ibuprofen potentiates the hypoglycemic effect of oral hypoglycemic agents and insulin. Dosage adjustment may be necessary.
Mifepristone: Combination with non-steroidal anti-inflammatory drugs (NSAIDs) is likely to increase exposure to NSAIDs. A reduction in the efficacy of mifepristone is theoretically possible due to the anti-prostaglandin properties of NSAIDs. Studies carried out on the effects of ibuprofen in single administration or in repeated administrations starting on the day of administration of the prostaglandins (or in case of necessity) have shown no deleterious effect on the action of mifepristone nor on the general clinical effectiveness of the pregnancy termination protocol.
Methotrexate used at doses less than or equal to 20 mg/week: Increased toxicity, in particular haematological, of methotrexate (decreased renal clearance of methotrexate by anti-inflammatories).
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.
Phytotherapy products: The combination of ginkgo biloba and NSAIDs can increase the risk of bleeding.
Tenofovir disoproxil+Pemetrexed (patients with normal kidney function): Risk of increased toxicity of pemetrexed (decreased renal clearance by NSAIDs).
Biological monitoring of the renal function.
Voriconazole or fluconazole: Concomitant use of ibuprofen may increase ibuprofen exposure and plasma concentrations.
Zidovudine: Concomitant administration of zidovudine and ibuprofen may increase the risk of haemarthroses and hematomas in HIV-infected haemophilia patients.
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 ulcerogenic and digestive bleeding.
Concomitant administration of ibuprofen and acetylsalicylic acid is generally not recommended due to the increased potential for adverse effects.
Experimental data suggest that ibuprofen competitively inhibits the effect of low doses of acetylsalicylic acid on platelet aggregation when co-administered. Although there are uncertainties regarding the extrapolation of these data to clinical situations, the possibility that regular, long-term ibuprofen use may reduce the cardioprotective effect of low doses of acid acetylsalicylic acid cannot be excluded. No clinically relevant effects are considered likely for occasional use of ibuprofen.
Antiplatelet agents: Increased risk of gastrointestinal bleeding (see Precautions).
Beta-blockers (except esmolol) (including eye drops): Reduction of the antihypertensive effect (inhibition of vasodilator prostaglandins by nonsteroidal anti-inflammatory drugs).
Deferasirox: Increased risk of ulcerogenic and digestive bleeding.
Glucocorticoids (except hydrocortisone): Increased risk of gastrointestinal ulceration and bleeding (see Precautions).
Heparins (preventive doses): Increased risk of bleeding.
Selective serotonin reuptake inhibitors: Increased risk of bleeding.
Mixed adrenergic-serotonergic drugs: Increased risk of bleeding.
Pentoxifylline: Increased risk of bleeding.
Impact on diagnostic test results: Bleeding time (possible prolongation of bleeding time up to 1 day after stopping treatment); Blood sugar (possible reduction); Creatinine clearance (possible reduction); Hematocrit or hemoglobin (possible reduction); Concentrations of blood urea nitrogen, serum creatinine, potassium (possible elevation); Liver function test (possible elevation of transaminases).
Drug incompatibility: Because there is no research on drug incompatibility, do not mix this drug with other drugs.