Clinically important interactions of nonsteroidal antiinflammatory drugs with other medications

Abstract

While many interactions between nonsteroidal antiinflammatory drugs (NSAID) and other drugs are reported, only a limited number of them are clinically important. These interactions can be divided into those explainable on mainly pharmacokinetic grounds, those explainable on interactions between pharmacokinetics and pharmacodynamics, and those that remain unexplained. Among those explainable on primarily kinetic grounds are interactions of NSAID with antacids, anticoagulants, hypoglycemics, methotrexate, lithium, probenecid, and phenytoin. More complex interactions between dynamics and kinetics are those relating NSAID interactions with diuretics, beta-blockers, other NSAID, and some anticoagulants. Finally important interactions whose causes are not understood include those between aspirin and corticosteroid, indomethacin and triamterene, and flurbiprofen with certain anticoagulants.