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Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction
BACKGROUND: Low-dose aspirin irreversibly inhibits platelet cyclooxygenase-1 (COX-1) and suppresses platelet aggregation. It is effective for secondary prevention of cardiovascular events. Because nonsteroidal anti-inflammatory drugs (NSAIDs) reversibly bind with COX-1, the antiplatelet effects of a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345232/ https://www.ncbi.nlm.nih.gov/pubmed/28293429 http://dx.doi.org/10.1186/s40780-017-0078-7 |
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author | Shibata, Kenta Akagi, Yuuki Nozawa, Naofumi Shimomura, Hitoshi Aoyama, Takao |
author_facet | Shibata, Kenta Akagi, Yuuki Nozawa, Naofumi Shimomura, Hitoshi Aoyama, Takao |
author_sort | Shibata, Kenta |
collection | PubMed |
description | BACKGROUND: Low-dose aspirin irreversibly inhibits platelet cyclooxygenase-1 (COX-1) and suppresses platelet aggregation. It is effective for secondary prevention of cardiovascular events. Because nonsteroidal anti-inflammatory drugs (NSAIDs) reversibly bind with COX-1, the antiplatelet effects of aspirin may be suppressed when NSAIDs are co-administered. This interaction could be avoided by avoiding simultaneous administration; however, the minimum interval that should separate the administration of aspirin and loxoprofen is not well known. In this study, we investigated how to avoid the influence of NSAIDs on the antiplatelet effects of aspirin. An in vitro experiment was performed to investigate the influence of ibuprofen and loxoprofen at various concentrations on aspirin’s antiplatelet action. METHODS: Platelet aggregation and thromboxane B(2) (TXB(2)) levels were measured after addition of aspirin only and NSAIDs plus aspirin to platelet-rich plasma. NSAIDs were used at their maximum plasma concentrations, the assumed concentration after 6 h (for loxoprofen only), and the assumed concentration after 12 h of taking one clinical dose. Platelet aggregation threshold index (PATI), defined as the putative stimulus concentration giving 50% aggregation, was calculated as an index of aggregation activity. RESULTS: PATI decreased in ibuprofen plus aspirin group compared to that in the aspirin only group, regardless of ibuprofen concentration. Furthermore, PATI significantly decreased when aspirin was added after loxoprofen-trans-OH addition at the maximum concentration (4.1 ± 0.1 μg/mL), compared to that in aspirin only group (5.9 ± 0.1 μg/mL). PATI showed no significant difference after addition of loxoprofen at the assumed concentration after 6 h (aspirin only group, 5.0 ± 0.5 μg/mL; loxoprofen-trans-OH plus aspirin group, 4.9 ± 0.4 μg/mL).In addition, TXB(2) concentration tended to decrease with increasing PATI. CONCLUSIONS: It is desirable to avoid ibuprofen co-administration with the usual once-daily low-dose aspirin therapy; however, a 6-h interval between loxoprofen and aspirin could avoid this potential interaction when loxoprofen is taken before aspirin. |
format | Online Article Text |
id | pubmed-5345232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53452322017-03-14 Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction Shibata, Kenta Akagi, Yuuki Nozawa, Naofumi Shimomura, Hitoshi Aoyama, Takao J Pharm Health Care Sci Research Article BACKGROUND: Low-dose aspirin irreversibly inhibits platelet cyclooxygenase-1 (COX-1) and suppresses platelet aggregation. It is effective for secondary prevention of cardiovascular events. Because nonsteroidal anti-inflammatory drugs (NSAIDs) reversibly bind with COX-1, the antiplatelet effects of aspirin may be suppressed when NSAIDs are co-administered. This interaction could be avoided by avoiding simultaneous administration; however, the minimum interval that should separate the administration of aspirin and loxoprofen is not well known. In this study, we investigated how to avoid the influence of NSAIDs on the antiplatelet effects of aspirin. An in vitro experiment was performed to investigate the influence of ibuprofen and loxoprofen at various concentrations on aspirin’s antiplatelet action. METHODS: Platelet aggregation and thromboxane B(2) (TXB(2)) levels were measured after addition of aspirin only and NSAIDs plus aspirin to platelet-rich plasma. NSAIDs were used at their maximum plasma concentrations, the assumed concentration after 6 h (for loxoprofen only), and the assumed concentration after 12 h of taking one clinical dose. Platelet aggregation threshold index (PATI), defined as the putative stimulus concentration giving 50% aggregation, was calculated as an index of aggregation activity. RESULTS: PATI decreased in ibuprofen plus aspirin group compared to that in the aspirin only group, regardless of ibuprofen concentration. Furthermore, PATI significantly decreased when aspirin was added after loxoprofen-trans-OH addition at the maximum concentration (4.1 ± 0.1 μg/mL), compared to that in aspirin only group (5.9 ± 0.1 μg/mL). PATI showed no significant difference after addition of loxoprofen at the assumed concentration after 6 h (aspirin only group, 5.0 ± 0.5 μg/mL; loxoprofen-trans-OH plus aspirin group, 4.9 ± 0.4 μg/mL).In addition, TXB(2) concentration tended to decrease with increasing PATI. CONCLUSIONS: It is desirable to avoid ibuprofen co-administration with the usual once-daily low-dose aspirin therapy; however, a 6-h interval between loxoprofen and aspirin could avoid this potential interaction when loxoprofen is taken before aspirin. BioMed Central 2017-03-09 /pmc/articles/PMC5345232/ /pubmed/28293429 http://dx.doi.org/10.1186/s40780-017-0078-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Shibata, Kenta Akagi, Yuuki Nozawa, Naofumi Shimomura, Hitoshi Aoyama, Takao Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title | Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title_full | Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title_fullStr | Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title_full_unstemmed | Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title_short | Influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
title_sort | influence of nonsteroidal anti-inflammatory drugs on aspirin’s antiplatelet effects and suggestion of the most suitable time for administration of both agents without resulting in interaction |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5345232/ https://www.ncbi.nlm.nih.gov/pubmed/28293429 http://dx.doi.org/10.1186/s40780-017-0078-7 |
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