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Easprin and Zilretta

Determining the interaction of Easprin and Zilretta and the possibility of their joint administration.

Check result:
Easprin <> Zilretta
Relevance: 08.05.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using aspirin together with triamcinolone may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. In addition, steroid medications like triamcinolone have been reported to decrease the blood levels of aspirin and similar drugs in some cases, which may make them less effective in treating your condition. On the other hand, if you have been receiving both medications and triamcinolone is stopped, blood levels of aspirin may subsequently increase and a dosage reduction may be required to avoid toxicity. Talk to your doctor if you have any questions or concerns. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with corticosteroids may decrease the serum concentrations and therapeutic effects of salicylates. Likewise, serum salicylate levels may increase following withdrawal of corticosteroid therapy, potentially resulting in salicylate toxicity. This interaction has been reported in patients receiving intra-articular as well as oral corticosteroids. One or more mechanisms may be involved, including an increase in the renal clearance and/or an induction of hepatic metabolism of salicylates caused by corticosteroids. Pharmacologically, the potential for increased gastrointestinal (GI) toxicity, including inflammation, bleeding, ulceration and perforation, should be considered due to additive ulcerogenic effects of these agents (especially aspirin) on the GI mucosa.

MANAGEMENT: Patients treated concomitantly with a corticosteroid may require higher dosages of salicylates or salicylate-like drugs. Pharmacologic response to these agents should be monitored more closely whenever a corticosteroid is added to or withdrawn from therapy in patients stabilized on their existing salicylate regimen, and the salicylate dosage adjusted as necessary. During concomitant therapy, patients should be advised to take the medications with food and to immediately report signs and symptoms of GI ulceration and bleeding such as severe abdominal pain, dizziness, lightheadedness, and the appearance of black, tarry stools. The selective use of prophylactic anti-ulcer therapy (e.g., antacids, H2-antagonists) may be appropriate, particularly in patients with a prior history of peptic ulcer disease or GI bleeding and in elderly and debilitated patients.

References
  • Piper JM, Ray WA, Daugherty JR, Griffin MR "Corticosteroid use and peptic ulcer disease: role of nonsteroidal ani-inflammatory drugs." Ann Intern Med 114 (1991): 735-40
  • Hansen RA, Tu W, Wang J, Ambuehl R, McDonald CJ, Murray MD "Risk of adverse gastrointestinal events from inhaled corticosteroids." Pharmacotherapy 28 (2008): 1325-34
  • Edelman J, Potter JM, Hackett LP "The effect of intra-articular steroids on plasma salicylate concentrations." Br J Clin Pharmacol 21 (1986): 301-7
  • Koren G, Roifman C, Gelfand E, Lavi S, Suria D, Stein L "Corticosteroids-salicylate interaction in a case of juvenile rheumatoid arthritis." Ther Drug Monit 9 (1987): 177-9
  • Baer PA, Shore A, Ikeman RL "Transient fall in serum salicylate levels following intraarticular injection of steroid in patients with rheumatoid arthritis." Arthritis Rheum 30 (1987): 345-7
Easprin

Generic Name: aspirin

Brand name: Arthritis Pain, Aspir 81, Aspir-Low, Bayer Childrens Aspirin, Durlaza, Ecotrin, Ecpirin, Fasprin, Halfprin, Miniprin, Aspiritab, Bayer, Bayer Low Strength, Bayer Children's, St. Joseph 81 mg Adult

Synonyms: Easprin (Oral)

Zilretta

Generic Name: triamcinolone

Brand name: Kenalog-40, Zilretta, Aristocort, Azmacort

Synonyms: Zilretta (injection)

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction