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Intake of aspirin prior to metamizole does not completely prevent high on treatment platelet reactivity.
Pfrepper, Christian; Dietze, Carolin; Remane, Yvonne; Bertsche, Thilo; Schiek, Susanne; Kaiser, Thorsten; Gockel, Ines; Josten, Christoph; Petros, Sirak.
Afiliación
  • Pfrepper C; Division of Haemostaseology, Medical Department I, University Hospital Leipzig, Leipzig, Germany. Christian.pfrepper@medizin.uni-leipzig.de.
  • Dietze C; Hospital Pharmacy, University Hospital Leipzig, Leipzig, Germany.
  • Remane Y; Hospital Pharmacy, University Hospital Leipzig, Leipzig, Germany.
  • Bertsche T; Drug Safety Center and Department of Clinical Pharmacy, Leipzig University, Leipzig, Germany.
  • Schiek S; Drug Safety Center and Department of Clinical Pharmacy, Leipzig University, Leipzig, Germany.
  • Kaiser T; Institute of Laboratory Medicine, University Hospital Leipzig, Leipzig, Germany.
  • Gockel I; Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
  • Josten C; Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
  • Petros S; Division of Haemostaseology, Medical Department I, University Hospital Leipzig, Leipzig, Germany.
Eur J Clin Pharmacol ; 76(4): 483-490, 2020 Apr.
Article en En | MEDLINE | ID: mdl-31915847
PURPOSE: Metamizole can sterically inhibit aspirin (ASA) from binding to cyclooxygenase 1 (COX1). It is recommended that ASA should be taken 30 min prior to metamizole to maintain the irreversible inhibition of arachidonic acid (AA)-induced platelet aggregation. We aimed to analyse the inhibitory effect of ASA and metamizole on AA-induced platelet aggregation over the course of the day. METHODS: We analysed hospitalized patients who ingested ASA at least 30 min prior to metamizole (recommended dosing group, n = 15), metamizole prior or simultaneously with ASA (not recommended dosing group, n = 16) and patients with unknown or mixed intake (mixed dosing group, n = 5). AA-induced light transmission (LTA) and impedance aggregometry (IA) were measured before, 1-2 and 5-6 h after the intake of ASA ± metamizole. RESULTS: Maximum AA-induced LTA prior to the intake of ASA was significantly lower and the rate of high on treatment platelet reactivity (HTPR) higher in the recommended compared with the not recommended dosing group (19.6% vs. 46.9%, p = 0.011 and 4/15 vs. 12/16 patients, p = 0.017). There was no difference when IA was used. Maximum AA-induced LTA after the intake of ASA ± metamizole was lower in patients in the not recommended but not in the recommended dosing group. All patients with HTPR in the recommended dosing group had regular inhibition of AA-induced LTA after discontinuation of metamizole. CONCLUSION: Co-medication of ASA and metamizole significantly influences platelet inhibition with variations during the day and can cause HTPR in patients taking ASA prior to metamizole or simultaneously.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Enfermedades Cardiovasculares / Agregación Plaquetaria / Antiinflamatorios no Esteroideos / Aspirina / Dipirona Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Pharmacol Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inhibidores de Agregación Plaquetaria / Enfermedades Cardiovasculares / Agregación Plaquetaria / Antiinflamatorios no Esteroideos / Aspirina / Dipirona Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Pharmacol Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania