Interactions : אינטראקציות

4.5     Interaction with other medicinal products and other forms of interaction
Pharmacokinetic induction of metabolizing enzymes:
Dipyrone might induce metabolizing enzymes, including CYP2B6 and CYP3A4. The simultaneous use of Dipyrone with bupropion, efavirenz, methadone, valproate, ciclosporin, tacrolimus or sertraline might result in a reduction of the plasma concentration of these medicinal products with a potential decrease in clinical efficacy. Therefore, caution must be taken when using Dipyrone simultaneously with these drugs; the clinical response and/or the efficacy levels should be monitored accordingly.
Severe hypothermia might occur with simultaneous use of this medicinal product and chlorpromazine.
The administration of Dipyrone in addition to methotrexate might increase the hepatotoxicity of methotrexate, in particular in elderly patients. This combination should therefore be avoided.
Dipyrone can reduce the effect of acetylsalicylic acid on the thrombocyte aggregation when used at the same time. Therefore, Dipyrone should be used with caution in patients who are taking acetylsalicylic acid in low doses for cardiac protection.
It is known for the substance class of pyrazolones that interactions with oral anticoagulants, captopril, lithium and triamterene and changes of the efficacy of antihypertensive agents and diuretics might occur. It is not known to what extent Dipyrone leads to these interactions.
Effect on examination methods
With Dipyrone treatment, there were reports of impairment of laboratory diagnostic investigations, which are based on the Trinder reaction or Trinder-like reactions (e.g. determination of creatinine, triglyceride, HDL cholesterol or uric acid serum levels) in patients.