Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction
Pharmacokinetic induction of metabolic enzymes:
Dipyrone can induce metabolic enzymes including CYP2B6 and CYP3A4. The concomitant use of dipyrone with bupropion, efavirenz, methadone, valproate, ciclosporin, tacrolimus or sertraline can bring about a reduction in the plasma concentration of these medicinal products, with a potential decrease in clinical efficacy.
Caution is therefore required in the case of co-administration with dipyrone; the clinical response and/or active substance levels should be monitored accordingly.

If dipyrone and chlorpromazine are co-administered, severe hypothermia can occur.

The concomitant administration of dipyrone with methotrexate can potentiate the haematotoxicity of methotrexate, especially in elderly patients. This combination should therefore be avoided.

Dipyrone, if co-administered, can reduce the effect of aspirin on platelet aggregation.
Dipyrone should therefore be used with caution in patients who are taking low-dose aspirin for cardioprotection.
It is known of the pyrazolone substance class that interactions can occur with oral anticoagulants, captopril, lithium and triamterene, as well as changes in the efficacy of antihypertensives and diuretics. It is not known to what extent dipyrone has these Interactions.
Effect on test methods
Interference with laboratory diagnostic tests based on the Trinder reaction or Trinder- like reactions (e.g. determination of serum creatinine, triglyceride, HDL-cholesterol or uric acid levels) have been reported in patients on treatment with dipyrone.
Possible interaction between dipyrone and diagnostics :
1. Enzymatic Creatinine
2. Cholesterol
3. Triglyceride
4. Uric acid
5. Lactase
6. Lipase.
The possible interaction is significantly lower results than the real values in patients treated by dipyrone prior to undergoing the above testing. In case any of those tests have to be performed, dipyrone has to be administered after the testing.