aspirin
5 interactions related to aspirin
aspirin + ginkgo
Ginkgo biloba can inhibit platelet-activating factor (PAF) and platelet aggregation, which can add to aspirin's irreversible inhibition of cyclooxygenase-1 and thromboxane A2. The combination may modestly increase minor bleeding events, with case reports of more serious bleeds in vulnerable patients.
aspirin + fish oil
Omega-3 fatty acids in fish oil reduce platelet aggregation and prolong bleeding time slightly, theoretically adding to aspirin's antiplatelet effect. Clinical trials, however, consistently show no clinically significant increase in major bleeding even with high-dose fish oil added to aspirin.
valproate + aspirin
Aspirin (and other salicylates) displace valproate from plasma albumin binding sites and also inhibit valproate's beta-oxidation, leading to increases in the free (active) valproate fraction by up to fourfold. Even total valproate levels may not rise dramatically, masking the increase in pharmacologically active free drug and raising the risk of valproate toxicity (sedation, tremor, hyperammonemia, hepatotoxicity).
alcohol + aspirin
Alcohol and aspirin together significantly increase the risk of gastrointestinal bleeding because aspirin irreversibly inhibits platelets for their entire 7-10 day lifespan while alcohol damages the gastric lining and impairs clot formation. The risk is particularly elevated for daily low-dose aspirin users who drink regularly.
vitamin e + platelet function test
High-dose vitamin E (alpha-tocopherol above 400 IU per day) inhibits platelet aggregation through a protein kinase C-dependent mechanism, producing prolonged bleeding times and abnormal results on platelet function analyzers (such as PFA-100, VerifyNow, and light transmission aggregometry). The effect is most pronounced when vitamin E is combined with aspirin or other antiplatelet agents and can interfere with workup for bleeding disorders.