Drug interactions
Bivalirudin + Diflunisal
Severity: Major
Bivalirudin and Diflunisal: major interaction.
Last updated Sources: EMA SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Diflunisal impairs platelet function and can injure the GI mucosa, which adds to the bleeding risk of the direct thrombin inhibitor bivalirudin.
What this interaction means in plain words
Bivalirudin and Diflunisal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive hemostatic impairment from direct thrombin inhibition and NSAID-induced platelet inhibition.
What to do
Avoid NSAIDs around bivalirudin therapy where possible. If they are used, monitor closely for bleeding and hemoglobin changes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Frequently asked questions
Can I take Bivalirudin with Diflunisal?
MediHelp rates the interaction as major. Bivalirudin and Diflunisal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Diflunisal impairs platelet function and can injure the GI mucosa, which adds to the bleeding risk of the direct thrombin inhibitor bivalirudin.
How serious is the interaction between Bivalirudin and Diflunisal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid NSAIDs around bivalirudin therapy where possible. If they are used, monitor closely for bleeding and hemoglobin changes.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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