Topical diclofenac does not affect the antiplatelet properties of aspirin as compared to the intermediate effects of oral diclofenac: A prospective, randomized, complete crossover study.
Nonsteroidal anti-inflammatory drugs (NSAIDs) adversely interact with aspirin, diminishing its antiplatelet effect and potentially placing patients at an increased risk for recurrent thrombotic events. This crossover study aimed to determine whether the topical NSAID diclofenac epolamine 1.3% patch or oral diclofenac 50 mg interfered with the antiplatelet effects of aspirin 325 mg. Twelve healthy men and women aged 18-50 were included. Participants were randomized into 5 treatment arms: aspirin, diclofenac potassium 50 mg, diclofenac patch, diclofenac potassium plus ASA 325 mg, and diclofenac patch plus aspirin. Platelet responsiveness was determined using whole-blood impedance aggregation (WBA) to collagen 1 μg/mL and arachidonic acid (AA) 0.5 mM and was sampled every 2 hours. No significant difference in platelet function was observed following the diclofenac patch and aspirin vs aspirin alone. Oral diclofenac produced a mixed effect with significant reduction in platelet inhibition at hour 2 and hour 8 following aspirin administration. Topical diclofenac does not significantly interfere with the antiplatelet effects of aspirin and may be a safer alternative to the oral formulation.
Dent Neurologic Institute, Amherst, NY, USA.|State University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA.
M
M
Rowcliffe
Novartis, East Hanover, NJ, USA.
B
B
Nezami
Dent Neurologic Institute, Amherst, NY, USA.
E S
ES
Westphal
Dent Neurologic Institute, Amherst, NY, USA.
M
M
Rainka
State University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA.
M
M
Janda
Dent Neurologic Institute, Amherst, NY, USA.
V
V
Bates
Dent Neurologic Institute, Amherst, NY, USA.|State University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA.
F
F
Gengo
D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage*; D001792:Blood Platelets / Q000187:drug effects*; D003094:Collagen / Q000378:metabolism; D018592:Cross-Over Studies; D004008:Diclofenac / Q000008:administration & dosage* / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D010979:Platelet Function Tests / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D004008:Diclofenac; D003094:Collagen; D001241:Aspirin
aspirin; diclofenac; drug interactions; nonsteroidal anti-inflammatory agents; platelet aggregation