AlendronateAdverse Effect GI distressClinical Management Monitor patients for gastrointestinal distress. If gastrointestinal effects (nausea, abdominal pain, dyspepsia, constipation, diarrhea, acid regurgitation) become unacceptable, mesalamine doses may need to be reduced or discontinued.
LMWH sod.salt Adverse Effect Increased risk of bleeding and hematoma when neuraxial anesthesia is employedClinical Management Mesalazine - Antisecr should be discontinued prior to the initiation of therapy with LMWH sod.salt or heparinoid. If this is not possible, patients receiving LMWH sod.salt or heparinoid and Mesalazine - Antisecr concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin or heparinoid therapy. Clinicians should be aware that the increased risk of bleeding with this combination will not be fully reflected by the partial thromboplastin time.
MercaptopurineAdverse Effect an increased risk of bone marrow suppressionClinical Management If olsalazine and 6-mercaptopurine are coadministered, use the lowest possible doses of each drug and monitor the patient for bone marrow suppression, especially leukopenia.
WarfarinAdverse Effect Decreased warfarin efficacyClinical Management Prothrombin time (PT) or international normalized ratio (INR) should be closely monitored in patients receiving warfarin and mesalamine therapy concurrently.
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