Drug General Information (ID: DDIF4RXUW2)
Drug Name			Dihydrocodeine		Drug Info		Prasugrel		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Narcotic Analgesics				Antiplatelet Agents
Structure

Mechanism of Dihydrocodeine-Prasugrel Interaction (Severity Level: Moderate)
Altered gastrointestinal dynamics Click to Show/Hide Mechanism Graph
Drug Name		Dihydrocodeine				Prasugrel
Mechanism		Delayed gastric emptying				Absorption affected by delayed gastric emptying
Key Mechanism Factor 1
		Factor Name		Gastrointestinal Motility
		Factor Description		Gastrointestinal motility is an important factor in determining the absorption of orally administered drugs, and it controls the residence time of the drug in the digestive tract.
Mechanism Description		Altered absorption of Prasugrel due to GI dynamics variation caused by Dihydrocodeine

Recommended Action
Management		Although data are limited, caution is recommended when orally administered P2Y12 inhibitors are given concomitantly with opioid agonists. In acute coronary syndrome patients who require an opioid agonist, the use of a parenteral antiplatelet agent, such as cangrelor, should be considered.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Hobl EL, Reiter B, Schoergenhofer C, et al. "Morphine Decreases Ticagrelor Concentrations but not its Antiplatelet Effects: A Randomized Trial in Healthy Volunteers." Eur J Clin Invest 46 (2015): 7-14. [PMID: 26449338]