| Warafarin drug –drug interactions: Warfarin (Coumadin) is an anticoagulant used to thin the blood and prevent it from clotting. It is a somewhat dangerous drug that can be affected by many substances. Warfarin has many drug interactions, some of which are potentially serious. Drugs can interact with warfarin through a variety of mechanisms including: impaired warfarin absorption, displacement of warfarin from plasma protein-binding sites, altered warfarin metabolism, and others. In general, interactions are more likely to be significant if a second drug is added to a patient previously stabilized on warfarin therapy or if the second drug is stopped while warfarin therapy continues. These interactions are rated as of major severity and may cause bruising, bleeding, hematuria, hemoptysis, and hemorrhage. Because of potentially serious outcomes, the combinations should be avoided and alternative drugs used when possible. Management of these types of interactions includes monitoring of anticoagulation parameters (prothrombin time and internationalized normalized ratio); reduction of warfarin dosage to compensate for the enhanced anticoagulant effect (in some cases, warfarin may have to be stopped for a time); and monitoring for signs of bleeding such as coughing up blood in the form of coffee grinds (hemoptysis), gum bleeding, nose bleeds, cola- or tea-colored urine (hematuria), and black, tarry stools (hemoccult positive). If the interacting drug is discontinued, the warfarin dosage may need to be increased as the effects of inhibition subside. Drug interactions that decrease the effect of warfarin "winword document" Warfarin herb interactions Warfarin vitamin interactions |
Drug Interactions
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