Oral Anticoagulants Interactions

Concomitant use may increase prolongation of prothrombin time and abnormal INR. Monitoring and dose adjustments may be necessary.

Source: NLP:amoxicillin

Abnormal prolongation of prothrombin time and increased INR reported. Monitoring and dose adjustments of anticoagulants may be necessary.

Source: NLP:amoxicillin and clavulanate potassium

Increased risk of bleeding. Aspirin can displace warfarin from protein binding sites, prolonging prothrombin time and bleeding time.

Source: NLP:aspirin and extended-release dipyridamole

Bicalutamide can displace coumarin anticoagulants from protein binding sites. PT/INR should be closely monitored and anticoagulant dose adjustment may be necessary.

Source: NLP:bicalutamide

Potentiation of anticoagulant effect; Prothrombin time, INR, or other anticoagulation tests should be closely monitored.

Source: NLP:bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride

Aspirin enhances effects causing bleeding by inhibiting prothrombin formation and displacing anticoagulants from plasma protein binding sites.

Source: NLP:butalbital, aspirin, and caffeine

Concomitant use may increase the risk of bleeding. Avoid concomitant use when possible and monitor closely for bleeding.

Source: NLP:caplacizumab

Increased prothrombin time, with or without clinical bleeding, has been reported when cefixime is administered concomitantly with anticoagulants.

Source: NLP:cefixime

Chenodiol hepatotoxicity can affect coumarin pharmacodynamics, causing unexpected prolongation of prothrombin time and hemorrhages. Careful monitoring required.

Source: NLP:chenodiol

Potentiate CNS-depressant action of clonazepam.

Source: NLP:clonazepam

Methylphenidate may inhibit the metabolism of coumarin anticoagulants. Downward dose adjustments may be required and coagulation times should be monitored.

Source: NLP:dexmethylphenidate hydrochloride

Vitamin K1 in soybean oil component may counteract anticoagulant activity. Monitor laboratory parameters for anticoagulant activity.

Source: NLP:dextrose, soybean oil, electrolytes, lysine, phenylalanine, leucine, valine, threonine, methionine, isoleucine, tryptophan, alanine, arginine, glycine, proline, histidine, glutamic acid, serine, aspartic acid and tyrosine

Increased anticoagulant effects when used concomitantly with erythromycin, potentially more pronounced in elderly patients.

Source: NLP:erythromycin

Increased anticoagulant effects have been reported with concomitant use, particularly in elderly patients.

Source: NLP:erythromycin ethylsuccinate

Androgens may decrease anticoagulant requirements; patients require close monitoring, especially when androgens are started or stopped.

Source: NLP:esterified estrogens and methyltestosterone

Simvastatin prolongs INR. Achieve stable INR before starting therapy and monitor frequently upon initiation or dose changes.

Source: NLP:ezetimibe and simvastatin

Potentiation of coumarin anticoagulant effects with prolongation of PT/INR. Dosage reduction and frequent PT/INR monitoring recommended to prevent bleeding complications.

Source: NLP:fenofibrate

Fibrates may potentiate coumarin anticoagulant effects with prolongation of PT/INR. Reduce anticoagulant dosage and monitor PT/INR frequently to prevent bleeding complications.

Source: NLP:fenofibric acid

Thyroid hormones increase catabolism of vitamin K-dependent clotting factors, impairing compensatory synthesis. Patients may require reduced anticoagulant dosage when starting thyroid replacement.

Source: NLP:levothyroxine, liothyronine

Levothyroxine increases the response to oral anticoagulant therapy. Decrease in anticoagulant dose may be warranted with correction of hypothyroidism. Prothrombin time should be closely monitored.

Source: NLP:levothyroxine sodium anhydrous

Produces increased CNS-depressant effects including respiratory depression and sedation.

Source: NLP:lorazepam

Highly protein-bound drug that may increase methotrexate plasma concentrations, increasing risk of severe adverse reactions and potentially reducing clinical effectiveness.

Source: NLP:methotrexate

Metronidazole potentiates the anticoagulant effect of oral coumarin anticoagulants, resulting in prolongation of prothrombin time. Prothrombin time and INR should be carefully monitored.

Source: NLP:metronidazole

Prolonged anticoagulant effects reported with oral metronidazole co-administration, resulting in prothrombin time prolongation.

Source: NLP:metronidazole vaginal gel, 1.3 %

Nintedanib is a VEGFR inhibitor that may increase bleeding risk. Monitor patients on full anticoagulation therapy closely and adjust treatment as necessary.

Source: NLP:nintedanib

Prolonged prothrombin time and INR occasionally associated with hemorrhage reported in patients receiving oxaliplatin with fluorouracil/leucovorin. Increase monitoring frequency.

Source: NLP:oxaliplatin

Combination prolongs INR. Achieve stable INR prior to starting rosuvastatin and monitor frequently upon initiation or alteration of therapy.

Source: NLP:rosuvastatin

Rosuvastatin significantly prolongs INR in patients receiving coumarin anticoagulants. Monitor INR frequently until stable.

Source: NLP:rosuvastatin calcium

Salicylate competition for serum albumin binding increases bleeding risk.

Source: NLP:salicylic acid 10%

Salicylates given concomitantly with anticoagulant drugs may predispose to systemic bleeding.

Source: NLP:salsalate

SEYSARA may depress plasma prothrombin activity, increasing bleeding risk. Decrease anticoagulant dosage as appropriate.

Source: NLP:sarecycline hydrochloride

Significant increase in anticoagulant effect may occur; careful monitoring of prothrombin time is recommended.

Source: NLP:tamoxifen citrate

Produces additive CNS-depressant effects when co-administered with temazepam.

Source: NLP:temazepam

May decrease anticoagulant requirement; patients require close monitoring especially when androgens are started or stopped.

Source: NLP:testosterone enanthate

Thyroid hormones increase catabolism of vitamin K-dependent clotting factors, impairing compensatory increases in clotting factor synthesis. Patients may require reduction in anticoagulant dosage.

Source: NLP:thyroid, porcine

Tinidazole may enhance the effect of coumarin anticoagulants, resulting in prolongation of prothrombin time. Dosage adjustment may be needed during tinidazole co-administration and up to 8 days after discontinuation.

Source: NLP:tinidazole

Concomitant use increases the risk of bleeding.

Source: NLP:tirofiban

Variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants with chlordiazepoxide. Monitor patients closely.

Source: NLP:chlordiazepoxide hydrochloride and clidinium bromide

Concomitant use may potentiate risk of bleeding. Inform patients of increased bleeding risk.

Source: NLP:citalopram hydrobromide

Both increased and decreased warfarin effects have been reported in patients receiving warfarin and cyclophosphamide.

Source: NLP:cyclophosphamide

May increase formation of dapsone hydroxylamine, a metabolite associated with hemolysis. Monitor for hemolytic reactions.

Source: NLP:dapsone

Tetracyclines depress plasma prothrombin activity; patients on anticoagulant therapy may require downward adjustment of anticoagulant dosage.

Source: NLP:demeclocycline

Tetracyclines depress plasma prothrombin activity; patients may require downward adjustment of anticoagulant dosage.

Source: NLP:demeclocycline hydrochloride

May potentiate or be potentiated by diazepam action. Careful consideration should be given when combining.

Source: NLP:diazepam

Diazoxide is highly bound to serum proteins and may displace coumarin, resulting in higher blood levels of coumarin.

Source: NLP:diazoxide

Disulfiram may prolong prothrombin time. Dosage adjustment may be necessary when beginning or stopping disulfiram.

Source: NLP:disulfiram

Tetracyclines depress plasma prothrombin activity; patients on anticoagulant therapy may require downward adjustment of anticoagulant dosage.

Source: NLP:doxycycline

Tetracyclines depress plasma prothrombin activity; anticoagulant dosage may require downward adjustment.

Source: NLP:doxycycline hyclate

Epoprostenol has the potential to increase the risk of bleeding when used concomitantly with anticoagulants, though clinical trials showed no evidence of increased bleeding.

Source: NLP:epoprostenol

Tetracyclines depress plasma prothrombin activity; patients on anticoagulant therapy may require downward adjustment of anticoagulant dosage.

Source: NLP:eravacycline

May potentiate the action of estazolam; careful consideration of CNS effects needed.

Source: NLP:estazolam

Decreased prothrombin time response. Monitor prothrombin levels and adjust anticoagulant dosage accordingly.

Source: NLP:fludrocortisone acetate

May potentiate hypoglycemic action of glyburide; patient should be closely observed for hypoglycemia.

Source: NLP:glyburide

Highly protein-bound drugs that may increase glucose-lowering effect of glimepiride, increasing susceptibility to hypoglycemia.

Source: NLP:glimepiride

Coumarins may potentiate hypoglycemic action of glipizide. Patient should be observed closely for hypoglycemia when initiated or withdrawn.

Source: NLP:glipizide

May potentiate hypoglycemic action of glyburide; monitor closely for hypoglycemia.

Source: NLP:glyburide and metformin hydrochloride

May potentiate hypoglycemic action of glyburide; monitor for hypoglycemia.

Source: NLP:glyburide-metformin hydrochloride

Variable effect with reports of both enhanced and diminished anticoagulant effects when given concurrently with corticosteroids. Coagulation indices should be monitored.

Source: NLP:hydrocortisone

Omega-3 fatty acids may prolong bleeding time. Monitor patients for bleeding when icosapent ethyl is used concomitantly with anticoagulants.

Source: NLP:icosapent ethyl

Methohexital may influence the metabolism of anticoagulants.

Source: NLP:methohexital sodium

Methylphenidate may inhibit metabolism of coumarin anticoagulants. Downward dose adjustments may be required and coagulation times should be monitored.

Source: NLP:methylphenidate

Methylphenidate may inhibit metabolism of coumarin anticoagulants; downward dose adjustment may be required and coagulation times should be monitored.

Source: NLP:methylphenidate hydrochloride

Effect is variable with reports of both enhanced and diminished anticoagulant effects; coagulation indices should be monitored.

Source: NLP:methylprednisolone

Metolazone may affect hypoprothrombinemic response to anticoagulants; dosage adjustments may be necessary.

Source: NLP:metolazone

May affect the results of the metyrapone test. Consider withdrawing if possible before testing.

Source: NLP:metyrapone

Tetracyclines depress plasma prothrombin activity; patients may require downward adjustment of anticoagulant dosage.

Source: NLP:minocycline

Tetracyclines depress plasma prothrombin activity; patients may require downward adjustment of anticoagulant dosage.

Source: NLP:minocycline hydrochloride

Morphine may increase the anticoagulant activity of coumarin and other anticoagulants.

Source: NLP:morphine sulfate

Rare reports of increased prothrombin time in patients taking coumarin anticoagulants with nifedipine, though relationship uncertain.

Source: NLP:nifedipine

Natural Vitamin K1 content in olive and soybean oils may counteract the anticoagulant activity of coumarin derivatives.

Source: NLP:olive oil and soybean oil

Omega-3-acid ethyl esters may prolong bleeding time. Patients receiving both should be monitored periodically.

Source: NLP:omega-3-acid ethyl esters

Bleeding reported in patients treated with pentoxifylline with concomitant anticoagulants. Monitoring of anticoagulant activity recommended.

Source: NLP:pentoxifylline

Monitor coagulation parameters in patients receiving piperacillin and tazobactam with oral anticoagulants.

Source: NLP:piperacillin sodium and tazobactam sodium

Prednisone may enhance or diminish anticoagulant effects variably; coagulation indices should be monitored to maintain desired anticoagulant effect.

Source: NLP:prednisone

No data available on concomitant use. Consider risks and benefits; concomitant use was not allowed in clinical studies.

Source: NLP:remibrutinib

Concurrent use may potentiate the risk of bleeding.

Source: NLP:sertraline hydrochloride

Obtain INR before simvastatin initiation and monitor INR during dosage initiation or adjustment.

Source: NLP:simvastatin

Somatropin may alter clearance of anticonvulsants metabolized by CYP450 liver enzymes; careful monitoring is advised.

Source: NLP:somatropin

Changes in anticoagulant activity may occur with androgens. More frequent monitoring of INR and prothrombin time is recommended, especially at initiation and termination of therapy.

Source: NLP:testosterone

Androgens may increase sensitivity to oral anticoagulants, requiring dosage reduction to maintain therapeutic hypoprothrombinemia.

Source: NLP:testosterone cypionate

Androgens may change anticoagulant activity. More frequent monitoring of INR and prothrombin time is recommended, especially at initiation and termination of therapy.

Source: NLP:testosterone gel, 1%

Androgens may alter anticoagulant activity. Frequent monitoring of INR and prothrombin time is necessary, especially at initiation and termination of therapy.

Source: NLP:testosterone undecanoate

Tetracyclines depress plasma prothrombin activity; patients may require downward adjustment of anticoagulant dosage.

Source: NLP:tetracycline hydrochloride

The effect of oral anticoagulants may be decreased when used concurrently with hydrochlorothiazide; dosage adjustments may be necessary.

Source: NLP:triamterene and hydrochlorothiazide

Concomitant use may potentiate the risk of bleeding. Monitor patients closely for bleeding when initiating or discontinuing venlafaxine.

Source: NLP:venlafaxine

Concomitant use may potentiate bleeding risk. Closely monitor for bleeding when initiating or discontinuing venlafaxine.

Source: NLP:venlafaxine hydrochloride

Concurrent use may potentiate bleeding risk. Monitor INR carefully for warfarin.

Source: NLP:vilazodone hydrochloride