This panel provides information on interacting drugs and their ADRs along with references
| Interacting drug |
Toxicity |
Interaction Type |
Mechanism |
Reference |
|---|
| Sorafenib (284461-73-0) | Bleeding | Antagonistic | sorafenib inhibits the cytochrome P450 isoenzyme CYP2C9, the main isoenzyme involved in the metabolism of warfarin. | Fulminant Hepatitis and Fatal Toxic Epidermal Necrolysis (Lyell Disease) Coincident With Clarithromycin Administration in an Alcoholic Patient Receiving Disulfiram Therapy
|
| Sorafenib (284461-73-0) | International Normalized Ratio Increased | Antagonistic | sorafenib inhibits the cytochrome P450 isoenzyme CYP2C9, the main isoenzyme involved in the metabolism of warfarin. | Pancytopenia and Colitis with Clostridium difficile in a Rheumatoid Arthritis Patient Taking Methotrexate, Antibiotics and Non-steroidal Anti-inflammatory Drugs
|
| Amiodarone (1951-25-3) | Bleeding | Antagonistic | Amiodarone inhibits the metabolism of warfarin, probably because it,and/'or its metabolite desethylamiodarone, inhibit the cytochrome P450isoenzyme CYP2C9, CYP3A4 and CYP1A2 | Interaction between warfarin sodium and amiodarone
|
| Aztreonam (78110-38-0) | Hypoprothrombinaemia | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Comparison of two schedules of cefoperazone plus aztreonam in the treatment of neutropenic patients with fever
|
| Cefaclor (53994-73-3) | Anticoagulation | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefamandole (34444-01-4) | Bleeding | Additive | cephalosporins with the N-methylthiotetrazole side-chain appear to increase the risk of bleeding, and might therefore interact cefamandole to a lesser extent shown to increase the response to warfarin | Gastrointestinal bleeding due to vitamin K deficiency in patients on parenteral cefamandole
|
| Cefazolin (25953-19-9) | Bleeding | Additive | cephalosporins with the N-methylthiotetrazole side-chain appear to increase the risk of bleeding, and might therefore interact cefazolin to a lesser extent shown to increase the response to warfarin | The comparative influence of prophylactic antibiotics on the prothrombin response to warfarin in the postoperative prosthetic cardiac valve patient Cefamandole, cefazolin, vancomycin
|
| Cefixime (79350-37-1) | Anticoagulation | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefmenoxime (65085-01-0) | Bleeding | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefmetazole (56796-20-4) | Bleeding | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefonicid (61270-58-4) | Anticoagulation | Additive | cephalosporins with the N-methylthiotetrazole side-chain appear to increase the risk of bleeding, and might therefore interact | Life-threatening bleeding in a patient treated with cefonicid
|
| Cefoperazone (62893-19-0) | Hypoprothrombinaemia | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Comparison of two schedules of cefoperazone plus aztreonam in the treatment of neutropenic patients with fever
|
| Ceforanide (60925-61-3) | Platelet Dysfunction | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefotetan (69712-56-7) | Platelet Dysfunction | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Cefotetan and hypoprothrombinemia
|
| Cefotiam (61622-34-2) | Anticoagulation | Additive | cephalosporins with the N-methylthiotetrazole side-chain appear to increase the risk of bleeding, and might therefore interact | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Cefpiramide (70797-11-4) | Platelet Dysfunction | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Ceftriaxone (73384-59-5) | Hypoprothrombinaemia | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Hypoprothrombobinaemic bleeding associated with ceftriaxone
|
| Cephalothin (153-61-7) | Hypoprothrombinaemia | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Influence of cephalosporin antibiotics on blood coagulation and platelet function
|
| Chloramphenicol (56-75-7) | International Normalized Ratio Increased | Antagonistic | chloramphenicol inhibits the liver enzymes concerned with the metabolism of the anticoagulants so that their effects are prolonged and increased In vitro work with human liver microsomes showed that chloramphenicol did not inhibit the hydroxylation of S-warfarin, but it did inhibit R-warfarin metabolism, probably via CYP3A4. antibacterial diminishes the gut bacteria thereby decreasing a source of vitamin K, but it is doubtful if these bacteria are normally an important source of the vitamin except in exceptional cases where dietary levels are very inadequate. chloramphenicol blocks production of prothrombin by the liver | Potential interaction between warfarin and ocular chloramphenicol
|
| Ciprofloxacin (85721-33-1) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Effect of ciprofloxacin on the pharmacokinetics and pharmacodynamics of warfarin
|
| Clindamycin (18323-44-9) | International Normalized Ratio Increased | Antagonistic | Not understood | Managing patients on warfarin therapy: a case report
|
| Gatifloxacin (112811-59-3) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Drug interaction
|
| Isoniazid (54-85-3) | Bleeding | Antagonistic | Not understood. It seems possible that isoniazid may inhibit the metabolism of the coumarin anticoagulants, since in vitro study in human liver microsomes has shown it inhibits S-warfarin 7-hydroxylation by the cytochrome P450 isoenzyme CYP2C9, but this needs confirmation in vivo | Interaction of isoniazid and warfarin
|
| Levofloxacin (100986-85-4) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Adverse reaction reporting of interaction between warfarin and fluoroquinolones
|
| Moxalactam (64952-97-2) | Hypoprothrombinaemia | Additive | Cephalosporins with an N-methylthiotetrazole side-chain can, like the oral anticoagulants, act as vitamin K antagonists to reduce the production of some blood clotting factors. They can therefore cause bleeding on their own. | Enhanced bleeding with cefoxitin or moxalactam Statistical analysis within a defined population of 1493 patients
|
| Moxifloxacin (151096-09-2) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased. nalidixic acid can displace warfarin from its binding sites on human plasma
albumin, but this mechanism on its own is almost certainly not the full
explanation | Adverse reaction reporting of interaction between warfarin and fluoroquinolones
|
| Nalidixic Acid (389-08-2) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Letter: Interaction of nalidixic acid and warfarin
|
| Norfloxacin (70458-96-7) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Norfloxacin and warfarin
|
| Ofloxacin (82419-36-1) | Bleeding | Antagonistic | Uncertain. It is not clear what factors might have been responsible in those cases where the effects of the anticoagulants were increased | Ofloxacin and warfarin
|
| Oxandrolone (53-39-4) | Bleeding | Antagonistic | Not understood | EFFECTS OF ANABOLIC STEROIDS ON ANTICOAGULANT REQUIREMENTS
|
| Oxymetholone (434-07-1) | Bleeding | Antagonistic | Not understood | Decreased anticoagulant tolerance with oxymetholone (Pubmed ID 4103994)
|
| Stanozolol (10418-03-8) | Bleeding | Antagonistic | Not understood | Possible interaction of warfarin and stanozolol
|