Aceclofenac [1], coumarin anticoagulants ---> SmPC of [1] of eMC
NSAIDs may enhance the effects of anti-coagulants, such as warfarin
Alcohol, coumarin anticoagulants
The acute/chronic alcohol intake enhances/decreases the anticoagulant effect
Allopurinol [1], coumarin anticoagulants ---> SmPC of [1] of eMC
There have been rare reports of increased effect of warfarin and other coumarin anticoagulants when co-administered with allopurinol, therefore, all patients receiving anticoagulants must be carefully monitored.
Allopurinol/lesinurad [1], coumarin anticoagulants ---> SmPC of [1] of EMA
An interaction between allopurinol and coumarins has been seen under experimental conditions. All patients receiving coumarin anticoagulants must be carefully monitored.
Alteplase [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Increased risk of haemorrhage
Amfepramone, coumarin anticoagulants
Decreased coumarine metabolism
Amitriptyline, coumarin anticoagulants
Amitriptyline may influence the anticoagulant effect. It is necessary a continous control of the coagulation parameters. The concomitant use should be done with caution
Amoxicillin, coumarin anticoagulants
The co-administration may prolong the bleeding time.
Androgens, coumarin anticoagulants
High doses of androgens may enhance the anticoagulant action of coumarine type agents and additional monitoring of INR and adjustment of anticoagulant dose may need to be considered.
Antiestrogens, coumarin anticoagulants ---> SmPC of [toremifene] of EMA
There is a known interaction between anti-estrogens and warfarin-type anticoagulants leading to a seriously increased bleeding time. Therefore, the concomitant should be avoided.
Antifibrinolytics, coumarin anticoagulants
The co-administration may weaken the effect of antifibrinolytic agent
Apalutamide [1], coumarin anticoagulants ---> SmPC of [1] of EMA
Co-administration of apalutamide with warfarin and coumarin-like anticoagulants should be avoided.
Apixaban [1], coumarin anticoagulants ---> SmPC of [1] of EMA
Due to an increased bleeding risk, concomitant treatment of apixaban with any other anticoagulants is contraindicated
Asparaginase [1], coumarin anticoagulants ---> SmPC of [1] of EMA
Concomitant use of glucocorticoids and/ or anticoagulants with asparaginase may increase the risk of a change in coagulation parameters (see section 4.4). This can promote tendency to bleeding (anticoagulants) or thrombosis (glucocorticoids).
Atorvastatin [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Prothrombin time should be determined before starting atorvastatin in patients taking coumarin anticoagulants and frequently enough during early therapy to ensure that no significant alteration of prothrombin time occurs.
Atovaquone/proguanil [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Proguanil may potentiate the effect of warfarin and other coumarin based anticoagulants which may lead to an increase in the risk of haemorrhage.
Azithromycin [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Potentiation of the anticoagulant effect. Careful monitor the prothrombin time
Bempedoic acid/ezetimibe [1], coumarin anticoagulants ---> SmPC of [1] of EMA
If Nustendi is added to warfarin, other coumarin anticoagulants, or fluindione, INR should be appropriately monitored
Bezafibrate [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Care is required in administering bezafibrate to patients taking coumarin-type anti-coagulants, the action of which may be potentiated.
Bicalutamide [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Bicalutamide can displace the coumarin anticoagulant, warfarin, from its protein binding site. It is recommended that prothrombin time is closely monitored if bicalutamide is started in patients who are already receiving coumarin anticoagulants.
Budesonide, coumarin anticoagulants
Decreased anticoagulant effect
Capecitabine [1], coumarin anticoagulants ---> SmPC of [1] of EMA
Altered coagulation parameters and/or bleeding have been reported in patients taking capecitabine concomitantly with coumarin-derivative anticoagulants such as warfarin and phenprocoumon.
Cefixime, coumarin anticoagulants
Cefixime should be administered with caution to patients receiving coumarin-type anticoagulants. Since cefixime may enhance effects of the anticoagulants, prolonged prothrombin time with or without bleeding may occur.
Chloral hydrate, coumarin anticoagulants
In patients taking anticoagulants, when chloral hydrate is added to or withdrawn from the drug regimen, or its dosage changed, careful monitoring of the prothrombin time is required.
Chlorpropamide, coumarin anticoagulants
Possible enhancement of hypoglycemic effect
Cholestyramine, coumarin anticoagulants
Cholestyramine may delay/decrease the absorption of the co-administered medicament. This medicine should be administered 1 hour before or 4-6 hours after colestyramine
Cimetidine [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Cimetidine, enzyme inhibitor, may increase the plasma levels of coumarine and prolong the prothrombin time
Clomiphene, coumarin anticoagulants
Seriously increased bleeding time. The concomitant use should be avoided
Clomipramine [1], coumarin anticoagulants ---> SmPC of [1] of eMC
Tricyclic antidepressants may potentiate the anti-coagulant effect of coumarin drugs by inhibiting hepatic metabolism of anticoagulants.
Cloprednol, coumarin anticoagulants
Decreased anticoagulant effect
Colesevelam [1], coumarin anticoagulants ---> SmPC of [1] of EMA
Anticoagulant therapy should be monitored closely in patients receiving warfarin or similar agents, since bile acid sequestrants have been shown to reduce absorption of vitamin K and therefore interfere with warfarin's anticoagulant effect.
Corticosteroids, coumarin anticoagulants ---> SmPC of [acenocoumarol] of eMC
The co-administration may potentiate the anticoagulant effect of coumarin derivative
Cotrimoxazole, coumarin anticoagulants
Cotrimoxazole may enhance the effect of oral anticoagulants (enhanced hypoprothrombinemic effect of coumarins)
Coumarin anticoagulants [1], itraconazol ---> SmPC of [1] of eMC
Itraconazole may increase the plasma concentrations of coumarin
Coumarin anticoagulants [1], ranitidine ---> SmPC of [1] of eMC
There have been reports of altered prothrombin time with coumarin anticoagulants. Due to the narrow therapeutic index, close monitoring of increased or decreased prothrombin time is recommended during concurrent treatment with ranitidine.
Coumarin anticoagulants [1], tetracyclines ---> SmPC of [1] of eMC
Tetracyclines depress plasma prothrombin activity and reduced doses of concomitant anti-coagulants such as coumarins and phenindione may be required.
Coumarin anticoagulants, CYP3A4 and CYP2C9 inhibitors
The inhibition of CYP2C9 and CYP3A4 may increase the plasma concentrations of coumarin and therefore may cause an increase in prothrombin time
Coumarin anticoagulants, danazol
Seriously increased bleeding time. The concomitant use should be avoided
Coumarin anticoagulants, deflazacort
Decreased anticoagulant effect
Coumarin anticoagulants, demeclocycline
Tetracyclines depress plasma prothrombin activity and reduced doses of concomitant anti-coagulants such as coumarins and phenindione may be required.
Coumarin anticoagulants, dexketoprofen [2] ---> SmPC of [2] of eMC
NSAIDs may enhance the effects of anti-coagulants, such as warfarin, due to the high plasma protein binding of dexketoprofen and the inhibition of platelet function and damage to the gastroduodenal mucosa.
Coumarin anticoagulants, diazoxide
Diazoxide may displace other principle actives from its plasma protein binding and increase their plasma concentrations
Coumarin anticoagulants, diclofenac
The NSAID may enhance the effects of anti-coagulant.
Coumarin anticoagulants, digital glycosides
The co-administration may decrease the anticoagulant effect
Coumarin anticoagulants, doxycycline
Doxycycline depresses plasma prothrombin activity thereby potentiating the effect of anticoagulant of the dicoumarol type
Coumarin anticoagulants, erlotinib [2] ---> SmPC of [2] of EMA
Interaction with coumarin-derived anticoagulants including warfarin leading to increased International Normalized Ratio (INR) and bleeding events, which in some cases were fatal, have been reported in patients receiving erlotinib.
Coumarin anticoagulants, esomeprazole [2] ---> SmPC of [2] of EMA
The co-administration may increase the international normalised ratio (INR). Appropriate monitoring of INR is desirable.
Coumarin anticoagulants, exenatide [2] ---> SmPC of [2] of EMA
Increased INR has been spontaneously reported during concomitant use of warfarin and prolonged-release exenatide. INR should be monitored during initiation of prolonged-release exenatide therapy in patients on warfarin and/or cumarol derivatives
Coumarin anticoagulants, ezetimibe [2] ---> SmPC of [2] of eMC
There have been post-marketing reports of increased INR in patients who had ezetimibe added to warfarin or fluindione. If ezetimibe is added to coumarin anticoagulant, or fluindione, INR should be appropriately monitored
Coumarin anticoagulants, ezetimibe/atorvastatin
If ATOZET is added to warfarin, another coumarin anticoagulant, or fluindione, INR should be appropriately monitored
Coumarin anticoagulants, ezetimibe/simvastatine [2] ---> SmPC of [2] of eMC
There have been post-marketing reports of increased INR in patients who had ezetimibe added to warfarin or fluindione. If ezetimibe is added to coumarin anticoagulant, or fluindione, INR should be appropriately monitored
Coumarin anticoagulants, fibrates
Potentiation of the anticoagulant effect
Coumarin anticoagulants, fluconazole [2] ---> SmPC of [2] of eMC
In patients receiving coumarin-type anticoagulants concurrently with fluconazole the prothrombin time should be carefully monitored.
Coumarin anticoagulants, fludrocortisone
The co-administration may influence the anticoagulant effect of coumarin derivative. Close monitoring
Coumarin anticoagulants, fluocortolone
Decreased anticoagulant effect
Coumarin anticoagulants, flupirtine
It is recommended to control more frequently the Quick value when flupirtine be co-administered with coumarine derivates in order to preclude a possible effect or to reduce the dose of the coumarine.
Coumarin anticoagulants, fluvastatin [2] ---> SmPC of [2] of eMC
Isolated incidences of bleeding episodes and/or increases prothrombin times have been reported very rarely in patients on fluvastatin receiving concomitant warfarin or other coumarin derivatives.
Coumarin anticoagulants, fusidic acid
The co-administration with fusidate systemically may increase the plasma concentration of the anticoagulant.
Coumarin anticoagulants, gestagens
Progestogens may either enhance or reduce the anticoagulant effects of coumarins
Coumarin anticoagulants, ginseng
The co-administration of ginseng with anti-coagulant effect of coumarin drugs may potentiate the anti-coagulant effect
Coumarin anticoagulants, glibenclamide [2] ---> SmPC of [2] of EMA
Potentiate or weaken the effect of coumarin derivatives
Coumarin anticoagulants, glimepiride [2] ---> SmPC of [2] of eMC
Glimepiride may either potentiate or weaken the effects of coumarin derivatives.
Coumarin anticoagulants, gliquidone
The effect of coumarins may be increased or decreased
Coumarin anticoagulants, glucocorticoids
Decreased anticoagulant effect
Coumarin anticoagulants, glucosamine
The co-administration may enhance the effect of coumarin anticoagulant
Coumarin anticoagulants, griseofulvin
The co-administration may decrease the anticoagulant effect
Coumarin anticoagulants, hydrocortisone
Decreased anticoagulant effect, an adjustment of dose may be necessary
Coumarin anticoagulants, hydrotalcite
The co-administration of hydrotalcite with other drugs may decrease the absorption of these drugs. It is recommended to separate the times of administration by at least 1-2 hours
Coumarin anticoagulants, iloprost [2] ---> SmPC of [2] of EMA
Since iloprost inhibits platelet function its use with anticoagulants or other inhibitors of platelet aggregation may increase the risk of bleeding. A careful monitoring of the patients is recommended.
Coumarin anticoagulants, imatinib [2] ---> SmPC of [2] of EMA
Because of known increased risks of bleeding in conjunction with the use of imatinib (e.g. haemorrhage), patients who require anticoagulation should receive low-molecular-weight or standard heparin, instead of coumarin derivatives such as warfarin.
Coumarin anticoagulants, imipramine [2] ---> SmPC of [2] of eMC
Tricyclic antidepressants may potentiate the anti-coagulant effect of coumarin drugs by inhibiting hepatic metabolism of anticoagulants.
Coumarin anticoagulants, indobufen
Indobufen can displace the anticoagulant from its plasma protein binding and increase its effects
Coumarin anticoagulants, indometacin [2] ---> SmPC of [2] of eMC
NSAIDs may enhance the effects of oral anti-coagulants (e.g. warfarin, dicoumarol)
Coumarin anticoagulants, insulin degludec/liraglutide [2] ---> SmPC of [2] of EMA
Upon initiation of liraglutide treatment in patients on warfarin or other coumarin derivatives, more frequent monitoring of INR (International Normalised Ratio) is recommended.
Coumarin anticoagulants, insulin glargine/lixisenatide [2] ---> SmPC of [2] of EMA
No dose adjustment for warfarin is required when co-administered with lixisenatide; however, frequent monitoring of INR in patients on warfarin and/or coumarin derivatives is recommended at the time of initiation or ending of lixisenatide treatment.
Coumarin anticoagulants, isoniazid
Increased anticoagulant effect with haemorrhagic diathesis
Coumarin anticoagulants, kebuzone
The co-administration may enhance the effects and increase the bleeding risk
Coumarin anticoagulants, ketoconazole [2] ---> SmPC of [2] of EMA
Potential increase in plasma concentrations of warfarin. Careful monitoring. INR (international normalised ratio) monitoring recommended.
Coumarin anticoagulants, ketorolac [2] ---> SmPC of [2] of eMC
Ketorolac is contraindicated in combination with anti-coagulants, such as warfarin since co-administration of NSAIDs and anti-coagulants may cause an enhanced anti-coagulant effect
Coumarin anticoagulants, leflunomide [2] ---> SmPC of [2] of EMA
There have been case reports of increased prothrombin time, when leflunomide and warfarin were co-administered. Therefore, when warfarin or another coumarin anticoagulant is co-administered, close INR follow-up and monitoring is recommended.
Coumarin anticoagulants, lenalidomide
A treatment with coumarins is not recommended due to the hight risk of thrombocytopenia
Coumarin anticoagulants, lepirudin [2] ---> SmPC of [2] of EMA
Concomitant treatment of lepirudin with coumarin derivatives (vitamin K antagonists) and drugs that affect platelet function may also increase the risk of bleeding.
Coumarin anticoagulants, levothyroxine [2] ---> SmPC of [2] of eMC
Levothyroxine increases the effect of anticoagulants and it may be necessary to reduce the anticoagulation dosage if excessive, hypoprothrombinaemia and bleeding are to be avoided.
Coumarin anticoagulants, light paraffin
The co-administration of paraffin oil and oral anticoagulant may decrease the absorption of the oral anticoagulant
Coumarin anticoagulants, liothyronine
Liothyronine sodium therapy may potentiate the action of anticoagulants (coumarins and phenindione).
Coumarin anticoagulants, liraglutide [2] ---> SmPC of [2] of EMA
Upon initiation of liraglutide treatment in patients on warfarin or other coumarin derivatives, more frequent monitoring of INR (International Normalised Ratio) is recommended.
Coumarin anticoagulants, lixisenatide [2] ---> SmPC of [2] of EMA
No dose adjustment for warfarin is required when co-administered with lixisenatide; however, frequent monitoring of INR in patients on warfarin and/or coumarin derivatives is recommended at the time of initiation or ending of lixisenatide treatment.
Coumarin anticoagulants, lomitapide [2] ---> SmPC of [2] of EMA
In patients taking coumarins (such as warfarin) and lomitapide concomitantly, INR should be determined before starting lomitapide and monitored regularly with dosage of coumarins adjusted as clinically indicated
Coumarin anticoagulants, lovastatine
The co-administration of lovastatine and coumarin anticoagulants may prolong the prothrombin time
Coumarin anticoagulants, lymecycline
The tetracycline may decrease the plasma prothrombin time and increase the anticoagulant activity. A reduction of the of anti-coagulant doses may be required
Coumarin anticoagulants, maprotiline
The antidepressant may potentiate the anticoagulant effect of coumarin drug by inhibiting its metabolism by the liver
Coumarin anticoagulants, mephenytoin
Increased hydantoin plasma levels
Coumarin anticoagulants, meprobamate [2] ---> SmPC of [2] of eMC
Like barbiturates, meprobamate can cause induction of liver enzymes, so that the availability and blood levels of drugs given concurrently that are metabolised in the liver may be affected.
Coumarin anticoagulants, mesalazine [2] ---> SmPC of [2] of eMC
Administration of mesalazine with coumarin-type anticoagulants could result in decreased anticoagulant activity. Prothrombin time should be closely monitored if this combination is essential.
Coumarin anticoagulants, methoxsalen
The co-administration may displace methoxsalen from its albumin binding and increase the photosensitivity
Coumarin anticoagulants, methylphenidate
The methylphenidate may inhibit the metabolism of coumarin anticoagulants
Coumarin anticoagulants, methylprednisolone [2] ---> SmPC of [2] of eMC
The efficacy of coumarins may be enhanced by concurrent corticosteroid therapy and close monitoring of the INR or prothrombin time is required to avoid spontaneous bleeding.
Coumarin anticoagulants, metronidazole [2] ---> SmPC of [2] of eMC
Some potentiation of anticoagulant therapy has been reported when metronidazole has been used with the warfarin type oral anticoagulants. Dosage of the latter may require reducing.
Coumarin anticoagulants, mianserin
Mianserin may potentiate the anticoagulant effect of coumarin drug by inhibiting its metabolism by the liver
Coumarin anticoagulants, minocycline
Tetracyclines depress plasma prothrombin activity and reduced dosages of concomitant anticoagulants may be necessary
Coumarin anticoagulants, mitotane [2] ---> SmPC of [2] of EMA
Mitotane, inductor of hepatic microsomal enzymes, accelerates the metabolism of the anticoagulant. Closely monitoring
Coumarin anticoagulants, nafoxidine
Seriously increased bleeding time. The concomitant use should be avoided
Coumarin anticoagulants, naproxen [2] ---> SmPC of [2] of eMC
NSAIDs may enhance the effects of anti-coagulants
Coumarin anticoagulants, naproxen/esomeprazole [2] ---> SmPC of [2] of eMC
NSAIDs may enhance the effects of oral anti-coagulants (e.g. warfarin, dicoumarol)
Coumarin anticoagulants, nimesulide
The coagulation inhibition and the gastrointestinal adverse effects increase the bleeding risk. The co-administration should be avoided
Coumarin anticoagulants, nitazoxanide
The co-administration may increase the prothrombin time
Coumarin anticoagulants, nitroimidazoles
Nitroimidazole potentiate the anticoagulant effect of oral coumarin anticoagulants, resulting in a prolongation of prothrombin time.
Coumarin anticoagulants, nortriptyline
Nortriptyline may enhance the anticoagulant effects of coumarine derivatives or of indandione
Coumarin anticoagulants, noscapine
Noscapine may enhance the effect of oral anticoagulants of the type coumarine
Coumarin anticoagulants, NSAID ---> SmPC of [naproxen/esomeprazole] of eMC
NSAIDs may enhance the effects of oral anti-coagulants (e.g. warfarin, dicoumarol)
Coumarin anticoagulants, ofloxacin [2] ---> SmPC of [2] of eMC
The co-administration may enhance the effect of coumarin derivative
Coumarin anticoagulants, olsalazine
Olsalazine may enhance the effect of coumarin-type anticoagulants
Coumarin anticoagulants, ornidazole
Ornidazole enhances the anticoagulant effect
Coumarin anticoagulants, oxetacaine
Decreased absorption of coumarine
Coumarin anticoagulants, oxycodone [2] ---> SmPC of [2] of eMC
Clinically relevant changes in International Normalized Ratio (INR) in both directions have been observed in individuals if coumarin anticoagulants are co-applied with oxycodone.
Coumarin anticoagulants, oxytetracycline
Oxytetracycline may prolong the action of coumarin anticoagulant
Coumarin anticoagulants, pantoprazole [2] ---> SmPC of [2] of EMA
In patients treated with coumarin anticoagulants monitoring of prothrombin time/INR is recommended after initiation, termination or during irregular use of pantoprazole.
Coumarin anticoagulants, paracetamol [2] ---> SmPC of [2] of eMC
The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.
Coumarin anticoagulants, parecoxib [2] ---> SmPC of [2] of EMA
Anticoagulant therapy should be monitored, particularly during the first few days after initiating parecoxib therapy in patients receiving warfarin or other anticoagulants, since these patients have an increased risk of bleeding complications.
Coumarin anticoagulants, pegaspargase [2] ---> SmPC of [2] of EMA
The use of Oncaspar can lead to fluctuating coagulation factors. This can promote the tendency to bleeding and/or thrombosis. Caution is therefore needed when anticoagulants are given concomitantly.
Coumarin anticoagulants, pelargonium sidoides
Pelargonium sidoides may enhance the effect of anticoagulants. The combination is not recommended
Coumarin anticoagulants, pentoxifylline [2] ---> SmPC of [2] of eMC
Post-marketing cases of increased anti-coagulant activity have been reported in patients concomitantly treated with pentoxifylline and anti-vitamin K.
Coumarin anticoagulants, phenobarbital
Phenobarbital, enzymatic inductor, may increase the metabolism of coumarine and decrease its plasma levels and effect
Coumarin anticoagulants, phenytoin
Phenytoin may decrease the plasma concentrations of coumarin anticoagulants
Coumarin anticoagulants, phytomenadione [2] ---> SmPC of [2] of eMC
Antagonism of coumarin anticoagulants.
Coumarin anticoagulants, pioglitazone/glimepiride [2] ---> SmPC of [2] of EMA
Glimepiride may either potentiate or weaken the effects of coumarin derivatives.
Coumarin anticoagulants, prasugrel [2] ---> SmPC of [2] of EMA
Because of the potential for increased risk of bleeding, warfarin (or other coumarin derivatives) and Efient should be co-administered with caution
Coumarin anticoagulants, prednisolone [2] ---> SmPC of [2] of eMC
The efficacy of coumarin anticoagulants may be enhanced by concurrent corticosteroid therapy
Coumarin anticoagulants, primidone
Primidone therapy may lead to altered pharmacokinetics in concomitantly administered drugs, whose metabolism may be increased and lead to lowered plasma levels and/or a shorter half-life.
Coumarin anticoagulants, proguanil
Proguanil may potentiate the effect of warfarin and other coumarin based anticoagulants which may lead to an increase in the risk of haemorrhage.
Coumarin anticoagulants, propylthiouracil
The co-administration may enhance the anticoagulant effect and increase the bleeding risk
Coumarin anticoagulants, quinolones ---> SmPC of [ofloxacin] of eMC
The co-administration may enhance the effect of coumarin derivative
Coumarin anticoagulants, raloxifene [2] ---> SmPC of [2] of EMA
Modest decreases in the prothrombin time. The prothrombin time should be monitored
Coumarin anticoagulants, reviparin
Caution is recommended when coadministering reviparin with oral anticoagulants
Coumarin anticoagulants, rifampicin
Rifampicin, enzymatic inductor, may increase the metabolism of coumarine and decrease its plasma levels and effect
Coumarin anticoagulants, riociguat [2] ---> SmPC of [2] of EMA
The concomitant use of riociguat with other cumarin-derivatives (e.g. phenprocoumon) is also not expected to alter prothrombin time.
Coumarin anticoagulants, rosuvastatin [2] ---> SmPC of [2] of eMC
The co-administration may increase the international normalised ratio (INR). Appropriate monitoring of INR is desirable.
Coumarin anticoagulants, selexipag [2] ---> SmPC of [2] of EMA
Selexipag is an inhibitor of platelet aggregation in vitro. In the Phase 3 placebo-controlled study in patients with PAH, no increased risk of bleeding was detected with selexipag compared to placebo
Coumarin anticoagulants, semaglutide [2] ---> SmPC of [2] of EMA
Upon initiation of semaglutide treatment in patients on warfarin or other coumarin derivatives, frequent monitoring of INR is recommended.
Coumarin anticoagulants, simvastatine [2] ---> SmPC of [2] of eMC
In two clinical studies, one in normal volunteers and the other in hypercholesterolaemic patients, simvastatin 20-40 mg/day modestly potentiated the effect of coumarin anticoagulants
Coumarin anticoagulants, spiramycin
Spiramycin may delay the elimination of coumarine
Coumarin anticoagulants, St. John's wort
The co-administration decreases the anticoagulant effect (risk of thromboembolias). St. John's Wort should be avoided
Coumarin anticoagulants, strong CYP3A4 and CYP2C9 inhibitors
The inhibition of CYP2C9 and CYP3A4 may increase the plasma concentrations of coumarin and therefore may cause an increase in prothrombin time
Coumarin anticoagulants, sulfinpyrazone
Sulfinpyrazone may potentiate the action of coumarin-type anticoagulants
Coumarin anticoagulants, sulfonylureas
The hypoglycaemic action of sulphonylureas in general may be potentiated by drugs that are highly protein bound
Coumarin anticoagulants, tamoxifen [2] ---> SmPC of [2] of eMC
When coumarin-type anti-coagulants are used in combination with tamoxifen a significant increase in anticoagulant effect may occur.
Coumarin anticoagulants, tegafur
Patients receiving coumarin anticoagulants (e.g. warfarin or acenocoumarol) should be closely monitored for their prothrombin time INR
Coumarin anticoagulants, tegafur/gimeracil/oteracil [2] ---> SmPC of [2] of EMA
The activity of a coumarin-derivative anticoagulant was enhanced by Teysuno. Caution is advised as co-administration may increase the risk of bleeding
Coumarin anticoagulants, tenoxicam ---> SmPC of [naproxen/esomeprazole] of eMC
NSAIDs may enhance the effects of oral anti-coagulants (e.g. warfarin, dicoumarol)
Coumarin anticoagulants, tetracosactide
Decreased anticoagulant effect
Coumarin anticoagulants, thiopental
The enzymatic induction by thiopental may decrease the exposition of coumarin derivative
Coumarin anticoagulants, tisopurine
Tisopurine may increase the anticoagulant effect
Coumarin anticoagulants, tolbutamide
Increased hypoglycaemic effects have occurred or might be expected
Coumarin anticoagulants, toremifene [2] ---> SmPC of [2] of EMA
There is a known interaction between anti-estrogens and warfarin-type anticoagulants leading to a seriously increased bleeding time. Therefore, the concomitant use of toremifene with such drugs should be avoided.
Coumarin anticoagulants, tramadol [2] ---> SmPC of [2] of eMC
There have been isolated reports of interaction with coumarin anticoagulants resulting in an increased INR. Care should be taken if treatment with tramadol is started in patients taking anticoagulants.
Coumarin anticoagulants, tricyclic antidepressant ---> SmPC of [imipramine] of eMC
Tricyclic antidepressants may potentiate the anti-coagulant effect of coumarin drugs by inhibiting hepatic metabolism of anticoagulants.
Coumarin anticoagulants, triiodthyronine
Liothyronine sodium therapy may potentiate the action of anticoagulants (coumarins and phenindione).
Coumarin anticoagulants, trimethoprim
Trimethoprim may potentate the anticoagulant effect of warfarin and other coumarins.
Coumarin anticoagulants, trimethoprim/sulfamethoxazol
Cotrimoxazole may enhance the effect of oral anticoagulants (enhanced hypoprothrombinemic effect of coumarins)
Coumarin anticoagulants, vitamin K
The co-administration may decrease or abolish the anticoagulant effect
Coumarin anticoagulants, voriconazole [2] ---> SmPC of [2] of EMA
Voriconazole may increase the plasma concentrations of coumarins that may cause an increase in prothrombin time.