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Warfarin Drug Interactions

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1. Critical pharmacokinetic and pharmacodynamic drug-herb interactions in rats between warfarin and pomegranate peel or guava leaves extracts. (PubMed)

Critical pharmacokinetic and pharmacodynamic drug-herb interactions in rats between warfarin and pomegranate peel or guava leaves extracts. In-depth information of potential drug-herb interactions between warfarin and herbal compounds with suspected anticoagulant blood thinning effects is needed to raise caution of concomitant administration. The current study aimed to investigate the impact of co-administration of pomegranate peel and guava leaves extracts, including their quality markers (...) CYP activities.All combinations enhanced the anticoagulant activity of warfarin as the results of in vivo and in vitro studies were consistent. The current investigation confirmed serious drug herb interactions between warfarin and pomegranate peel or guava leaf extracts. Such results might conclude a high risk of bleeding from the co-administration of the investigated herbal drugs with warfarin therapy. In addition, the results raise attention to the blood-thinning effects of pomegranate peel

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2019 BMC Complementary and Alternative Medicine

2. Drug-drug Interaction Study to Evaluate the Effect of ISIS 681257 on Warfarin

Drug-drug Interaction Study to Evaluate the Effect of ISIS 681257 on Warfarin Drug-drug Interaction Study to Evaluate the Effect of ISIS 681257 on Warfarin - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . Drug-drug Interaction Study to Evaluate the Effect of ISIS 681257 on Warfarin The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03426033 Recruitment Status : Completed First Posted : February 8, 2018 Last Update Posted : April 5, 2018 Sponsor: Akcea Therapeutics Information provided by (Responsible

2018 Clinical Trials

3. Identifying Drug-Drug Interactions by Data Mining: A Pilot Study of Warfarin-Associated Drug Interactions. (PubMed)

Identifying Drug-Drug Interactions by Data Mining: A Pilot Study of Warfarin-Associated Drug Interactions. Knowledge about drug-drug interactions commonly arises from preclinical trials, from adverse drug reports, or based on knowledge of mechanisms of action. Our aim was to investigate whether drug-drug interactions were discoverable without prior hypotheses using data mining. We focused on warfarin-drug interactions as the prototype.We analyzed altered prothrombin time (measured (...) derivatives, and combinations of penicillins, including β-lactamase inhibitors) and two had a known interaction in a closely related drug group (oripavine derivatives [buprenorphine] and natural opium alkaloids). Antipropulsives had an unknown signal of increasing INR.We were able to identify known warfarin-drug interactions without a prior hypothesis using clinical registries. Additionally, we discovered a few potentially novel interactions. This opens up for the use of data mining to discover unknown

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2016 Circulation. Cardiovascular quality and outcomes

4. Population Impact of Drug Interactions with Warfarin: A Real-World Data Approach. (PubMed)

Population Impact of Drug Interactions with Warfarin: A Real-World Data Approach. To investigate the population impact of previously reported interactions between warfarin and other drugs on international normalized ratio (INR) levels.Using The Health Improvement Network (THIN), a United Kingdom primary care database, a cohort of warfarin users between 2005 and 2013 (N = 121,962) was followed until the first qualifying prescription for the potential interacting drugs was evaluated. Sixteen sub (...) -cohorts, one for each study drug, and a control sub-cohort of warfarin were ascertained. Short-term changes in INR levels were assessed by comparing INR values measured before and after initiation of the interacting drug with paired Student's t-test. We also evaluated the proportion of patients with INR values outside the therapeutic range (INR: 2-3).Miconazole use was associated with the highest mean increase in INR (+3.35), followed by amiodarone (+1.28), fluconazole (+0.79), metronidazole (+0.75

2018 Thrombosis and haemostasis

5. Significant drug–drug interaction between warfarin and nafcillin (PubMed)

Significant drug–drug interaction between warfarin and nafcillin Nafcillin, a beta-lactam semisynthetic penicillin, is highly resistant to penicillinase and is similar to other penicillins except that it is primarily metabolized in the liver. It is believed that nafcillin causes CYP3A4 enzyme induction which decreases warfarin's half-life. The onset of CYP3A4 induction by nafcillin occurs within the first 7 days, but maximal effects may take up to 2 weeks. Once nafcillin is discontinued (...) , the effects persist for several weeks. A 79-year-old male with a history of atrial fibrillation and a 53-year-old male with a history of recurrent venous thromboembolism required significantly higher weekly warfarin doses during courses of nafcillin therapy. Both patients required a 2.5-3.5-fold increase from their baseline weekly warfarin dose to achieve therapeutic international normalized ratios (INRs) while on nafcillin. Traditional protocol-driven warfarin management can result in suboptimal

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2018 Therapeutic advances in drug safety

6. Review of potential drug interaction between Oseltamivir and Warfarin and why it is important for emergency medicine physicians. (PubMed)

Review of potential drug interaction between Oseltamivir and Warfarin and why it is important for emergency medicine physicians. Oseltamivir is a very commonly prescribed anti-viral medication by the Emergency Medicine (EM) physicians for the prophylactic and therapeutic treatment of Influenza infection. While the drug interaction of Warfarin with various antibiotics is known, the drug interaction between Oseltamivir and Warfarin is not common. We present a case where an 83-year female patient (...) , on Warfarin for Pulmonary Embolism, had worsening of coagulopathy after she was started on Oseltamivir. The INR was monitored daily in our patient and Warfarin was stopped when the INR became supra-therapeutic. Our patient did not have any minor or major bleeding complication. This is the first reported case of Oseltamivir related worsening coagulopathy in patient on Warfarin to the best of our knowledge. Keeping in mind the possible interaction between the two as it was evident in our case and few other

2017 American Journal of Emergency Medicine

7. Drug-Drug Interaction Study to Assess the Effects of Multiple-Dose Administration of K-877 on the Pharmacodynamics and the Pharmacokinetics of Multiple-Dose Administration of Warfarin in Healthy Adult Volunteers

Drug-Drug Interaction Study to Assess the Effects of Multiple-Dose Administration of K-877 on the Pharmacodynamics and the Pharmacokinetics of Multiple-Dose Administration of Warfarin in Healthy Adult Volunteers Drug-Drug Interaction Study to Assess the Effects of Multiple-Dose Administration of K-877 on the Pharmacodynamics and the Pharmacokinetics of Multiple-Dose Administration of Warfarin in Healthy Adult Volunteers - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record (...) managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Drug-Drug Interaction Study to Assess the Effects of Multiple-Dose Administration of K-877 on the Pharmacodynamics and the Pharmacokinetics of Multiple-Dose Administration of Warfarin in Healthy Adult Volunteers The safety and scientific

2016 Clinical Trials

8. New drugs for deep vein thrombosis may offer a safe alternative to warfarin

the clot could move and travel to one of the lung arteries causing a life threatening condition called pulmonary embolism. Pulmonary embolism is estimated to affect 3 to 4 per 10,000 people. DVT is usually treated first of all by injections of a drug called heparin, followed by an anti-clotting drug taken by mouth, mostly commonly warfarin. But warfarin has several drawbacks. It interacts with other drugs and needs frequent monitoring and dose control to ensure the right balance between clotting (...) threatening condition called pulmonary embolism. Pulmonary embolism is estimated to affect 3 to 4 per 10,000 people. DVT is usually treated first of all by injections of a drug called heparin, followed by an anti-clotting drug taken by mouth, mostly commonly warfarin. But warfarin has several drawbacks. It interacts with other drugs and needs frequent monitoring and dose control to ensure the right balance between clotting and bleeding risk is achieved. NICE has carried out individual assessments for some

2018 NIHR Dissemination Centre

9. New drugs for deep vein thrombosis may offer a safe alternative to warfarin

the clot could move and travel to one of the lung arteries causing a life threatening condition called pulmonary embolism. Pulmonary embolism is estimated to affect 3 to 4 per 10,000 people. DVT is usually treated first of all by injections of a drug called heparin, followed by an anti-clotting drug taken by mouth, mostly commonly warfarin. But warfarin has several drawbacks. It interacts with other drugs and needs frequent monitoring and dose control to ensure the right balance between clotting (...) threatening condition called pulmonary embolism. Pulmonary embolism is estimated to affect 3 to 4 per 10,000 people. DVT is usually treated first of all by injections of a drug called heparin, followed by an anti-clotting drug taken by mouth, mostly commonly warfarin. But warfarin has several drawbacks. It interacts with other drugs and needs frequent monitoring and dose control to ensure the right balance between clotting and bleeding risk is achieved. NICE has carried out individual assessments for some

2018 NIHR Dissemination Centre

10. Recommendations for Management of Clinically Significant Drug-Drug Interactions With Statins and Select Agents Used in Patients With Cardiovascular Disease: A Scientific Statement From the American Heart Association

increase in AUC Combination may be considered Warfarin Fluvastatin Increased INR/potential for increased bleeding Variable Combination therapy is useful Lovastatin Increased INR/potential for increased bleeding Variable Combination is useful Rosuvastatin Increased INR/potential for increased bleeding Variable Combination is useful Simvastatin Increased INR/potential for increased bleeding Up to 30% change in INR Combination is useful Magnitude of drug-drug interactions based on AUC increase: minor (...) Recommendations for Management of Clinically Significant Drug-Drug Interactions With Statins and Select Agents Used in Patients With Cardiovascular Disease: A Scientific Statement From the American Heart Association Recommendations for Management of Clinically Significant Drug-Drug Interactions With Statins and Select Agents Used in Patients With Cardiovascular Disease: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email

2016 American Heart Association

11. Pharmacokinetic and Pharmacodynamic Evaluation of the Drug‐Drug Interaction Between Isavuconazole and Warfarin in Healthy Subjects (PubMed)

Pharmacokinetic and Pharmacodynamic Evaluation of the Drug‐Drug Interaction Between Isavuconazole and Warfarin in Healthy Subjects This phase 1 trial evaluated pharmacokinetic and pharmacodynamic interactions between the novel triazole antifungal agent isavuconazole and warfarin in healthy adults. Multiple doses of isavuconazole were administered as the oral prodrug, isavuconazonium sulfate (372 mg 3 times a day for 2 days loading dose, then 372 mg once daily thereafter; equivalent (...) to isavuconazole 200 mg), in the presence and absence of single doses of oral warfarin sodium 20 mg. Coadministration with isavuconazole increased the mean area under the plasma concentration-time curves from time 0 to infinity of S- and R-warfarin by 11% and 20%, respectively, but decreased the mean maximum plasma concentrations of S- and R-warfarin by 12% and 7%, respectively, relative to warfarin alone. Mean area under the international normalized ratio curve and maximum international normalized ratio were

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2016 Clinical pharmacology in drug development

12. Warfarin Drug Interactions

Warfarin Drug Interactions Warfarin Drug Interactions Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Warfarin Drug Interactions (...) Warfarin Drug Interactions Aka: Warfarin Drug Interactions , Drug Interactions with Coumadin , Coumadin Drug Interactions From Related Chapters II. Risk Factors: Drug Interaction with Warfarin Older age Acutely ill Dietary change Concurrent infection III. Precautions Avoid using agents with major s with When using medications known to affect INR, monitor INR closely Check INR 5 days after starting medication Check INR after stopping the medication IV. Drug Interactions: Agents that increase INR

2018 FP Notebook

13. Drug-drug interactions in an era of multiple anticoagulants: a focus on clinically relevant drug interactions. (PubMed)

Drug-drug interactions in an era of multiple anticoagulants: a focus on clinically relevant drug interactions. Oral anticoagulants are commonly prescribed but high risk to cause adverse events. Skilled drug interaction management is essential to ensure safe and effective use of these therapies. Clinically relevant interactions with warfarin include drugs that modify cytochrome 2C9, 3A4, or both. Drugs that modify p-glycoprotein may interact with all direct oral anticoagulants, and modifiers (...) of cytochrome 3A4 may interact with rivaroxaban and apixaban. Antiplatelet agents, nonsteroidal anti-inflammatory drugs, and serotonergic agents, such as selective serotonin reuptake inhibitors, can increase risk of bleeding when combined with any oral anticoagulant, and concomitant use should be routinely assessed. New data on anticoagulant drug interactions are available almost daily, and therefore, it is vital that clinicians regularly search interaction databases and the literature for updated

2018 Blood

14. Glucosamine ? drug interactions

Glucosamine ? drug interactions Glucosamine – drug interactions – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Menu · · Published 11th August 2017, updated 18th August 2017 This updated medicine Q&A considers the limited information available on potential drug interactions between glucosamine and conventional medicines. There are a number of reports describing enhanced anticoagulant effects when glucosamine has been taken with warfarin. The mechanism (...) of the interaction is unclear. The MHRA recommend that patients on warfarin should not take glucosamine. It has also been suggested that glucosamine should be used with caution in patients taking antiplatelet agents. No reports of interaction between glucosamine and the NOACs were located; until more is known, caution is warranted. There is a theoretical risk that glucosamine may interact with doxorubicin and etoposide; because of the potential clinical significance of this interaction, glucosamine should

2017 Specialist Pharmacy Services

15. Dose-dependent artificial prolongation of prothrombin time by interaction between daptomycin and test reagents in patients receiving warfarin: a prospective in vivo clinical study (PubMed)

Dose-dependent artificial prolongation of prothrombin time by interaction between daptomycin and test reagents in patients receiving warfarin: a prospective in vivo clinical study Daptomycin has been reported to cause artificial prolongation of prothrombin time (PT) by interacting with some test reagents of PT. This prolongation was particularly prominent with high concentrations of daptomycin in vitro. However, whether this prolongation is important in clinical settings and the optimal timing (...) was not observed for any PT reagents.We found that a higher concentration of daptomycin could lead to artificial prolongation of PT-INR by interacting with some PT reagents. This change may not be clinically negligible, especially in warfarin users receiving a high dose of daptomycin. It may be better to measure PT at the trough rather than at the peak daptomycin concentration.

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2017 Annals of Clinical Microbiology and Antimicrobials

16. Assessment of Pharmacokinetic Interactions Between Obeticholic Acid and Caffeine, Midazolam, Warfarin, Dextromethorphan, Omeprazole, Rosuvastatin, and Digoxin in Phase 1 Studies in Healthy Subjects (PubMed)

Assessment of Pharmacokinetic Interactions Between Obeticholic Acid and Caffeine, Midazolam, Warfarin, Dextromethorphan, Omeprazole, Rosuvastatin, and Digoxin in Phase 1 Studies in Healthy Subjects Obeticholic acid (OCA), a potent and selective farnesoid X receptor agonist, is indicated for the treatment of primary biliary cholangitis (PBC). We investigated the potential drug-drug interaction effect of OCA on metabolic CYP450 enzymes and drug transporters.Five phase 1 single-center, open-label (...) , and dextromethorphan and weak interactions with caffeine, omeprazole, rosuvastatin, and midazolam. The maximal pharmacodynamic responses (E max) to warfarin-based INR, PT, and aPTT were reduced by 11%, 11%, and 1%, respectively, for the 10-mg dose group and by 7%, 7% and 0%, respectively, for the 25-mg dose group. Overall, drugs dosed in combination with OCA were well tolerated, and most adverse events were mild in severity. No clinically important trends were noted in laboratory evaluations, vital signs, or 12

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2017 Advances in therapy

17. Detecting Signals of Interactions Between Warfarin and Dietary Supplements in Electronic Health Records (PubMed)

Detecting Signals of Interactions Between Warfarin and Dietary Supplements in Electronic Health Records Drug and supplement interactions (DSIs) have drawn widespread attention due to their potential to affect therapeutic response and adverse event risk. Electronic health records provide a valuable source where the signals of DSIs can be identified and characterized. We detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng (...) significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.

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2017 Studies in health technology and informatics

18. Pharmacokinetic Evaluation of the Interactions of Amenamevir (ASP2151) with Ketoconazole, Rifampicin, Midazolam, and Warfarin in Healthy Adults (PubMed)

of ketoconazole (400 mg) and rifampicin (600 mg) on the pharmacokinetics of a single oral dose of amenamevir. The other two studies were randomized, double-blind, parallel-group studies that evaluated the effects of multiple doses of amenamevir on the pharmacokinetics of a single dose of midazolam (7.5 mg) and warfarin (25 mg). A drug interaction was considered to occur if the 90% confidence interval (CI) of the least squares geometric mean ratio (GMR) of amenamevir to the comparator was outside (...) Pharmacokinetic Evaluation of the Interactions of Amenamevir (ASP2151) with Ketoconazole, Rifampicin, Midazolam, and Warfarin in Healthy Adults Amenamevir is a nonnucleoside antiherpes virus compound available for treating herpes zoster infections. Four studies aimed to determine any potential interactions between amenamevir and ketoconazole, rifampicin, midazolam, or warfarin in healthy male participants.Two studies were open-label studies that evaluated the effects of multiple doses

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2017 Advances in therapy

19. The Significance of Drug—Drug and Drug—Food Interactions of Oral Anticoagulation (PubMed)

The Significance of Drug—Drug and Drug—Food Interactions of Oral Anticoagulation Vitamin K antagonists (VKAs) such as warfarin are the most commonly prescribed oral anticoagulants worldwide. However, factors affecting the pharmacokinetics of VKAs, such as food and drugs, can cause deviations from their narrow therapeutic window, increasing the bleeding or thrombosis risk and complicating their long-term use. The use of direct oral anticoagulants (DOACs) offers a safer and more convenient (...) alternative to VKAs. However, it is important to be aware that plasma levels of DOACs are affected by drugs that alter the cell efflux transporter P-glycoprotein and/or cytochrome P450. In addition to these pharmacokinetic-based interactions, DOACs have the potential for pharmacodynamic interaction with antiplatelet agents and non-steroidal anti-inflammatory drugs. This is an important consideration in patient groups already at high risk of bleeding, such as patients with renal impairment.

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2018 Arrhythmia & electrophysiology review

20. A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors

A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer (...) to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Phase I, Multi-center, Open Label, Drug-drug Interaction Study to Assess the Effect of Ceritinib on the Pharmacokinetics of Warfarin and Midazolam in Patients With ALK-positive Advanced Tumors The safety and scientific validity of this study is the responsibility

2015 Clinical Trials

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