Ament PW, Gent M, 2008 Apr;28(4):540-8. doi: 10.1592/phco.28.4.540.Hematology Am Soc Hematol Educ Program. Simply log in to access the full article, or register for free if you do not yet have a username and password.
2018 Nov 30;2018(1):339-347. doi: 10.1182/asheducation-2018.1.339.J Thromb Thrombolysis. Patients also should be informed about the risk of bleeding associated with combined warfarin and NSAID therapy.Fluoroquinolone antibiotics are useful in the management of infections caused by a variety of pathogens.
Basile F,
doi: 10.1097/01.AOG.0000196722.13403.33. When given to or withdrawn from patients maintained on warfarin, NSAIDs may actually alter anticoagulant control as a result of changes in the amount of circulating warfarin released from plasma albumin binding sites.Concomitant use of NSAIDs and warfarin should be avoided, especially in patients who are at increased risk for NSAID gastropathy (e.g., age greater than 65 years, history of peptic ulcer disease, systemic steroid therapy, heavy smoking or high NSAID dosage). Almost all antibiotics can potentiate the effects of warfarin by inhibiting intestinal flora that produce vitamin K. Inhibition of the hepatic metabolism of warfarin is another possible mechanism for increased bleeding.Clinical trials evaluating warfarin-antibiotic combinations have had mixed outcomes.Unless the prothrombin International Normalized Ratio (INR) can be monitored every other day, ciprofloxacin, macrolide antibiotics, metronidazole and trimethoprim-sulfamethoxazole generally should not be prescribed to patients who are taking warfarin. Serum antiepileptic drug levels should be monitored in patients who receive any of these combinations.Lithium therapy is useful for indications ranging from bipolar disorder to migraine headaches, but several interactions must be considered. Monitor phenytoin levels.Clinical significance has not been established. Suchowersky O, As a result, serum lithium levels increase secondary to enhanced reabsorption.If coadministration is necessary, the dosage of lithium should be reduced by 50 percent when a diuretic or an NSAID is added. Co-administration of fluoxetine and sumatriptan: the Canadian experience. However, one half of the women had either a clinically relevant increase of the INR greater than 4, or bleeding that required their dosage of warfarin to be decreased.
Holbrook AM, Miller KE. Shorr RI, Most evidence supports using drugs that inhibit 3-hydroxy-3-methylglutaryl–coenzyme A (HMG-CoA) reductase in the liver, which is the main site of cholesterol synthesis.The HMG-CoA reductase inhibitors (statins) include atorvastatin (Lipitor), cerivastatin (Baycol), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol) and simvastatin (Zocor).
Signs or symptoms of lithium toxicity involve the central nervous system (drowsiness, confusion, hand tremor, blurred vision, vertigo and seizures), gastrointestinal tract (nausea and vomiting) and cardiovascular system (arrhythmias and widening of the QRS complex).Rifampin can increase the activity of hepatic enzymes involved in the metabolism of exogenous estrogens.
Fleischer AB Jr,
The mechanisms of this interaction are antiplatelet effect and gastric mucosal damage, because most NSAIDs do not produce a hypothrombinemic response.
Single dose fluconazole is not recommended for use in children under 18 years of age except under doctor supervision. Adverse consequences of fluoxetine-MAOI combination therapy.
Bergeron R. Thus, their effects may be potentiated by drugs that inhibit cytochrome P450 hepatic metabolism, such as macrolide antibiotics, cimetidine (Tagamet) and fluconazole (Diflucan).Agents that inhibit cytochrome P450 metabolism or depend on cytochrome P450 for metabolism (substrate)Rifampin (Rifadin) is the “classic hepatic enzyme inducer.” When this agent is administered to patients who are taking an antiepileptic medication, increased hepatic metabolism may decrease the serum levels of the antiepileptic drug,Specific data support interactions between the following drugs: erythromycin and carbamazepine; cimetidine and carbamazepine or phenytoin; fluconazole and phenytoin; and rifampin and phenytoin. Clipboard, Search History, and several other advanced features are temporarily unavailable. Brodell RT, Fluconazole ↑ Hold warfarin x1 for single dose.