Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
ALLOPURINOL INTERACTIONS WITH WARFARIN (Coumadin, Jantoven)
THIS INTERACTION IS NOT WELL REPORTED IN THE MEDICAL LITERATURE. I HAVE SEEN IT HAPPEN SEVERAL TIMES AND THINK THAT THIS IS A MUCH MORE DANGEROUS INTERACTION THAT PUBLISHED REPORTS WOULD LEAD YOU TO BELIEVE. IT MAY BE RELATED TO THE DOSE OF ALLOPURINOL. PEOPLE WHO ARE ABLE TO GET RELIEF WITH 100 MG OF ALLOPURINOL DAILY SEEN TO HAVE LESS PROBLEMS THAN THOSE WHO TAKE 300 MG DAILY.
If you are taking warfarin (Coumadin, Jantoven) and start taking allopurinol, you can expect your INR to rise. This means that you will have an effect as if you had increased your dose of warfarin (Coumadin, Jantoven). To make sure that your INR does not get high enough to cause bleeding problems, you should have your blood checked. Your dose of warfarin (Coumadin, Jantoven) will very likely need to be adjusted downward.
There is a possibility that this interaction is related to the dose of allopurinol. I have treated one person who has a mechanical heart valve and suffered a serious stomach bleed with an elevated INR. She was having very painful gout attacks. The safest drug to use in this case was allopurinol. Her doctor started her on 100mg of allopurinol daily and we monitored her INR every week for about a month. The INR did not increase by very much and she was eventually able to get relief from the gour with little danger of bleeding.
Allopurinol is one of those medication that people think that they do not need any more after a gout attack stops. If you stop allopurinol and continue warfarin (Coumadin, Jantoven), you are putting yourself at risk of having both a blood clot and a gout attack.
DO NOT TAKE A CHANCE WITH THIS INTERACTION. BE SURE THAT YOU HAVE GOOD MEDICAL ADVICE AND CLOSE MONITORING OF YOUR INR IF ANYTHING IS TO BE CHANGED.
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Last modified June 14, 2007
