Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
DANAZOL INTERACTIONS WITH WARFARIN (Coumadin, Jantoven_
Brand Name: Danocrine
There are some reports of this combination causing an increase in the INR. Little is known about how it occurs, how long it takes to elevate the INR or what happens when the combination is stopped.
Meeks et al reported on two cases where the INR became elevated after danazol was added to the medications of people taking warfarin (Coumadin, Jantoven). Hinata et al (article written in Japanese) reported on the case of a woman with prosthetic heart valves who had danazol added to her warfarin (Coumadin, Jantoven) and dipyridamole anticoagulation. The woman developed bleeding into the brain, but was successfully treated.
It would seem prudent to monitor the INR about 3 to 4 days and again 7 days after starting danazol therapy. The same should be done if danazol is stopped and the person remains on warfarin (Coumadin, Jantoven). Monitoring should continue until the INR is in the desired range on two consecutive visits.
The action of danazol closely resembles the action of warfarin (Coumadin, Jantoven). In fact, it has been tried as an anticoagulant in people who were unable to take warfarin (Coumadin, Jantoven). Ledford et al reported on the case of a man with protein S deficiency which became resistant to warfarin (Coumadin, Jantoven) therapy. It appears that his improvement was because danazol inhibited platelets and inhibited thrombin. There did not appear to be an increase in protein S.
However, Bower et al reported on a case of protein S deficiency where there was no improvement in recurrent thrombophlebitis after danazol was given for eight weeks.
References:
Meeks ML et al. Danazol increases the anticoagulant effect of warfarin. Ann Pharmacother 1992;26:641-642
Hinata S et al. Subarachanoid hemorrhage following commencement of danazol in a patient well controlled on warfarin anticoagulation. Kyobu Geka 1991;44:555-557
Ledford MR et al. Efficacy of danazol in a patient with congenital protein-S deficiency; paradoxical evidence for decreased platelet activation with inhibited thrombin generation. Thromb Res 1997;87:473-482.
Bower et al. Failure of the synthetic androgen, danazol, to increase protein-s or prevent thrombosis in a patient with severe protein-S deficiency. Haemostasis 1995;25:144-148.
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Last modified May 8, 2006