Warfarin Institute of America

DEDICATED TO YOUR HEALTH SINCE 2000

ERYTHROMYCIN INTERACTIONS WITH WARFARIN
  In an article in Pharmacy Times (June 2000), Michael Mancano, Pharm. D., reviews the interaction between erythromycin and warfarin.  There have bee numerous reports of increased INRs after one week of therapy, but few reports of bleeding complications.

  He concludes that the clinical importance of this interaction most likely depends on many patient-specific factors. including: fever, low dietary vitamin K, age, rate of warfarin clearance, concurrent therapy, and ability to shunt warfarin metabolism to uninhibited pathways.

 The selection of an alternate antimicrobial agent is advisable to prevent this interaction.

  Dr. Mancano states that azithromycin and clarithromycin do not seem to have this same interaction.  This may be true but I have seen several cases of elevated INRs that I thought were caused by either azithromycin or clarithromycin.  For more information access these pages: azithromycin or clarithromycin 

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Last modified May 11, 2006