Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
WARFARIN INTERACTIONS WITH OTHER MEDICATIONS
Think of warfarin as being one side of a teeter-totter. Whenever you add or remove any medication, you have the potential to upset the balance. Your INR can be shot skyward or come crashing down depending on the action taken. This is so important that it must be repeated. Just because you see a medication that you are taking on the list of interacting items, it does not mean that you must not take the combination. Stopping an interaction can have serious consequences. This must be discussed with your physician before any change is made.
What if you are taking warfarin and an interacting medication is added?
If your INR has been stable and you add an interacting medication, your INR may either go up or down. If your INR goes up, you increase your chances of having a serious bleeding episode. If your INR goes down, you increase your chances of having a blood clot. The way you work around this is to have your INR tested more frequently than usual. If the INR gets out of your therapeutic range, the dose of warfarin is adjusted appropriately. This way your INR is not out of the therapeutic range for very long. Any time that a medication is added or subtracted, it is wise to have an INR test done in 3 to 7 days. Some medications not on the list of interacting medications do not truly interact yet they are able to affect the INR.
What if you are taking an interacting medication and warfarin is added?
If you have been taking a medication on the list of items that interact with warfarin and your physician now prescribes warfarin, what should you do? If you are going to have your INR checked in three to seven days, it is probably not necessary to do anything. The dose of warfarin may be more or less than it would have been without the interaction. Actually the dose of warfarin is irrelevant as long as the INR is in the therapeutic range. If you do not have an INR test scheduled, you should call your physician and insist that one be scheduled in the next 3 to 7 days. Some interactions take longer to occur, but this will give a good screen against an adverse event.
What if you are taking warfarin and an interacting medication is stopped?
Remember that your INR is balanced between warfarin and the interacting medication. Removing the interacting medication can make your INR go either up or down. It is very important that you do not stop an interacting combination on your own. Doing so can have disastrous consequences. You must keep your physician informed and have your INR checked again in three to seven days. Some medications will act longer in your body, but this will give a good screening.
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Last updated April 5, 2007