Warfarin Institute of America
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METRONIDAZOLE INTERACTIONS WITH WARFARIN
This interaction could also be troublesome because metronidazole is one of
the medications used to treat H.pylori. This bacteria is implicated
as a cause of duodenal ulcers. An ulcer, alone, will increase the
risk of bleeding. If a patient is taking warfarin and is treated
with metronidazole for an ulcer there is probably a great risk of
bleeding.
If this combination must be used, careful monitoring of the INR must be done. The dose of warfarin may have to be reduced while taking metronidazole. Likewise, when the course of metronidazole is
completed, the dose of warfarin will probably need to be increased.
This reaction also happens with other members of this family: econazole, fluconazole, itraconazole, miconazole and voriconazole.
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Last updated November 14, 2004