التداخل بين إيزيتيميب وسيمفاستاتين وريفاروكسابان

Coumarin Anticoagulants: Obtain INR before VYTORIN initiation and monitor INR during VYTORIN dosage initiation or adjustment.

Table 4: VYTORIN Effects on Other Drugs Coumarin Anticoagulants Clinical Impact: VYTORIN may potentiate the effect of coumarin anticoagulants and increase the INR.

The concomitant use of simvastatin (20 to 40 mg) and coumarin anticoagulants increased the INR from a baseline of 1.7 to 1.8 in healthy subjects and from 2.6 to 3.4 in patients with hyperlipidemia.

There are postmarketing reports of clinically evident bleeding and/or increased INR in patients taking concomitant statins (with or without ezetimibe) and coumarin anticoagulants.

Intervention: In patients taking coumarin anticoagulants, obtain an INR before starting VYTORIN and frequently enough after initiation, dose titration, or discontinuation to ensure that no significant alteration in INR occurs.