التداخل بين تولميتين ووارفارين

…Drugs Anticoagulants argatroban, dabigatran, bivalirudin, desirudin, heparin, lepirudin Antiplatelet Agents aspirin, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine Non-steroidal Anti-Inflammatory Agents celecoxib, diclofenac, diflunisal, fenoprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, mefenamic acid, naproxen, oxaprozin, piroxicam,…

Warfarin: The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.

However, increased prothrombin time and bleeding have been reported in patients on concomitant tolmetin and warfarin therapy.

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status.

Therefore, caution should be exercised when administering tolmetin to patients on anticoagulants.

The in vitro binding of warfarin to human plasma proteins is unaffected by TOLECTIN, and TOLECTIN does not alter the prothrombin time of normal volunteers.