Bivalirudine : interactions médicamenteuses

Warfarin Potentiates anticoagulant response and can result in serious or fatal bleeding. (notice Amiodarone, Interactions médicamenteuses)

If anticoagulation with ELIQUIS is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant [see Dosage and Administration (2.5) , Warnings and Precautions (5.1) , and Clinical Studies (14.1) ] . (notice Apixaban, Mise en garde encadrée)

Anticoagulants: warfarin ↑ warfarin Coadministration with REYATAZ has the potential to produce serious and/or life-threatening bleeding and has not been studied. (notice Atazanavir, Interactions médicamenteuses)

To reduce this risk, consider coverage with another anticoagulant if PRADAXA is discontinued for a reason other than pathological bleeding or completion of a course of therapy ( 2.6 , 2.7 , 2.8 , 5.1 ). (notice Dabigatran, Mise en garde encadrée)

In these patients another anticoagulant should be used ( 5.1 ). (notice Édoxaban, Mise en garde encadrée)

…Voxilaprevir ↓ velpatasvir ↓ voxilaprevir Coadministration of efavirenz and sofosbuvir/velpatasvir/voxilaprevir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir/voxilaprevir Other agents Anticoagulant:Warfarin ↑ or ↓ warfarin Monitor international normalised ratio (INR) and adjust warfarin dosage if necessary. (notice Éfavirenz, Interactions médicamenteuses)

Among patients who experienced an AST, one fatality (0.03%) occurred in a bivalirudin treated patient and one fatality (0.03%) in a heparin treated patient. (notice Bivalirudine, Mises en garde et précautions)

Unless contraindicated, administer anticoagulant therapy to patients receiving VELETRI to reduce the risk of pulmonary thromboembolism or systemic embolism through a patent foramen ovale. (notice Époprosténol, Mises en garde et précautions)

…use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants • a history of traumatic or repeated epidural or spinal puncture • a history of spinal deformity or spinal surgery • Optimal timing between the administration of fondaparinux… (notice Fondaparinux, Mise en garde encadrée)

Among patients who experienced an AST, one fatality (0.03%) occurred in a bivalirudin treated patient and one fatality (0.03%) in a heparin treated patient. (notice Bivalirudine, Mises en garde et précautions)

Anticoagulants and Antiplatelets Ticagrelor Contraindicated during and 2 weeks after TOLSURA treatment. (notice Itraconazole, Interactions médicamenteuses)

…Antipsychotics Haloperidol Decrease plasma concentrations by 70% Lurasidone Prevention or Management: Concomitant use is contraindicated (See CONTRAINDICATIONS ) Decrease exposure Oral Anticoagulants Prevention or Management: Perform prothrombin time daily or as frequently as necessary to establish and maintain the required dose of anticoagulant Warfarin Decrease… (notice Rifampicine, Interactions médicamenteuses)

Anticoagulant: rivaroxaban ↑ rivaroxaban Avoid concomitant use of rivaroxaban and ritonavir. (notice Ritonavir, Interactions médicamenteuses)

If anticoagulation with XARELTO is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant [see Dosage and Administration (2.3 , 2.4) , Warnings and Precautions (5.1) , and Clinical Studies (14.1) ] . (notice Rivaroxaban, Mise en garde encadrée)

For women with DCIS and for the reduction in breast cancer incidence in women at high risk, tamoxifen is contraindicated in women who require concomitant warfarin-type anticoagulant therapy or in women with a history of deep vein thrombosis or pulmonary embolus. (notice Tamoxifène, Mises en garde et précautions)

A number of drugs, including ethacrynic acid, have been shown to displace warfarin from plasma protein; a reduction in the usual anticoagulant dosage may be required in patients receiving both drugs. (notice Acide étacrynique, Interactions médicamenteuses)

Increased Bleeding Risk with Coumarin Anticoagulants Exercise caution when co-administering anticoagulants with fenofibric acid delayed-release capsules because of the potentiation of coumarin-type anticoagulant effects in prolonging the prothrombin time/International Normalized Ratio (PT/INR). (notice Acide fénofibrique, Mises en garde et précautions)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy, concomitant use of oral corticosteroids, anti-platelet drugs (such as aspirin), anticoagulants, or selective serotonin reuptake inhibitors (SSRIs), smoking, use of alcohol, older age, and poor general health status. (notice Acide méfénamique, Mises en garde et précautions)

The therapeutic relevance of this is unknown; however, coagulation tests should be monitored if valproate therapy is instituted in patients taking anticoagulants. (notice Acide valproïque, Interactions médicamenteuses)

Dicumarol Clinical Impact Allopurinol tablets prolongs the half-life of the anticoagulant, dicumarol. (notice Allopurinol, Interactions médicamenteuses)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

…hemorrhagic ophthalmic conditions Septic thrombophlebitis or occluded AV cannula at seriously infected site Advanced age [see Use in Specific Populations (8.5) ] Patients currently receiving anticoagulants (e.g., warfarin sodium) Any other condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of its location. (notice Altéplase, Mises en garde et précautions)

Concomitant use of amoxicillin and oral anticoagulants may increase the prolongation of prothrombin time. (notice Amoxicilline, Interactions médicamenteuses)

Concomitant use Amoxicillin and Clavulanate Potassium Extended Release Tablets and oral anticoagulants may increase the prolongation of prothrombin time. (notice Amoxicilline et acide clavulanique, Interactions médicamenteuses)

Monitor patients for bleeding, including those receiving concomitant therapy with other drugs known to cause bleeding (e.g., anticoagulants, PDE3 inhibitors, NSAIDs, antiplatelet agents, selective serotonin reuptake inhibitors) [see Drug Interactions (7.3) , Clinical Pharmacology (12.3) ] . (notice Anagrélide, Mises en garde et précautions)

Concomitant use of argatroban with antiplatelet agents, thrombolytics, and other anticoagulants may increase the risk of bleeding. (notice Argatroban, Mises en garde et précautions)

The chance is higher if you are age 60 or older take a blood thinning (anticoagulant) or steroid drug have 3 or more alcoholic drinks every day while using this product have had stomach ulcers or bleeding problems take more or for a longer time than directed take other drugs containing prescription or nonprescription NSAIDs [aspirin, ibuprofen, naproxen, or others]… (notice Aspirine, Mises en garde)

Risk factors for bleeding include the use of other drugs that increase the risk of bleeding (e.g., anticoagulants, antiplatelet agents, heparin, anagrelide, fibrinolytic therapy, and chronic use of NSAIDs) [see Drug Interactions ( 7.1 )]. (notice Aspirine et dipyridamole, Mises en garde et précautions)

• Proguanil may potentiate anticoagulant effect of warfarin and other coumarin-based anticoagulants. (notice Atovaquone et proguanil, Interactions médicamenteuses)

Prothrombin times should be carefully monitored while patients are receiving azithromycin and oral anticoagulants concomitantly. (notice Azithromycine, Interactions médicamenteuses)

Concomitant administration of betaxolol with the oral anticoagulant warfarin has been shown not to potentiate the anticoagulant effect of warfarin. (notice Bétaxolol, Interactions médicamenteuses)

Closely monitor the Prothrombin Time (PT) and International Normalized Ratio (INR), and adjust the anticoagulant dose as needed. (notice Bicalutamide, Mises en garde et précautions)

Butalbital, Aspirin, and Caffeine Capsules may enhance the effects of: Oral anticoagulants, causing bleeding by inhibiting prothrombin formation in the liver and displacing anticoagulants from plasma protein binding sites. (notice Butalbital, aspirine et caféine, Interactions médicamenteuses)

Anticoagulants Clinical Impact: Aspirin may enhance the effects of anticoagulants. (notice Butalbital, aspirine, caféine et codéine, Interactions médicamenteuses)

Closely monitor for adverse reactions of CYP2C9 substrates where minimal concentration changes may lead to serious adverse reactions when used concomitantly with XELODA (e.g., anticoagulants, antidiabetic drugs). (notice Capécitabine, Interactions médicamenteuses)

Warfarin (CYP1A2 and CYP3A4 Substrate) Through induction of CYP1A2 and CYP3A4, EQUETRO decreases the concentration of warfarin and decreases its anticoagulant effectiveness. (notice Carbamazépine, Interactions médicamenteuses)

Those at risk include patients with renal or hepatic impairment, or poor nutritional state, as well as patients receiving a protracted course of antibacterial therapy, and patients receiving anticoagulant therapy. (notice Céfalexine, Mises en garde et précautions)

Those at risk include patients with renal or hepatic impairment or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy, and patients previously stabilized on anticoagulant therapy. (notice Céfazoline, Mises en garde et précautions)

Those at risk include patients with renal or hepatic impairment, or poor nutritional state, as well as patients receiving a protracted course of antimicrobial therapy, and patients previously stabilized on anticoagulant therapy. (notice Céfixime, Mises en garde et précautions)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants; or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Célécoxib, Mises en garde et précautions)

Drug Interactions Cimetidine tablets, apparently through an effect on certain microsomal enzyme systems, has been reported to reduce the hepatic metabolism of warfarin-type anticoagulants, phenytoin, propranolol, nifedipine, chlordiazepoxide, diazepam, certain tricyclic antidepressants, lidocaine, theophylline, and metronidazole, thereby delaying elimination… (notice Cimétidine, Interactions médicamenteuses)

Anti-coagulant drugs Use with caution (Increase in anticoagulant effect) The risk may vary with the underlying infection, age and general status of the patient so that the contribution of ciprofloxacin to the increase in INR (international normalized ratio) is difficult to assess. (notice Ciprofloxacine, Interactions médicamenteuses)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk. (notice Citalopram, Mises en garde et précautions)

Oral Anticoagulants: There is a risk of serious hemorrhage and significant elevations in INR and prothrombin time when clarithromycin is co-administered with warfarin. (notice Clarithromycine, Mises en garde et précautions)

Risk factors for bleeding include concomitant use of other drugs that increase the risk of bleeding (e.g., anticoagulants, antiplatelet agents, and chronic use of NSAIDs) [see Drug Interactions (7.4 , 7.5 , 7.6 , 7.7) ]. (notice Clopidogrel, Mises en garde et précautions)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (notice Cyclophosphamide, Interactions médicamenteuses)

Anticoagulants : Direct Oral Anticoagulants (DOACs) apixaban ↑ apixaban Due to potentially increased bleeding risk, dosing recommendations for co-administration of apixaban with PREZISTA/ritonavir depend on the apixaban dose. (notice Darunavir, Interactions médicamenteuses)

Anticoagulants: Direct Oral Anticoagulants (DOACs) apixaban ↑ apixaban Due to potentially increased bleeding risk, dosing recommendations for co-administration of apixaban with PREZCOBIX or PREZCOBIX PED depend on the apixaban dose. (notice Darunavir et cobicistat, Interactions médicamenteuses)

Use caution if used concomitantly with medications that inhibit platelet function or anticoagulants. (notice Dasatinib, Mises en garde et précautions)

The risk of GI hemorrhage may be increased when administering Exjade in combination with drugs that have ulcerogenic or hemorrhagic potential, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, oral bisphosphonates, or anticoagulants. (notice Déférasirox, Mises en garde et précautions)

Drug Interactions Because tetracyclines have been shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. (notice Déméclocycline, Interactions médicamenteuses)

• Increased Risk of Bleeding: Concomitant use of aspirin, NSAIDs, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.4 ). (notice Desvenlafaxine, Mises en garde et précautions)

(‎ 5.3 ) • Venous and Arterial Thromboembolism: Risk increased; consider anticoagulant prophylaxis and monitor for evidence of thromboembolism. (notice Dexaméthasone, Mises en garde et précautions)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Diclofénac, Mises en garde et précautions)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Diclofénac et misoprostol, Mises en garde et précautions)

Dicloxacillin may reduce the anticoagulant response to dicumarol and warfarin. (notice Dicloxacilline, Interactions médicamenteuses)

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. (notice Diflunisal, Mises en garde)

It may be necessary to adjust the dosage of oral anticoagulants upon beginning or stopping disulfiram, since disulfiram may prolong prothrombin time. (notice Disulfirame, Interactions médicamenteuses)

The therapeutic relevance of this is unknown; however, coagulation tests should be monitored if valproate therapy is instituted in patients taking anticoagulants. (notice Divalproate de sodium (valproate), Interactions médicamenteuses)

Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (notice Dofétilide, Interactions médicamenteuses)

Patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. (notice Doxycycline, Interactions médicamenteuses)

Concomitant use of antiplatelet drugs and anticoagulants may increase this risk. (notice Duloxétine, Mises en garde et précautions)

- 7.1 Warfarin Concomitant administration of econazole and warfarin has resulted in enhancement of anticoagulant effect. (notice Éconazole, Interactions médicamenteuses)

Concomitant Drug Class: Drug Name Effect Clinical Comment Anticoagulant: Warfarin ↑ or ↓ warfarin Monitor INR and adjust warfarin dosage if necessary. (notice Éfavirenz, lamivudine et ténofovir, Interactions médicamenteuses)

Anticoagulants: Direct Oral Anticoagulants (DOACs) apixaban rivaroxaban betrixaban dabigatran edoxaban ↑ apixaban Due to potentially increased bleeding risk, dosing recommendations for coadministration with GENVOYA depends on the apixaban dose. (notice Elvitégravir, cobicistat, emtricitabine et ténofovir, Interactions médicamenteuses)

Use of Thrombolytics, Anticoagulants, and Other Antiplatelet Agents Risk factors for bleeding include older age, a history of bleeding disorders, and concomitant use of drugs that increase the risk of bleeding (thrombolytics, oral anticoagulants, nonsteroidal anti-inflammatory drugs, and P2Y 12 inhibitors). (notice Eptifibatide, Mises en garde et précautions)

• Hemorrhage in patients taking warfarin: Regularly monitor INR in patients taking warfarin or other coumarin-derivative anticoagulants. (notice Erlotinib, Mises en garde et précautions)

There have been reports of increased anticoagulant effects when erythromycin and oral anticoagulants were used concomitantly. (notice Érythromycine, Interactions médicamenteuses)

Increased Risk of Bleeding: Concomitant use of nonsteroidal anti-inflammatory drugs, aspirin, other antiplatelet drugs, warfarin and other anticoagulants may increase risk ( 5.7 , 7) (notice Escitalopram, Mises en garde et précautions)

Patients taking omega-3-acid ethyl esters capsules and an anticoagulant or other drug affecting coagulation (e.g., anti-platelet agents) should be monitored periodically. (notice Esters éthyliques d'acides oméga-3, Interactions médicamenteuses)

Drug Interactions (Androgens) Anticoagulants: C-17 substituted derivatives of testosterone, such as methandrostenolone, have been reported to decrease the anticoagulant requirements of patients receiving oral anticoagulants. (notice Estrogènes estérifiés et méthyltestostérone, Interactions médicamenteuses)

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. (notice Étodolac, Mises en garde)

Anticoagulant : warfarin ↑ anticoagulants Warfarin concentrations may be increased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Coumarin Anticoagulants: Obtain INR before VYTORIN initiation and monitor INR during VYTORIN dosage initiation or adjustment. (notice Ézétimibe et simvastatine, Interactions médicamenteuses)

Increased Bleeding Risk with Coumarin Anticoagulants Exercise caution when co-administering anticoagulants with fenofibrate capsules because of the potentiation of coumarin-type anticoagulant effects in prolonging the prothrombin time/International Normalized Ratio (PT/INR). (notice Fénofibrate, Mises en garde et précautions)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Fénoprofène, Mises en garde et précautions)

Coumarin-type anticoagulants Prothrombin time may be increased in patients receiving concomitant fluconazole and coumarin-type anticoagulants. (notice Fluconazole, Interactions médicamenteuses)

Oral anticoagulants — decreased prothrombin time response. (notice Fludrocortisone, Interactions médicamenteuses)

Closely monitor patients receiving concomitant coumarin-derivative anticoagulants such as warfarin for INR or prothrombin time in order to adjust the anticoagulant dose accordingly [see Drug Interactions (7) ]. (notice Fluorouracile, Mises en garde et précautions)

Altered anticoagulant effects, including increased bleeding, have been reported when SNRIs or SSRIs are coadministered with warfarin. (notice Fluoxétine, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking, use of alcohol, older age, and poor general health status. (notice Flurbiprofène, Mises en garde et précautions)

Therefore close monitoring of prothrombin time is recommended and adjustment of the anticoagulant dose may be necessary when Eulexin ® capsules are administered concomitantly with warfarin. (notice Flutamide, Interactions médicamenteuses)

Thus patients receiving oral anticoagulants and Fluvoxamine Maleate Tablets should have their prothrombin time monitored and their anticoagulant dose adjusted accordingly. (notice Fluvoxamine, Mises en garde et précautions)

…Corticosteroids, doxycycline, estrogens, furosemide, oral contraceptives, paroxetine, quinidine, rifampin, sertraline, theophylline, and vitamin D Drugs whose level is decreased by phenytoin Anticoagulants Apixaban, dabigatran, edoxaban, rivaroxaban Antiepileptic drugs The effect of phenytoin on phenobarbital, valproic acid and sodium valproate serum levels is unpredictable. (notice Fosphénytoïne, Interactions médicamenteuses)

Risk of Bleeding: Use with caution in patients with bleeding diatheses, thrombocytopenia, or anticoagulant use. (notice Fulvestrant, Mises en garde et précautions)

Concomitant Anticoagulants – Caution should be exercised when warfarin is given in conjunction with LOPID. (notice Gemfibrozil, Mises en garde)

Le ginkgo peut accroître le risque de saignement lorsqu'il est pris avec des médicaments anticoagulants ou antiagrégants plaquettaires. (NCCIH, Ginkgo)

Warfarin Clincial Impact: GVOKE and GVOKE Vial Dx may increase the anticoagulant effect of warfarin. (notice Glucagon, Interactions médicamenteuses)

Griseofulvin decreases the activity of warfarin-type anticoagulants, so that patients receiving these drugs concomitantly may require dosage adjustment of the anticoagulant during and after griseofulvin therapy. (notice Griséofulvine, Interactions médicamenteuses)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Hydrocodone et ibuprofène, Mises en garde)

Intervention: Monitor coagulation indices in patients receiving ALKINDI SPRINKLE and concomitant warfarin to maintain the desired anticoagulant effect. (notice Hydrocortisone, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Ibuprofène, Mises en garde et précautions)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Ibuprofène et famotidine, Mises en garde et précautions)

Increased Bleeding Risk with Anticoagulants and Antiplatelet Agents: Some published studies with omega-3 fatty acids have demonstrated prolongation of bleeding time. (notice Icosapent éthyl, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Indométacine, Mises en garde et précautions)

Anticoagulants and Antiplatelet Drugs rivaroxaban cilostazol, coumarins, dabigatran Cilostazol: Concomitant administration of single doses of cilostazol 100 mg and ketoconazole 400 mg approximately doubled cilostazol concentrations and altered (increase/decrease) the concentrations of the active metabolites of cilostazol. (notice Kétoconazole, Interactions médicamenteuses)

Patients receiving Ketoprofen Capsules, USP who may be adversely affected by alterations in platelet function, such as those with coagulation disorders or patients receiving anticoagulants, should be carefully monitored. (notice Kétoprofène, Mises en garde et précautions)

In addition to past history of ulcer disease, 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. (notice Kétorolac, Mises en garde et précautions)

A significantly increased risk of DVT (7.4%) and of PE (3.7%) occurred in patients with MM after at least one prior therapy who were treated with REVLIMID and dexamethasone therapy compared to patients treated in the placebo and dexamethasone group (3.1% and 0.9%) in clinical trials with varying use of anticoagulant therapies. (notice Lénalidomide, Mises en garde et précautions)

Increased Risk of Bleeding : Concomitant use of NSAIDs, aspirin, other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (notice Lévomilnacipran, Mises en garde et précautions)

…Skyla with caution after careful assessment if any of the following conditions exist, and consider removal of the system if any of them arise during use: • Coagulopathy or use of anticoagulants • Migraine, focal migraine with asymmetrical visual loss or other symptoms indicating transient cerebral ischemia • Exceptionally severe headache • Marked increase of… (notice Lévonorgestrel, Mises en garde et précautions)

Oral Anticoagulants Levothyroxine increases the response to oral anticoagulant therapy. (notice Lévothyroxine, Interactions médicamenteuses)

Drug Interactions Oral Anticoagulants — Thyroid hormones appear to increase catabolism of vitamin K-dependent clotting factors. (notice Lévothyroxine et liothyronine, Interactions médicamenteuses)

Oral Anticoagulants Liothyronine sodium increases the response to oral anticoagulant therapy. (notice Liothyronine, Interactions médicamenteuses)

Also, bleeding and/or increased prothrombin time have been reported in a few patients taking coumarin anticoagulants concomitantly with lovastatin. (notice Lovastatine, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Méloxicam, Mises en garde et précautions)

Warfarin : Mercaptopurine tablets may decrease the anticoagulant effect. (notice Mercaptopurine, Interactions médicamenteuses)

Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect. (notice Méthylprednisolone, Interactions médicamenteuses)

DRUG INTERACTIONS Anticoagulants: C-17 substituted derivatives of testosterone, such as methandrostenolone, have been reported to decrease the anticoagulant requirements of patients receiving oral anticoagulants. (notice Méthyltestostérone, Interactions médicamenteuses)

Anticoagulants Metolazone, as well as other thiazide-like diuretics, may affect the hypoprothrombinemic response to anticoagulants; dosage adjustments may be necessary. (notice Métolazone, Interactions médicamenteuses)

Warfarin and Other Oral Anticoagulants : LIKMEZ can potentiate the anticoagulant effect. (notice Métronidazole, Interactions médicamenteuses)

Warfarin: Miconazole may enhance anticoagulant effect. (notice Miconazole, Interactions médicamenteuses)

Mifepristone should be used with caution in women who have hemorrhagic disorders or are receiving concurrent anticoagulant therapy. (notice Mifépristone, Mises en garde et précautions)

Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and other anticoagulants may add to this risk. (notice Milnacipran, Mises en garde et précautions)

Patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. (notice Minocycline, Interactions médicamenteuses)

Interacting Drug Interaction Warfarin Anticoagulant effect of warfarin may be enhanced. (notice Moxifloxacine, Interactions médicamenteuses)

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. (notice Nabumétone, Mises en garde)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Naproxène, Mises en garde et précautions)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Naproxène et ésoméprazole, Mises en garde et précautions)

Oral neomycin sulfate may enhance the effect of coumarin in anticoagulants by decreasing vitamin K availability. (notice Néomycine, Interactions médicamenteuses)

Caution should be observed when niacin extended-release tablets are administered concomitantly with anticoagulants; platelet counts should be monitored closely in such patients. (notice Niacine, Mises en garde et précautions)

Antithrombotics Coumarins: There have been rare reports of increased prothrombin time in patients taking coumarin anticoagulants to whom nifedipine was administered. (notice Nifédipine, Interactions médicamenteuses)

Anticoagulants Nintedanib is a VEGFR inhibitor and may increase the risk of bleeding. (notice Nintédanib, Interactions médicamenteuses)

Anticoagulants warfarin ↑↓ warfarin Closely monitor international normalized ratio (INR) if co-administration with warfarin is necessary. rivaroxaban ↑ rivaroxaban Increased bleeding risk with rivaroxaban. (notice Nirmatrelvir et ritonavir, Interactions médicamenteuses)

Warfarin Some quinolones have been reported to enhance the effects of the oral anticoagulant warfarin or its derivatives. (notice Ofloxacine, Interactions médicamenteuses)

Altered anticoagulant effects, including increased bleeding, have been reported when SNRIs or SSRIs are coadministered with warfarin [see Warnings and Precautions ( 5.16 )] . (notice Olanzapine et fluoxétine, Interactions médicamenteuses)

Anticoagulants including Warfarin Vitamin K absorption may be decreased with ORLISTAT. (notice Orlistat, Interactions médicamenteuses)

Hemorrhage : Increase frequency of monitoring in patients who are receiving oxaliplatin injection with fluorouracil/leucovorin and oral anticoagulants (5.9) (notice Oxaliplatine, Mises en garde et précautions)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Oxaprozine, Mises en garde et précautions)

Chronic oral acetaminophen use at a dose of 4,000 mg/day has been shown to cause an increase in international normalized ratio (INR) in some patients who have been stabilized on sodium warfarin as an anticoagulant. (notice Paracétamol, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy, concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Paracétamol et ibuprofène, Mises en garde et précautions)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, other antiplatelet drugs, warfarin, and other anticoagulant drugs may increase risk. (notice Paroxétine, Mises en garde et précautions)

DRUG INTERACTIONS Bleeding has been reported in patients treated with pentoxifylline extended-release tablets with or without concomitant NSAIDs, anticoagulants, or platelet aggregation inhibitors. (notice Pentoxifylline, Interactions médicamenteuses)

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. (notice Phénobarbital, hyoscyamine, atropine et scopolamine, Mises en garde)

…Corticosteroids, doxycycline, estrogens, furosemide, oral contraceptives, paroxetine, quinidine, rifampin, sertraline, theophylline, and vitamin D Drugs whose level is decreased by phenytoin Anticoagulants Apixaban, dabigatran, edoxaban, rivaroxaban Antiepileptic drugs The effect of phenytoin on phenobarbital, valproic acid and sodium valproate serum levels is unpredictable. (notice Phénytoïne, Interactions médicamenteuses)

Anticoagulants Phytonadione injectable emulsion may induce temporary resistance to prothrombin-depressing anticoagulants, especially when larger doses of phytonadione injectable emulsion are used. (notice Phytoménadione (vitamine K1), Interactions médicamenteuses)

Monitor coagulation parameters in patients receiving Piperacillin and Tazobactam for Injection and Sodium Chloride Injection and heparin or oral anticoagulants. (notice Pipéracilline et tazobactam, Interactions médicamenteuses)

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Piroxicam, Mises en garde et précautions)

In Trial 2, where anticoagulant therapies were mandated, thromboembolic events occurred in 8.0% of patients treated with POMALYST and low dose-dexamethasone (Low-dose Dex), and 3.3% of patients treated with high-dose dexamethasone. (notice Pomalidomide, Mises en garde et précautions)

Medications that increase the risk of bleeding (e.g., oral anticoagulants, chronic use of nonsteroidal anti-inflammatory drugs [NSAIDs], and fibrinolytic agents). (notice Prasugrel, Mises en garde et précautions)

Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect. (notice Prednisolone, Interactions médicamenteuses)

Anticoagulant agents: May enhance or diminish anticoagulant effects. (notice Prednisone, Interactions médicamenteuses)

Drug Interactions Anticoagulants (oral) : Due to the potential inhibition of vitamin K activity by propylthiouracil, the activity of oral anticoagulants (e.g., warfarin) may be increased; additional monitoring of PT/INR should be considered, especially before surgical procedures. (notice Propylthiouracile, Interactions médicamenteuses)

The anticoagulant effect of a single dose of warfarin (measured by prothrombin time) was not significantly changed by quinapril coadministration twice-daily. (notice Quinapril, Interactions médicamenteuses)

By a mechanism that is not understood, quinidine potentiates the anticoagulatory action of warfarin , and the anticoagulant dosage may need to be reduced. (notice Quinidine, Interactions médicamenteuses)

Warfarin and oral anticoagulants Cinchona alkaloids, including quinine, may have the potential to depress hepatic enzyme synthesis of vitamin K-dependent coagulation pathway proteins and may enhance the action of warfarin and other oral anticoagulants. (notice Quinine, Interactions médicamenteuses)

…Within Class Antiarrhythmics Disopyramide, mexiletine, quinidine, tocainide Antibiotics Chloramphenicol, clarithromycin, dapsone, doxycycline; Fluoroquinolones (such as ciprofloxacin) Oral Anticoagulants Warfarin Anticonvulsants Phenytoin Antimalarials Quinine Azole Antifungals Fluconazole, itraconazole, ketoconazole Antipsychotics Haloperidol Barbiturates Phenobarbital… (notice Rifapentine, Interactions médicamenteuses)

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. (notice Salsalate, Mises en garde)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.3 ) (notice Sertraline, Mises en garde et précautions)

Coumarin Anticoagulants: Obtain INR before ZOCOR initiation and monitor INR during ZOCOR dosage initiation or adjustment. (notice Simvastatine, Interactions médicamenteuses)

Anticoagulants: dabigatran etexilate ↑ dabigatran Clinical monitoring of dabigatran is recommended when coadministered with VOSEVI. (notice Sofosbuvir et velpatasvir, Interactions médicamenteuses)

Metronidazole has been reported to potentiate the anticoagulant effect of warfarin, and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time. (notice Sous-citrate de bismuth, métronidazole et tétracycline, Mises en garde et précautions)

Drug Interactions Administration of a sulfonamide may increase the effect of oral anticoagulants and methotrexate, probably by displacement of these drugs from binding sites on plasma albumin. (notice Sulfadiazine, Interactions médicamenteuses)

It has been reported that sulfamethoxazole and trimethoprim may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. (notice Sulfaméthoxazole et triméthoprime, Interactions médicamenteuses)

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. (notice Sulindac, Mises en garde)

Other factors that increase the risk for gastrointestinal bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (notice Sumatriptan et naproxène, Mises en garde et précautions)

…hemorrhagic ophthalmic conditions Septic thrombophlebitis or occluded AV cannula at seriously infected site Advanced age [see Use in Specific Populations (8.5) ] Patients currently receiving anticoagulants (e.g., warfarin sodium) Any other condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of its location. (notice Ténectéplase, Mises en garde et précautions)

Frequent monitoring of INR and prothrombin time may be necessary in patients taking anticoagulants, especially at the initiation and termination of androgen therapy. (notice Testostérone, Interactions médicamenteuses)

Because the tetracyclines have been shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage. (notice Tétracycline, Interactions médicamenteuses)

Drug Interactions Anticoagulants (oral): Due to potential inhibition of vitamin K activity by methimazole, the activity of oral anticoagulants (e.g., warfarin) may be increased; additional monitoring of PT/INR should be considered, especially before surgical procedures. β-adrenergic blocking agents: Hyperthyroidism may cause an increased clearance of beta blockers… (notice Thiamazole, Interactions médicamenteuses)

The following drug interactions were reported for metronidazole, a chemically-related nitroimidazole and may therefore occur with tinidazole: Warfarin and other oral coumarin anticoagulants: Anticoagulant dosage may need adjustment during and up to 8 days after tinidazole therapy ( 7.1 ) (notice Tinidazole, Interactions médicamenteuses)

Concomitant use of fibrinolytics, anticoagulants and antiplatelet drugs increases the risk of bleeding. (notice Tirofiban, Mises en garde et précautions)

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. (notice Tolmétine, Mises en garde)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (notice Trazodone, Mises en garde et précautions)

Therefore, coagulation indices should be monitored frequently to maintain the desired anticoagulant effect. (notice Triamcinolone, Interactions médicamenteuses)

The effect of oral anticoagulants may be decreased when used concurrently with hydrochlorothiazide; dosage adjustments may be necessary. (notice Triamtérène et hydrochlorothiazide, Interactions médicamenteuses)

Concomitant use of aspirin, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), warfarin, and other anticoagulants may add to this risk. (notice Venlafaxine, Mises en garde et précautions)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.3 ) (notice Vilazodone, Mises en garde et précautions)

La vitamine E peut inhiber l'agrégation plaquettaire et la coagulation dépendante de la vitamine K, ce qui accroît le risque de saignement avec les médicaments anticoagulants et antiagrégants plaquettaires. (NIH Office of Dietary Supplements, Vitamin E)

Warfarin (CYP2C9 Inhibition) Other Oral Coumarin Anticoagulants (CYP2C9/3A4 Inhibition) Prothrombin Time Significantly Increased Not Studied In Vivo or In Vitro for other Oral Coumarin Anticoagulants, but Drug Plasma Exposure Likely to be Increased If patients receiving coumarin preparations are treated simultaneously with voriconazole, the prothrombin time or… (notice Voriconazole, Interactions médicamenteuses)

Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, and other anticoagulants may add to this risk. (notice Vortioxétine, Mises en garde et précautions)

In clinical trials in patients undergoing PCI/ percutaneous transluminal coronary angioplasty (PTCA), coadministration of bivalirudin with heparin, warfarin, thrombolytics, or GPIs was associated with increased risks of major bleeding events compared to patients not receiving these concomitant medications. (notice Bivalirudine, Interactions médicamenteuses)

Patients on oral warfarin anticoagulant therapy and zafirlukast should have their prothrombin times monitored closely and anticoagulant dose adjusted accordingly (see PRECAUTIONS, Drug Interactions ). (notice Zafirlukast, Mises en garde)

Les compléments d'ail peuvent accroître le risque de saignement avec les anticoagulants tels que la warfarine. (NCCIH, Garlic)

Use with Warfarin: IMURAN may inhibit the anticoagulant effect of warfarin. (notice Azathioprine, Interactions médicamenteuses)

Interaction studies with warfarin and acenocoumarol have failed to identify any clinically important effects of benazepril on the serum concentrations or clinical effects of these anticoagulants. (notice Bénazépril et hydrochlorothiazide, Interactions médicamenteuses)

Anticoagulants: Direct Oral Anticoagulants (DOACs) rivaroxaban dabigatran edoxaban ↑ DOAC Refer to the DOAC prescribing information for concomitant administration with moderate CYP3A inhibitors and/or P-gp inhibitors. (notice Bictégravir, emtricitabine et ténofovir alafénamide, Interactions médicamenteuses)

Oral Anticoagulants Although clinical studies have not established a cause and effect relationship, physicians should be aware that variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants and chlordiazepoxide hydrochloride, a component of Librax. (notice Chlordiazépoxide et clidinium, Interactions médicamenteuses)

Chlorpromazine diminishes the effect of oral anticoagulants. (notice Chlorpromazine, Précautions)

More patients experienced clinically significant INR elevations (≥5) usually within 1 week after starting dronedarone versus placebo in patients taking oral anticoagulants in ATHENA. (notice Dronédarone, Interactions médicamenteuses)

Consequently, interactions with other drugs which are highly protein bound (e.g., anticoagulants ) would not be expected. (notice Flécaïnide, Interactions médicamenteuses)

Anticoagulant: Warfarin Concentrations of warfarin may be affected. (notice Fosamprénavir, Interactions médicamenteuses)

In a pharmacokinetic interaction study with warfarin, bioavailability parameters, the degree of protein binding, and the anticoagulant effect (measured by prothrombin time) of warfarin were not significantly changed. (notice Fosinopril, Interactions médicamenteuses)

Interaction studies with warfarin have failed to identify any clinically important effects of fosinopril on the serum concentration or clinical effects of the anticoagulant. (notice Fosinopril et hydrochlorothiazide, Interactions médicamenteuses)

Les compléments d'oméga-3 peuvent légèrement allonger le temps de saignement ; l'association avec des anticoagulants tels que la warfarine justifie une surveillance, bien que des saignements cliniquement significatifs n'aient pas été démontrés de façon constante. (NIH Office of Dietary Supplements, Omega-3 Fatty Acids)

Anticoagulants: Direct Oral Anticoagulants (DOACs) rivaroxaban dabigatran edoxaban ↑ DOAC Refer to the DOAC prescribing information for concomitant administration with moderate CYP3A inhibitors and/or P-gp inhibitors. (notice Lénacapavir, Interactions médicamenteuses)

Anticoagulants: warfarin, rivaroxaban ↑↓ warfarin ↑ rivaroxaban Concentrations of warfarin may be affected. (notice Lopinavir et ritonavir, Interactions médicamenteuses)

Nevertheless, the effects of mefloquine on travelers receiving concomitant medications, particularly diabetics or patients using anticoagulants, should be checked before departure. (notice Méfloquine, Interactions médicamenteuses)

Barbiturates may influence the metabolism of other concomitantly used drugs, such as phenytoin, halothane, anticoagulants, corticosteroids, ethyl alcohol, and propylene glycol-containing solutions. (notice Méthohexital, Interactions médicamenteuses)

In a large compassionate use program mexiletine has been used concurrently with commonly employed antianginal, antihypertensive, and anticoagulant drugs without observed interactions. (notice Mexilétine, Interactions médicamenteuses)

Oral Anticoagulants: Interaction studies with warfarin failed to identify any clinically important effect on the serum concentrations of the anticoagulant or on its anticoagulant effect. (notice Moexipril, Interactions médicamenteuses)

Phenothiazines can diminish the effect of oral anticoagulants. (notice Prochlorpérazine, Précautions)

The anticoagulant effect of warfarin was not significantly changed by trandolapril. (notice Trandolapril, Interactions médicamenteuses)

Phenothiazines may diminish the effect of oral anticoagulants. (notice Trifluopérazine, Précautions)

Investigations into the effect of acitretin on the protein binding of anticoagulants of the coumarin type (warfarin) revealed no interaction. (notice Acitrétine, Interactions médicamenteuses)

Warfarin In a study conducted in 16 male volunteers, anastrozole did not alter the exposure (as measured by C max and AUC) and anticoagulant activity (as measured by prothrombin time, activated partial thromboplastin time, and thrombin time) of both R- and S-warfarin. (notice Anastrozole, Interactions médicamenteuses)

Anticoagulants Interaction studies in humans have shown bumetanide to have no effect on warfarin metabolism or on plasma prothrombin activity. (notice Bumétanide, Interactions médicamenteuses)

Warfarin A clinical study has shown that fesoterodine 8 mg once daily has no significant effect on the pharmacokinetics or the anticoagulant activity (PT/INR) of warfarin 25 mg. (notice Fésotérodine, Interactions médicamenteuses)