Drugs interact with warfarin, adapted from MicroMedex. (Updating)
Level Generic Trade Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 1 Abciximab Reopro G . F R Y 2 Acarbose . U . P D Y 2 Acemetacin . E . P D Y CC117 Alkylated testostero . . Steroid, anabo lic . . YCC 6 Mercaptopurine . . Oncology, alkylate . . . Y 2Acetominaphen Tylenol, Panadol, Tem pra F Analgesic G D. Y2 Alclofenac . E . P D Y 2 Alcohol . F Alcohol F D Y Y 2Allopurinol Zyloprim, Purinol U Gout Rx P D Y1 Alteplase Activase G . F R Y 2Aminoglutethimide Cytraden F Steroid Rx F D Y CC2Aminoglycosides Amikacin(Amikin), Gentamycin (Geramycin) Kanamycin( Kantrex), Netimycin( Netromycin), Spectinomycin(Trobycin) Streptomycin, Tobramycin(Nebcin)
. Antibiotic . . . Y CCAminosalicylic acid Paser . . . . Y 2Amiodarone Cordarone, Pacerone F Antiarrhythmic E D Y2 Amitriptyline . A,F . F D Y 2Amobarbital . F Barbiturate E D . Y2 Amoxapine . A,F . F D Y 2 Amprenavir . F . P D Y 0 Antacid . . . . . 2 Apazone . D . P D Y 2 Aprobarbital . F . G D Y 2 Argatroban . M . P D Y 0 Ascorbic acid . . . . . 1 Aspirin, ASA Anacin, Ascriptin, Alka-Seltzer, Allerest, Aspergum, Bromo-Seltzer, Bufferin, Congestin, Coricidin, Cough/cold remedies, Darvon compound, Dristan E aspirin, Ecotrin, Empirin compound, Excedrin, Fiorinol, Fizrin, Nytol, Pepto-Bismol, Percodan, Sominex, Vanquish, Zactrin, Zorprin, others. D,F Analgesic E D Y0 Atorvastatin . . . . . 2 Azathioprine Imuran A,F Immunosuppres sion P D . Y2 Azithromycin Zithromax F Antibiotic F D Y. 0 Benazepril . . . . . 2 Benoxaprofen . E . F D Y 2 Benzbromarone . F . G D Y 2 Bicalutamide . D . P D Y 2 Bismuth subsalicy late . D . F D Y 2 Bivalirudin . U . P D Y 1 Boldo . U . P D Y 2 Bosentan . F . F R Y 2 Bromfenac . E . P D Y 2 Bufexamac . E . P D Y 2 Butabarbital Butisol F Barbiturate E D Y2 Butalbital Fiorinal, (more) F Barbiturate G D Y. Level of interaction: 1 = Strong, 2 = Moderate, 3 = Mild, CC = Need update, Mechanism of interaction: A = Absorbtion, B = Clearance, C = Induction, D = PB replacement, E = Platelet aggregation, F = Metabolism alteration, G = Additive, H = Decrease synthesis, M = Miscellaneous, U = Unknown. Documentation E= Exellent, G = Good, F = Fair, P = Poor. . Onset of interaction ( R = Rapid, D = Delay}, Change Warfarin dosage change. Increase INR. Decrease INR
Level Generic Trade Name Mecha- nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 2 Calcium channel blockers . G . P D Y 0 Candesartan . . . 1 Capecitabine Xeloda U . F D Y 2 Capsaicin E . F R Y 2Carbarmazepine Tegatrol FAnticonvulsant F D Y2 Carprofen . E . P D Y 2 Castor oil . A . P Y 2 Cefamandole Mandol E,H Antibiotic F D Y2 Cefazolin Ancef, Kefzol H Antibiotic F D Y2 Cefoperazone Cefobid E,H Antibiotic F D Y2 Cefoperazone/ sulbactam . E . F D Y 2 Cefotetan Cefotan E,H Antibiotic P D YCC Cefoxitin Mefoxin . Antibiotic . YCC Ceftriaxone Rocephin . Antibiotic . Y2 Celecoxib Celebrex F Cox 2 inhibitor E D Y0 Cerivastatin . . . CC2Cephalosporins . . Antibiotic . Y3 Chamomile . G . P D Y CC Chenodiol . . . . YCC Chlopropamide Diabenese . Diabetic . Y 2Chloral hydrate Noctec DHypnotic P R Y 2Chloramphenicol Chloromycetin FAntibiotic F D Y2 Chlordiazepoxide Libruim U Antianxiety P D Y2 Chlordiazepoxide / Amitriptyline . U . P D 0 Chlorothiazide . . . 2 Chloroguanide . U . P D Y 2 Chlorotrianisene . U . P D Y 2 Chlorpromazine . U . P D ? Chlorthalidone Hygroton . Diuretic P . Y 2Cholestyramine Questran ALipid Rx G D Y0 Cilostazol . . . 2Cimetidine Tagamet FUlcer, H2 blocker E D Y2 Ciprofloxacin Cipro U Antibiotic P D Y2 Cisapride . U . P D Y 2 Clarithromycin . F . F D 2Clofibrate .Astromid-S ULipid Rx E D Y2 Clomipramine . A,F . F D Y 2 Clopidogrel . G . P D Y 2 Cloxacillin . U . P D Y 1 Coenzyme Q10 . Vit K2 . P D Y 0 Colestipol Cholestid .Lipid Rx . 2 Cotrimoxazole . D,F . G D Y CC Contraceptives, oral . . Contraceptive . . YCC Corticotropin . . Steroid, adreno . YCC Cortisone . . Steroid, adreno . . Y2 Curcumin . E . P D Y CC Cyclophospha mide Cytoxan . Oncology . Y Y0 Cycloserine . . . 2 Cyclosporine Sandimmune, Neoral U Immunosup pression P D Y. Level of interaction: 1 = Strong, 2 = Moderate, 3 = Mild, CC = Need Update. Mechanism of interaction: A = Absorbtion, B = Clearance, C = Induction, D = PB replacement, E = Platelet aggregation, F = Metabolism alteration, G = Additive, H = Decrease synthesis, M = Miscellaneous, U = Unknown. Documentation E= Exellent, G = Good, F = Fair, P = Poor. . Onset of interaction ( R = Rapid, D = Delay}, Change Warfarin dosage change. Increase INR. Decrease INR
Level Generic Trade Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 2 Danaparoid E F R Y 2 Danazol Danocrine F OB/GYN G D Y 2 Danshen F F D Y 2 Delavirdine F P D Y 2 Demeclocycline U ? D Y 2 Desipramine F F D Y CC Dextran . . Volume . . Y . CCDextrothyroxin . . Thyroid . . Y .2 Diazoxide Hyperstat DAntihyperten P R . Y .2 Diclofenac Cytotec E P D Y 2Dicloxacillin Dynapen FAntibiotic G D . . YCC Dicoumarol . . Anticoagulant . . Y .2 Diethylstilbestrol U P D Y 3Diflunisal Dolobid . NSAID . . Y . .Digoxin immune Fab Digibind . . . . Y .0 Diphenhydramine 2 Dipyrone E P D Y 2 Dirithromycin P D Y 2Disopyramide Norpace UAntiarrhythmic P D . . Y 2Disulfiram Antabuse FAlcohol Rx F D . Y .CC Doclofenac . . . . . Y .0 Dofetilide 1 Dong Quai U P D Y 2 Dothiepin F F D Y 2 Doxepin A,F F D Y 2 Doxycycline Vibramycin, Doryx U Antibiotic P D . Y .2 Droxicam E F D Y 2 Enoxacin P D Y CC1 Eptifibatide G P D Y 2Erythromycin E-mycin, EES, Ilosone FAntibiotic F D . Y .2 Erythromycin/ sulfisoxazole F F D Y 0 Esmolol 2 Estrogens U P D 2 Ethacrynic acid Edecrin D Diuretic P D . Y . CC3Ethanol . . Alcohol . . Y . 2Ethchlorvynol Placidyl U . P D . . Y2 Ethinyl Estradiol U P D Y Y 2 Etidronate U P D Y 2 Etodolac D,E F D 0 Etoposide . . Oncology . . . 2Etretinate Tegison U . P D . . Y2 Evening Primrose Oil P R Y 2 Felbamate F P D Y 2 Fenbufen E F D 2 Fenofibrate U P D Y 2 Fenoprofen Nelfon E NSAID F D . Y .1 Fenugreek U P D Y 2 Feverfew E P D Y 0 Fish Oil 2 Floctafenine E P D Y 2 Flosequinan U P D Y CC Floxetine . . . . Y . 2Fluconazole . F Antifungal G D . Y .2 Flufenamic Acid E P D Y 2Fluorouracil . F Oncology G D . Y .2 Fluoxetine F F D Y 2 Fluoxymesterone U F D Y 2 Flurbiprofen E P D Y 2 Flutamide U P D Y 2 Fluvastatin U P D Y 2 Fluvoxamine Luvox F Antidepressant F D . Y .2 Fosphenytoin D F D 0 Furosemide
Level Generic Brand Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 1 Garlic G F D Y 2 Gatifloxacin U P D Y 2 Gemcitabine F,H P R Y 2Gemfibrozil Lopid D,F Lipid Rx P D . Y .0 Gemifloxacin 2 Ginger G P R Y 1 Ginkgo G F D 2 Ginseng E P D 2Glucagon . H . P D . Y . 2Glutethimide . F. G D . . YCC Glipizide .Glyburide DiaBeta, Glynase, Micronase, Glucovance . Diabetic . . Y .2 Green Tea P D Y Grepafloxacin U P D Y 2Griseofulvin . U Antifungal F D . Y .. CC Haloperidol Haldol . Antipsychotic . . . Y2 Halothane Fluothane D . P R . Y .2 Heparin . G Anticoagulant G R . Y .2 Heptabarbital F G D Y 2 Hexobarbital F G D Y 2 Ibuprofen . E NSAID F D . Y . 2Ifosfamide Ifex U Oncology, alka F D . Y .2 Imipramine U F D 2 Indomethacin . E NSAID P D . Y .2 Indoprofen E F D Y 2Influenza virus vaccine . UVaccine D . Y .CC Interferon . FAntiviral . . Y .0 Irbesartan 2Isoniazid . UAntimycobacte riu P D . Y .2 Isoxicam F D Y 2 Itraconazole Sporanox . Antifungal P D . Y .. 2Ketoconazole Nizoral F Antifungal P D . Y . 2Ketoprofen Orudis . NSAID F D . Y .2 Ketorolac Toradol . Analgesic P D . Y .. 2 Lepirudin G F R Y 2 Levamisole Ergamisol F Oncology F D . Y .2 Levofloxacin U P D Y 2 Levonorgestrel U P D CC Levothyroxin Synthroid . Thyroid . . Y .CC Liothyronine Cytomel, Triostat . Thyroid . . Y .2 Lornoxicam F F D Y 0 Losartan 2 Lovastatin Mevacor U. Lipid Rx P D . Y .2 Low Molecular Weight Heparin G F R Y . Level of interaction: 1 = Strong, 2 = Moderate, 3 = Mild, CC = Need update. Mechanism of interaction: A = Absorbtion, B = Clearance, C = Induction, D = PB replacement, E = Platelet aggregation, F = Metabolism alteration, G = Additive, H = Decrease synthesis, M = Miscellaneous, U = Unknown. Documentation E= Exellent, G = Good, F = Fair, P = Poor. . Onset of interaction ( R = Rapid, D = Delay}, Change Warfarin dosage change. Increase INR. Decrease INR
Level Generic Brand Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 2 Meclofenamate Meclomen E P D Y 2 Medroxyproges terone P D Y 2 Mefenamic acid Ponstel E . P D . Y .2 Meloxicam E P D Y 0 Meprobamate Miltown, Equagesic, Equanil . Antianxiety . . . Y2 Mercaptopurine U P D Y 2 Mesalamine U P D Y 2 Mestranol U P D 2 Methandrosteno lone U G D Y CC Methimazole Tapazole . Thyroid Rx . . Y YCC Methyldopa Aldomet . Antihypertensive . . Y. CC Methylphenidate Ritalin . CNS stimulant . . Y. 2 Methyl Salicylate
. F NSAID F D . Y. 2 Methylpredniso lone U F D Y Y 2 Methyltestoste rone U G D Y 0 Metolazone 2Metronidazole Flagyl F Antiparasite F D . Y. 2Miconazole Monistat B,D Antifungal F D . Y. CC2 Mineral oil P ? ? 2 Minocycline U P D Y 2Mitotane Lysodren F Oncology P D . Y. 2 Moricizine HCL Ethmozine U Antiarrhythmic P D . YY 2 Moxalactam E P D Y 2 Moxifloxacin U P D Y . 2 Nabumetone D.E F D Y 2 Nafcillin Unipen F Antibiotic F D . .Y 2 Nalidixic acid NegGram D Antibiotic P D . Y. 1 Nandrolone U P D 2 Naproxen . E NSAID P D . Y. 2 Neomycin . U Antibiotic P D . Y. 2 Nilutamide F P D Y 2 Nimesulide U P D Y 1NSAID (Naproxen) Aleve, Naprosyn, Anaprox. (Ketoprofen) Orudis, Actron. (Ibuprofen) Advil, Motrin, Nuprin, Medipren, Excedrin IB, Haltran, Midol 200, Pamprin-IB, Trendar, Rufen. Catafram, Clinoril, Daypro, Dolobid, Feldene, Indocin, Lodine, Nalforn, Naplelan, Oruvail, Ponstel, Relafen, tolectin, Tradin, Voltaren,
. NSAID . . Y .2 Norelgestromin U P D Y Y 2 Norethindrone U P D Y Y 2. Norfloxacin Chibroxin, Noroxin U Antibiotic P D . Y. 2 Norgestrel U P D Y Y 2 Nortriptyline A,F F D Y . 2 Ofloxacin Floxin U Antibiotic P .D . Y .2 Olsalazine Dipentum . Colitis Rx P . . Y . 2Omeprazole Prilosic FUlcer Rx, proton P D . Y .3 Orlistat P 2 Oxandrolone U F D Y 2 Oxaprozin Daypro E NSAID P D . Y .2 Oxymetholone . U . G D . Y .2 Oxyphenbuta zone D,F G D Y 2 Oxytetracycline U P D Y . Level of interaction: 1 = Strong, 2 = Moderate, 3 = Mild, CC = Need update. Mechanism of interaction: A = Absorbtion, B = Clearance, C = Induction, D = PB replacement, E = Platelet aggregation, F = Metabolism alteration, G = Additive, H = Decrease synthesis, M = Miscellaneous, U = Unknown. Documentation E= Exellent, G = Good, F = Fair, P = Poor. . Onset of interaction ( R = Rapid, D = Delay}, Change Warfarin dosage change. Increase INR. Decrease INR
Level Generic Brand Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA 1 Papaya P D Y CC Paraldehyde . . . . . . Y2 Paroxetine Paxil U Antidepressant P D . Y . CC3Penicillin G, IV . . Antibiotic . . Y .Pentobarbital Nembutal . Barbiturate . . . YPentoxifylline Trental . . . . Y .2 Perphenazine/ Amitripdtyline U P D 2 Phenobarbital Donnatal F Barbiturate E D . . Y 2Phenylbutazone . F/DGout Rx E D . Y . 2Phenytoin Dilantin D,FAnticonvulsant F D . Y Y2 Phytonadione
E D Y 0 Pioglitazone Piperacillin Pipracil, Zosyn . Antibiotic . . Y .2 Piracetam U P D Y .Piroxicam Feldine E NSAID F D . Y .2 Pirozolac E P D Y 2 Pirprofen E P D Y 0 Pravastatin Prednisone . . Steroid, adreno . . Y Y2 Primidone Mysoline F Anticonvulsant G D . . Y 2Propafenone Rhythmol BAntiarrhythmic F D . Y . 2Propoxyphene Darvon U Analgesic P D . Y .2 Propranolol Inderal U Beta blocker P D . Y .2 Propyphenazone E P D Y CC Propylthiouracil . KThyroid Rx . . Y Y2 Proquazone E P D Y 2 Protriptyline A F D Y 2 Quetiapine F P D Y 0 Quinapril 2Quinidine . . Antiarrhythmic F D . Y .2 Quinine G P D Y CCQuinolones . . . . . . .2 Raloxifene P R 2 Ranitidine Zantac F Ulcer, H2 blocker F D . Y2 Reteplase G F R Y 2 Rifabutin G D 2Rifampin Rimactane, Rifadin F Antimycobacte rium E D . . Y2 Ritonavir F F D Y 2 Rofecoxib Vioxx U Cox 2 inhibitor P R . Y .2 Roxithromycin F P D Y 2Salicylates . E NSAID F D . Y .2 Saquinavir F P D Y 2 Secobarbital Seconal F Barbiturate E D . . YCC Serotonin uptake inh (Serzone) Nefazodone, (Trazodone) Desyrel . Antidepressant . . . .CC Sertraline Zoloft . Antidepressant . . Y .2 Simvastatin Zocor FLipid Rx P D . Y .2 Skullcap E P R Y 0 Sotalol 2Spironolactone Aldactone M. P D . Y
1 St John's Wort F P D Y 2 Stanozolol Winstrol U. . F D . Y .2 Streptokinase Streptase G Antithrombotic P D . Y . 2Sucralfate Carafate A Ulcer Rx F D . . Y2 Sulfamethizole . . Antibiotic P D . Y .2 Sulfamethoxa zole Bactrim, Septra D,F Antibiotic G D . Y . CCSulfapyrazone Anturane . Antiplatelet . . Y .CC Sulfasalazine Y 2 Sulfipyrazone E D Y 2 Sulfisoxazole Gantrisin D,F Antibiotic F D . Y . CC2sulfonamides . F/DAntibiotic . . Y .2 Sulindac Clinoril E NSAID F D . Y .2 Sulofenur U P D Y 2 Suprofen E P D Y
Level Generic Brand Name Mecha nism ClassDoc On set Cha nge Inc DecAAA AAAAAAAAAA AAAAAAAAAAAAAAA AAA AAAAAAAAA AA AA AA AA AA CC2sulfonamides . F/DAntibiotic . . Y .2 Sulindac Clinoril E NSAID F D . Y .2 Sulofenur U P D Y 2 Suprofen E P D Y 2 Sulfamethizole . . Antibiotic P D . Y .2 Sulfamethoxa zole Bactrim, Septra D,F Antibiotic G D . Y . CCSulfapyrazone Anturane . Antiplatelet . . Y .CC Sulfasalazine Y 2 Sulfipyrazone E D Y 2 Sulfisoxazole Gantrisin D,F Antibiotic F D . Y . CC2sulfonamides . F/DAntibiotic . . Y .2 Sulindac Clinoril E NSAID F D . Y .2 Sulofenur U P D Y 2 Suprofen E P D Y 1Tamoxifen Nolvadex UOndology F D . Y .2 Tamsulosin P D ? ? CC Telmisartan P D CC Temafloxacin 2 Tenidap D P D Y 2 Tenoxicam E P D Y CC Terbinafine U F D 2 Testosterone U F D Y 2Tetracyclines (Doxycycline) Vibramycin U Antibiotic P D . Y . CC3Thiazide diuretics . . Diuretic . . . . CC2Thioamines . . . . . Y . CC3Thiopurines . . . . . . . 2Thyroid hormones . Vit K Thyroid G D . Y .2 Tiaprofenic Acid E P D Y 2 Tibolone U P D Y CC Ticarcillin Ticar, Timentin Antibiotic . . Y .2 Ticlopidine Ticlid E,FAntiplatelet P D . Y .2 Tobacco F P D Y Y CC0 TolbutamideAAA Orinase Diabetic 2 Tolmetin E P D Y 2 Tolterodine F P D Y 2 Toremifene U P R Y CC t-PA . G Antithrombotic R Y .2 Tramadol U P D Y 2 Trastuzumab U P D Y CCTrazodone Desyrel Antidepressant .CC Tricyclic antidepressant Elavil, Sinequan, Tofranil Antidepressant Y .CC Trimethoprim-sulfameth Bactrim, Septra FAntibiotic Y .2 Trimipramine A,F F D Y 2 Troglitazone F P D Y .Urokinase Abbokinase . Antithrombotic Y .. 2 Valdecoxib F F D Y CC3Valproic acid Depakene, Depakote, Depacon DAnticonvulsant Y .0 Valsartan 2 Vancomycin U F D Y Vitamin A U P D Y CC Vitamin C, high dose . . Vitamin . Y 2Vitamin E . U Vitamin P D Y . 1Vitamin K . Vitamin . Y2 Zafirlukast F P D Y 2 Zileuton B P D Y 2 Zomepirac E P D Y Zotepine U F R Y . Level of interaction: 1 = Strong, 2 = Moderate, 3 = Mild, CC = Need update. Mechanism of interaction: A = Absorbtion, B = Clearance, C = Induction, D = PB replacement, E = Platelet aggregation, F = Metabolism alteration, G = Additive, H = Decrease synthesis, M = Miscellaneous, U = Unknown. Documentation E= Exellent, G = Good, F = Fair, P = Poor. . Onset of interaction ( R = Rapid, D = Delay}, Change Warfarin dosage change. Increase INR. Decrease INR