Table 1 – Antibiotic Class Interactions with Warfarin . through other mechanisms (e.g. platelet function), can interact with warfarin without changing the INR. Alterations in INR are common among patients who receive antibiotics, noted the study, especially those prescribed antibiotics at high risk of interacting with warfarin: trimethoprim/sulfamethoxazole (TMP/SMX), metronidazole, fluconazole, ciprofloxacin, levofloxacin, azithromycin, and clarithromycin. Many antibiotics and related medications, including azole antifungal agents, heighten warfarin's blood-thinning ability and raise the risk of internal bleeding. Some antibiotics, such as rifampin, decrease warfarin's ability to "thin" the blood, increasing the risk a blood clot will form.
The primary mechanisms by which antibiotic medications interact with warfarin to increase the risk of major bleeding is through disruption of intestinal flora that synthesize vitamin K,2 and inhibition of cytochrome p isozymes which metabolize warfarin. Conclusion - Discussion. Prescribers must consider how adding and removing medications will affect a patient's INR. Medications that interact with warfarin often have a. Warfarin (Coumadin) can reportedly interact with more than different Other antibiotics shown to interact with warfarin include fluconazole.
Almost all antibiotics can potentiate the effects of warfarin by inhibiting .. Several cases of serious or fatal reactions have occurred when. Among antibiotics, those interfering with warfarin metabolism posed the of patients receiving warfarin and antibiotics not thought to interact. Cephalosporins possess inherent anticoagulant properties and may increase bleeding risk. Chloramphenicol. Chloromycetin. Moderate. Increases. Drugs that possibly can interact with warfarin, especially in elderly patients and those on multiple medications, include quinolones, omeprazole.