Drug interactions
Canakinumab + Warfarin
Severity: Moderate
Canakinumab and Warfarin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Chronic inflammation suppresses CYP450 enzyme expression, and blocking interleukin-1 with canakinumab may restore normal enzyme activity. This could increase warfarin clearance and lower the INR, reducing anticoagulant effect.
What this interaction means in plain words
Canakinumab and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Canakinumab belongs to Miscellaneous; Warfarin belongs to Cardiovascular.
Why it happens
Interleukin-1 blockade reverses cytokine-mediated downregulation of CYP450 enzymes, increasing warfarin metabolism.
What to do
Check INR more often after starting or stopping canakinumab. Adjust the warfarin dose to keep the INR in range.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Canakinumab
- Adalimumab + Canakinumab Major
- Anakinra + Canakinumab Major
- Baricitinib + Canakinumab Major
- Basiliximab + Canakinumab Major
- Canakinumab + Etanercept Major
- Canakinumab + Golimumab Major
Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Canakinumab with Warfarin?
MediHelp rates the interaction as moderate. Canakinumab and Warfarin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Chronic inflammation suppresses CYP450 enzyme expression, and blocking interleukin-1 with canakinumab may restore normal enzyme activity. This could increase warfarin clearance and lower the INR, reducing anticoagulant effect.
How serious is the interaction between Canakinumab and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR more often after starting or stopping canakinumab. Adjust the warfarin dose to keep the INR in range.
What other medicines interact with Canakinumab?
MediHelp also lists interactions of Canakinumab with, for example, Adalimumab, Anakinra, Baricitinib. The full list is on the Canakinumab page.
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