Drug interactions
Cefixime + Warfarin
Severity: Moderate
Cefixime 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
Cephalosporins can increase the anticoagulant effect of warfarin and raise INR in some patients, increasing the risk of bleeding. Infection itself, reduced food intake and antibiotic effects on gut flora also contribute to this change.
What this interaction means in plain words
Cefixime 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.
Cefixime belongs to Anti Bacterial; Warfarin belongs to Cardiovascular.
Why it happens
Probably reduced vitamin K availability from gut flora suppression, with the contribution of the acute illness; direct effect on warfarin metabolism is not established.
What to do
Check INR within a few days of starting cefixime and again during and after the course. Reduce the warfarin dose if INR rises and watch for bleeding.
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 Cefixime
- Cefixime + Typhoid vaccine live Major
- Cefixime + Cholera vaccine Moderate
- Cefixime + Kanamycin Moderate
- Cefixime + Microbiota Moderate
- Cefixime + Plazomicin Moderate
- Cefixime + Sodium picosulfate / magnesium oxide / anhydrous citric acid Moderate
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 Cefixime with Warfarin?
MediHelp rates the interaction as moderate. Cefixime 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. Cephalosporins can increase the anticoagulant effect of warfarin and raise INR in some patients, increasing the risk of bleeding. Infection itself, reduced food intake and antibiotic effects on gut flora also contribute to this change.
How serious is the interaction between Cefixime 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 within a few days of starting cefixime and again during and after the course. Reduce the warfarin dose if INR rises and watch for bleeding.
What other medicines interact with Cefixime?
MediHelp also lists interactions of Cefixime with, for example, Typhoid vaccine live, Cholera vaccine, Kanamycin. The full list is on the Cefixime page.
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