Drug interactions
Cefoxitin + Warfarin
Severity: Moderate
Cefoxitin 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, with a risk of bleeding, especially in ill or malnourished patients. Cefoxitin lacks the N-methylthiotetrazole side chain, so the risk is probably lower than with some other cephalosporins, but antibiotic therapy generally destabilizes INR.
What this interaction means in plain words
Cefoxitin 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.
Cefoxitin belongs to Anti Bacterial; Warfarin belongs to Cardiovascular.
Why it happens
Probable reduction of vitamin K-producing gut flora, with possible additional effects on vitamin K-dependent clotting factor synthesis; not fully established.
What to do
Check INR within a few days of starting cefoxitin and again after stopping it. Adjust the warfarin dose according to INR 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 Cefoxitin
- Amikacin + Cefoxitin Moderate
- Aztreonam + Cefoxitin Moderate
- Bcg vaccine live + Cefoxitin Moderate
- Cefoxitin + Chloramphenicol Moderate
- Cefoxitin + Cholera vaccine Moderate
- Cefoxitin + Dexamethasone-tobramycin 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 Cefoxitin with Warfarin?
MediHelp rates the interaction as moderate. Cefoxitin 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, with a risk of bleeding, especially in ill or malnourished patients. Cefoxitin lacks the N-methylthiotetrazole side chain, so the risk is probably lower than with some other cephalosporins, but antibiotic therapy generally destabilizes INR.
How serious is the interaction between Cefoxitin 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 cefoxitin and again after stopping it. Adjust the warfarin dose according to INR and watch for bleeding.
What other medicines interact with Cefoxitin?
MediHelp also lists interactions of Cefoxitin with, for example, Amikacin, Aztreonam, Bcg vaccine live. The full list is on the Cefoxitin page.
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