Drug interactions
Dienogest / estradiol valerate + Warfarin
Severity: Moderate
Dienogest / estradiol valerate 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
Estrogen-containing products alter clotting factor synthesis and can change warfarin response, and they also increase thrombotic risk. The INR effect is inconsistent, and the combination raises concern in patients needing anticoagulation.
What this interaction means in plain words
Dienogest / estradiol valerate 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.
Why it happens
Estrogens increase hepatic synthesis of clotting factors, which may oppose warfarin, with variable pharmacokinetic effects.
What to do
Monitor INR when starting or stopping the product and adjust warfarin as needed. Reassess whether an estrogen-containing contraceptive is appropriate in a patient who needs anticoagulation.
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 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 Dienogest / estradiol valerate with Warfarin?
MediHelp rates the interaction as moderate. Dienogest / estradiol valerate 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. Estrogen-containing products alter clotting factor synthesis and can change warfarin response, and they also increase thrombotic risk. The INR effect is inconsistent, and the combination raises concern in patients needing anticoagulation.
How serious is the interaction between Dienogest / estradiol valerate 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: Monitor INR when starting or stopping the product and adjust warfarin as needed. Reassess whether an estrogen-containing contraceptive is appropriate in a patient who needs anticoagulation.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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