Drug interactions
Enoxaparin + Phenindione
Severity: Major
Enoxaparin and Phenindione: major interaction.
Last updated Sources: US FDA label
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
Phenindione is an oral vitamin K antagonist, and adding enoxaparin increases bleeding risk through combined anticoagulant effects. Enoxaparin may also modestly affect INR readings. Overlap is intended only when transitioning therapy.
What this interaction means in plain words
Enoxaparin and Phenindione can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive anticoagulation from vitamin K-dependent factor inhibition and antithrombin-mediated factor Xa inhibition.
What to do
Use overlap only during initiation of the oral agent and stop enoxaparin once the INR is in range. Monitor INR (ideally trough, before the next enoxaparin dose) and watch for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Frequently asked questions
Can I take Enoxaparin with Phenindione?
MediHelp rates the interaction as major. Enoxaparin and Phenindione can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Phenindione is an oral vitamin K antagonist, and adding enoxaparin increases bleeding risk through combined anticoagulant effects. Enoxaparin may also modestly affect INR readings. Overlap is intended only when transitioning therapy.
How serious is the interaction between Enoxaparin and Phenindione?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use overlap only during initiation of the oral agent and stop enoxaparin once the INR is in range. Monitor INR (ideally trough, before the next enoxaparin dose) and watch for bleeding.
What other medicines interact with Enoxaparin?
MediHelp also lists interactions of Enoxaparin with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Enoxaparin page.
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