Drug interactions
Gemcitabine + Warfarin
Severity: Moderate
Gemcitabine 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
Elevated INR and bleeding have been reported in patients on warfarin who receive gemcitabine. Cancer, nutritional changes and thrombocytopenia also make anticoagulation unstable.
What this interaction means in plain words
Gemcitabine 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.
Gemcitabine belongs to Oncology; Warfarin belongs to Cardiovascular.
Why it happens
The mechanism is not established; chemotherapy effects on liver function, vitamin K intake and platelets may contribute.
What to do
Monitor INR and platelet counts closely during gemcitabine therapy and adjust warfarin dosing. Consider switching to low-molecular-weight heparin if INR is erratic.
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
Other interactions of Gemcitabine
Frequently asked questions
Can I take Gemcitabine with Warfarin?
MediHelp rates the interaction as moderate. Gemcitabine 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. Elevated INR and bleeding have been reported in patients on warfarin who receive gemcitabine. Cancer, nutritional changes and thrombocytopenia also make anticoagulation unstable.
How serious is the interaction between Gemcitabine 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 and platelet counts closely during gemcitabine therapy and adjust warfarin dosing. Consider switching to low-molecular-weight heparin if INR is erratic.
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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