Drug interactions
hydrocortisone + warfarin
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.
Overview
Systemic corticosteroids can alter warfarin response (↑ or ↓ INR) with reported bleeding; effect most notable with initiation or taper.
Mechanism of action
Unknown; proposed changes in hepatic metabolism and clotting factor synthesis; potential GI mucosal effects add bleeding risk.
Clinical management
Increase INR monitoring when starting, changing dose, or discontinuing systemic corticosteroids; adjust warfarin accordingly and monitor for bleeding.
Drug reference
References
- Warfarin: Drug Interactions (Corticosteroids) — Lexicomp
Frequently asked questions
Can I take hydrocortisone with warfarin?
The interaction is rated: Moderate. Systemic corticosteroids can alter warfarin response (↑ or ↓ INR) with reported bleeding; effect most notable with initiation or taper.
How serious is the interaction between hydrocortisone and warfarin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between hydrocortisone and warfarin managed?
Increase INR monitoring when starting, changing dose, or discontinuing systemic corticosteroids; adjust warfarin accordingly and monitor for bleeding.
Why do hydrocortisone and warfarin interact?
Unknown; proposed changes in hepatic metabolism and clotting factor synthesis; potential GI mucosal effects add bleeding risk.
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