Drug interactions
Inotersen + Warfarin
Severity: Major
Inotersen and Warfarin: major interaction.
Last updated Sources: EMA SmPC
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
Inotersen can cause thrombocytopenia, sometimes severe and sudden. When it is given with warfarin, the low platelet count adds to the anticoagulant effect and raises the risk of serious bleeding.
What this interaction means in plain words
Inotersen and Warfarin 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.
Inotersen belongs to Miscellaneous; Warfarin belongs to Cardiovascular.
Why it happens
Pharmacodynamic: inotersen-induced thrombocytopenia combined with warfarin anticoagulation increases bleeding risk.
What to do
Monitor platelet counts and INR closely, following the inotersen risk management program for platelet monitoring. Stop inotersen or reassess anticoagulation if platelets fall below the labeled thresholds or bleeding occurs.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Other interactions of Inotersen
Frequently asked questions
Can I take Inotersen with Warfarin?
MediHelp rates the interaction as major. Inotersen and Warfarin 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. Inotersen can cause thrombocytopenia, sometimes severe and sudden. When it is given with warfarin, the low platelet count adds to the anticoagulant effect and raises the risk of serious bleeding.
How serious is the interaction between Inotersen and Warfarin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor platelet counts and INR closely, following the inotersen risk management program for platelet monitoring. Stop inotersen or reassess anticoagulation if platelets fall below the labeled thresholds or bleeding occurs.
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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