Drug interactions
Warfarin + Zileuton
Severity: Major
Warfarin and Zileuton: major 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
Zileuton can raise plasma concentrations of R-warfarin and prolong the INR, increasing bleeding risk. This effect has been described in labeling and clinical reports.
What this interaction means in plain words
Warfarin and Zileuton 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.
Warfarin belongs to Cardiovascular; Zileuton belongs to Respiratory.
Why it happens
Zileuton inhibits CYP1A2 and CYP3A4 pathways involved in R-warfarin metabolism, reducing warfarin clearance.
What to do
Check the INR more frequently when zileuton is started, changed or stopped, and adjust the warfarin dose accordingly.
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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Other interactions of Zileuton
- Fezolinetant + Zileuton Contraindicated
- Pimozide + Zileuton Contraindicated
- Alosetron + Zileuton Major
- Clozapine + Zileuton Major
- Lomitapide + Zileuton Major
- Lonafarnib + Zileuton Major
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 Warfarin with Zileuton?
MediHelp rates the interaction as major. Warfarin and Zileuton 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. Zileuton can raise plasma concentrations of R-warfarin and prolong the INR, increasing bleeding risk. This effect has been described in labeling and clinical reports.
How serious is the interaction between Warfarin and Zileuton?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check the INR more frequently when zileuton is started, changed or stopped, and adjust the warfarin dose accordingly.
What other medicines interact with Zileuton?
MediHelp also lists interactions of Zileuton with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Zileuton page.
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