Interazioni tra farmaci
Amiodarone + Warfarin
Gravità: Maggiore
Amiodarone and Warfarin: major interaction.
Ultimo aggiornamento Fonti: US FDA label
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Sintesi
Amiodarone potentiates warfarin and commonly raises the INR, with a substantial increase in bleeding risk if the warfarin dose is not reduced. The effect builds over several weeks and may persist for weeks to months after amiodarone is stopped. It is one of the most clinically important warfarin interactions.
Cosa significa questa interazione in parole semplici
Amiodarone 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.
Amiodarone belongs to Cardiovascular; Warfarin belongs to Cardiovascular.
Perché avviene
Amiodarone and its metabolite inhibit CYP2C9, CYP3A4 and CYP1A2, reducing clearance of S- and R-warfarin.
Cosa fare
Reduce the warfarin dose empirically when starting amiodarone (often by about a quarter to a third, depending on the patient) and check INR weekly or more often for the first several weeks. Continue close monitoring until INR is stable.
Cosa chiedere al farmacista
- 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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Riferimenti
Altre interazioni di Warfarin
- Defibrotide + Warfarin Controindicata
- Ketorolac + Warfarin Controindicata
- Abciximab + Warfarin Maggiore
- Acetylsalicylic acid + Warfarin Maggiore
- Adagrasib + Warfarin Maggiore
- Amobarbital + Warfarin Maggiore
Altre interazioni di Amiodarone
- Amiodarone + Amisulpride Controindicata
- Amiodarone + Arsenic trioxide Controindicata
- Amiodarone + Dofetilide Controindicata
- Amiodarone + Dronedarone Controindicata
- Amiodarone + Droperidol Controindicata
- Amiodarone + Eliglustat Controindicata
Domande frequenti
Can I take Amiodarone with Warfarin?
MediHelp rates the interaction as major. Amiodarone 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. Amiodarone potentiates warfarin and commonly raises the INR, with a substantial increase in bleeding risk if the warfarin dose is not reduced. The effect builds over several weeks and may persist for weeks to months after amiodarone is stopped. It is one of the most clinically important warfarin interactions.
How serious is the interaction between Amiodarone 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: Reduce the warfarin dose empirically when starting amiodarone (often by about a quarter to a third, depending on the patient) and check INR weekly or more often for the first several weeks. Continue close monitoring until INR is stable.
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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