相互作用
Amiodarone + Warfarin
重症度: 重大
Amiodarone and Warfarin: major interaction.
最終更新日 出典: US FDA label
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概要
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.
この相互作用をわかりやすく説明すると
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.
なぜ起こるのか
Amiodarone and its metabolite inhibit CYP2C9, CYP3A4 and CYP1A2, reducing clearance of S- and R-warfarin.
対処法
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.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、AmiodaroneとWarfarinの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Warfarinのその他の相互作用
Amiodaroneのその他の相互作用
よくある質問
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
