Interações medicamentosas
Amiodarone + Warfarin
Gravidade: Grave
Amiodarone and Warfarin: major interaction.
Última atualização Fontes: US FDA label
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Resumo
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.
O que esta interação significa em palavras simples
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.
Por que acontece
Amiodarone and its metabolite inhibit CYP2C9, CYP3A4 and CYP1A2, reducing clearance of S- and R-warfarin.
O que fazer
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.
O que perguntar ao farmacêutico
- 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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Referências
Outras interações de Warfarin
- Defibrotide + Warfarin Contraindicada
- Ketorolac + Warfarin Contraindicada
- Abciximab + Warfarin Grave
- Acetylsalicylic acid + Warfarin Grave
- Adagrasib + Warfarin Grave
- Amobarbital + Warfarin Grave
Outras interações de Amiodarone
- Amiodarone + Amisulpride Contraindicada
- Amiodarone + Arsenic trioxide Contraindicada
- Amiodarone + Dofetilide Contraindicada
- Amiodarone + Dronedarone Contraindicada
- Amiodarone + Droperidol Contraindicada
- Amiodarone + Eliglustat Contraindicada
Perguntas frequentes
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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