Перейти к содержанию

Лекарственные взаимодействия

Amiodarone + Warfarin

Тяжесть: Тяжёлое

Amiodarone and Warfarin: major interaction.

Последнее обновление Источники: US FDA label

Для специалистов здравоохранения — только для справки. Эта страница — краткая сводка, а не медицинская консультация и не замена официальной инструкции или клинического суждения. Всегда проверяйте перед назначением или отпуском.

Клиническое содержание этой страницы доступно только на английском языке.

Кратко

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.

Что означает это взаимодействие простыми словами

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.

Уровень доказательности: High

Почему это происходит

Amiodarone and its metabolite inhibit CYP2C9, CYP3A4 and CYP1A2, reducing clearance of S- and R-warfarin.

Что делать

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.

О чём спросить фармацевта

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

Для подписчиков Pro+

Откройте страницу целиком

Создайте аккаунт и начните пробный период Pro+, чтобы открыть полные рекомендации по ведению для Amiodarone и Warfarin, дополнительные примечания, подробности о доказательной базе и проверку взаимодействий для всего рецепта.

  • Full clinical management advice
  • Additional notes
  • Evidence detail
  • Interaction checker for a whole prescription

Pro+ бесплатно 14 дней на сайте. Карта не нужна.

Источники

Частые вопросы

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.

Полные монографии, дозировки и проверка взаимодействий в приложении MediHelp

Откройте полный справочник, проверяйте взаимодействия нескольких препаратов и пользуйтесь инструментами дозирования в приложении MediHelp.

Обзор от A до Z · Лекарственные взаимодействия

Скачать приложение Войти