Bextra and Jantoven

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using warfarin together with valdecoxib can cause you to bleed more easily. You may need a dose adjustment in addition to testing of your prothrombin time or International Normalized Ratio (INR). Call your doctor promptly if you have any unusual bleeding or bruising, vomiting, blood in your urine or stools, headache, dizziness, or weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with valdecoxib may increase the plasma concentrations and hypoprothrombinemic effect of warfarin and other oral anticoagulants. The exact mechanism of interaction is unknown, although it is possible that valdecoxib partially inhibits the metabolic clearance of warfarin via CYP450 2C9 and 2C19. In healthy subjects given warfarin with valdecoxib (40 mg twice a day for 7 days), the area under the plasma concentration-time curve (AUC) of the biologically less active R(+) enantiomer and that of the more active S(-) enantiomer of warfarin increased by 12% and 15%, respectively. Although the average International Normalization Ratio (INR) values were only slightly increased, the day-to-day variability in individual INR values was increased. Parecoxib, a prodrug of valdecoxib, may also interact.

MANAGEMENT: Patients should be closely monitored during concomitant therapy with oral anticoagulants and valdecoxib or parecoxib. The INR should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of valdecoxib in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

Bextra

Generic Name: valdecoxib

Brand name:

Synonyms: n.a.

What is Bextra?

Jantoven

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Jantoven?