Coumadin Injection and Ticlopidine
Determining the interaction of Coumadin Injection and Ticlopidine and the possibility of their joint administration.
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.
Consumer:Using warfarin together with ticlopidine 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.
Professional:MONITOR: Although therapy with oral anticoagulants and ticlopidine may overlap in clinical practice, the potential for additive pharmacodynamic effects and increased risk of bleeding, especially gastrointestinal bleeding, should be considered. The combination of warfarin and ticlopidine has also been associated with rare cases of cholestatic hepatitis. In addition, ticlopidine may inhibit the metabolism of R-warfarin by an unknown mechanism. Increases in R-warfarin concentrations have been reported during concomitant therapy; however, there were no significant changes in INR.
MANAGEMENT: The manufacturer recommends discontinuation of any anticoagulants before initiating ticlopidine therapy. If concomitant use cannot be avoided, patients should be closely monitored for signs of bleeding and the anticoagulant dosage should be adjusted as appropriate to maintain therapeutic aPTT/INR values. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bruising, red or brown urine, or red or black stools.
- Gidal BE, Sorkness CA, McGill KA, Larson R, Levine RR "Evaluation of a potential enantioselective interaction between ticlopidine and warfarin in chronically anticoagulated patients." Ther Drug Monit 17 (1995): 33-8
- "Product Information. Ticlid (ticlopidine)." Syntex Laboratories Inc, Palo Alto, CA.
- "Product Information. Coumadin (warfarin)." DuPont Pharmaceuticals, Wilmington, DE.
- Hirsch J, Dalen J, Guyatt G, American College of Chest Physicians "The sixth (2000) ACCP guidelines for antithrombotic therapy for prevention and treatment of thrombosis. American College of Physicians." Chest 119(1 Suppl) (2001): 1S-2S
Generic Name: warfarin
Brand name: Coumadin, Jantoven
Synonyms: Coumadin
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- Coumadin Injection-Ticlopidine Hydrochloride
- Coumadin Injection-Ticon
- Coumadin Injection-Ticon oral/injection
- Coumadin Injection-Tigan
- Coumadin Injection-Tigan (Trimethobenzamide Capsules)
- Coumadin Injection-Tigan (Trimethobenzamide Injection Solution)
- Ticlopidine-Covaryx
- Ticlopidine-Covaryx HS
- Ticlopidine-Covera-HS
- Ticlopidine-Cozaar
- Ticlopidine-CPB WC
- Ticlopidine-CPM-PSE DM Drops