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Axid Oral Solution and Coumadin

Determining the interaction of Axid Oral Solution and Coumadin and the possibility of their joint administration.

Check result:
Axid Oral Solution <> Coumadin
Relevance: 16.06.2022 Reviewer: Shkutko P.M., M.D., in

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 raNITIdine 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: Limited data suggest that ranitidine may occasionally alter the hypoprothrombinemic effect of coumarin anticoagulants. There have been rare reports of altered prothrombin time or INR (both increases and decreases) during coadministration of ranitidine and warfarin. The mechanism of interaction is unknown. Ranitidine at usual therapeutic dosages has not been shown to significantly affect CYP450-mediated metabolism. Ranitidine also did not alter the pharmacokinetics or pharmacodynamics of warfarin in three out of four interaction studies. In the fourth study, oral clearance of a single dose of warfarin was reduced by 27% in five healthy subjects given ranitidine 150 mg twice a day for 7 days, and by more than 50% in two subjects given ranitidine 750 mg daily.

MANAGEMENT: Until more data are available, caution may be advisable if ranitidine is used in combination with coumarin anticoagulants. The INR should be checked regularly and anticoagulant dosage adjusted accordingly, particularly following initiation or discontinuation of ranitidine in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of bleeding to their doctor, 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.

References
  • O'Reilly RA "Comparative interaction of cimetidine and ranitidine with racemic warfarin in man." Arch Intern Med 144 (1984): 989-91
  • Serlin MJ, Sibeon RG, Breckenridge AM "Lack of effect of ranitidine on warfarin action." Br J Clin Pharmacol 12 (1981): 791-4
  • "Product Information. Zantac (ranitidine)." Glaxo Wellcome, Research Triangle Park, NC.
  • Toon S, Hopkins KJ, Garstang FM, Rowland M "Comparative effects of ranitidine and cimetidine on the pharmacokinetics and pharmacodynamics of warfarin in man." Eur J Clin Pharmacol 32 (1987): 165-72
  • Powell JR, Donn KH "Histamine H2-antagonist drug interactions in perspective: mechanistic concepts and clinical implications." Am J Med 77 (1984): 57-84
  • "Product Information. Coumadin (warfarin)." DuPont Pharmaceuticals, Wilmington, DE.
Axid Oral Solution

Generic Name: nizatidine

Brand name: Baciguent, Probiotic Formula, Proferrin-ES

Synonyms: n.a.

Coumadin

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

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.

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