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Cimetidine Injection and Coumadin

Determining the interaction of Cimetidine Injection and Coumadin and the possibility of their joint administration.

Check result:

Cimetidine Injection <> Coumadin

Relevance: 21.09.2023 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 cimetidine 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: Cimetidine inhibits the hepatic metabolism of warfarin, and may increase its anticoagulant effect over a one to two week period. This interaction appears to involve the less active R-warfarin more than the more active S-enantiomer. This effect may occur with other oral anticoagulants.

MANAGEMENT: If given together, the INR or PT should be monitored, and the lowest possible dose of cimetidine should be used. Another histamine-2 antagonist may be used with less risk of interaction. 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.

References

Kerley B, Ali M "Cimetidine potentiation of warfarin action." Can Med Assoc J 126 (1982): 116
Niopas I, Toon S, Rowland M "Further insight into the stereoselective interaction between warfarin and cimetidine in man." Br J Clin Pharmacol 32 (1991): 508-11
Flind AC "Cimetidine and oral anticoagulants ." Br Med J 2 (1978): 1367
Flind AC "Cimetidine and oral anticoagulants ." Lancet 2 (1978): 1054
Choonara IA, Cholerton S, Haynes BP, Breckenridge AM, Park BK "Stereoselective interaction between the R enantiomer of warfarin and cimetidine." Br J Clin Pharmacol 21 (1986): 271-7
Desmond PV, Mashford ML, Harman PJ, Morphett BJ, Breen KJ, Wang YM "Decreased oral warfarin clearance after ranitidine and cimetidine." Clin Pharmacol Ther 35 (1984): 338-41
Breckenridge AM, Challiner M, Mossman S, et al "Cimetidine increases the action of warfarin in man." Br J Clin Pharmacol 8 (1979): p392-3
Thijssen HH, Flin ois JP, Beaune PH "Cytochrome P4502C9 is the principal catalyst of racemic acenocoumarol hydroxylation reactions in human liver microsomes." Drug Metab Dispos 28 (2000): 1284-90
Wells PS, Holbrook AM, Crowther NR, Hirsh J "Interactions of warfarin with drugs and food." Ann Intern Med 121 (1994): 676-83
Serlin MJ, Sibeon RG, Mossman S, et al "Cimetidine: interaction with oral anticoagulants in man." Lancet 2 (1979): 317-9
O'Reilly RA "Comparative interaction of cimetidine and ranitidine with racemic warfarin in man." Arch Intern Med 144 (1984): 989-91
Serlin MJ, Challiner M, Park BK, Turcan PA, Breckenridge AM "Cimetidine potentiates the anticoagulant effect of warfarin by inhibition of drug metabolism." Biochem Pharmacol 29 (1980): 1971-2

Cimetidine Injection

Generic Name: cimetidine

Brand name: Tagamet HB, Tagamet

Synonyms: Cimetidine

What is Cimetidine Injection?

Coumadin

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Coumadin?

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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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