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Cordarone IV Intravenous and Coumadin

Determining the interaction of Cordarone IV Intravenous and Coumadin and the possibility of their joint administration.

Check result:

Cordarone IV Intravenous <> Coumadin

Relevance: 15.03.2023 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 amiodarone together with warfarin may cause you to bleed more easily. You may need a dose adjustment based on 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 CLOSELY: Amiodarone may increase the pharmacologic effects of warfarin by inhibiting CYP450 2C9 hepatic metabolism of S-warfarin. Similar effects may also occur with other oral anticoagulants, resulting in significant hypoprothrombinemia and bleeding. When amiodarone is added to an anticoagulant regimen, increased anticoagulant effects may become apparent within one to several weeks and may persist for months after the amiodarone is discontinued. The effects of this interaction are highly variable - while some patients are asymptomatic, serious and life-threatening bleeding complications have been reported in others. Patients who are poor CYP450 2C9 metabolizers may have a higher risk of bleeding and a faster onset of the interaction.

MANAGEMENT: An empiric 30% to 50% reduction in anticoagulant dosage has been recommended, in addition to frequent monitoring of the patient and the prothrombin time or International Normalized Ratio (INR). Patients should be advised to notify their physician promptly if they experience any signs of excessive anticoagulation such as unusual or prolonged bleeding, bruising, vomiting, change in stool or urine color, headache, dizziness, or weakness.

References

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Cheung B, Lam FM, Kumana CR "Lesson of the week: insidiously evolving, occult drug interaction involving warfarin and amiodarone." BMJ 312 (1996): 107-8
Shirolkar SC, Fiuzat M, Becker RC "Dronedarone and vitamin K antagonists: A review of drug-drug interactions." Am Heart J 160 (2010): 577-82
Hamer A, Peter T, Mandel WJ, et al "The potentiation of warfarin anticoagulation by amiodarone." Circulation 65 (1982): 1025-9
Serlin MJ, Sibeon RG, Breen GJ "Dangers of amiodarone and anticoagulant treatment." Br Med J (Clin Res Ed) 283 (1981): 58
Kerin NZ, Blevins RD, Goldman L, et al "The incidence, magnitude, and time course of the amiodarone-warfarin interaction." Arch Intern Med 148 (1988): 1779-81
Jafari-Fesharaki M, Scheinman MM "Adverse effects of amiodarone." Pacing Clin Electrophysiol 21 (1998): 108-20
Gill J, Heel RC, Fitton A "Amiodarone: an overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias." Drugs 43 (1992): 69-110
Wells PS, Holbrook AM, Crowther NR, Hirsh J "Interactions of warfarin with drugs and food." Ann Intern Med 121 (1994): 676-83
Caraco Y, Chajek-Shaul T "The incidence and clinical significance of amiodarone and acenocoumarol interaction." Thromb Haemost 62 (1989): 906-8
Neyroz P, Bonati M "In vitro amiodarone protein binding and its interaction with warfarin." Experientia 41 (1985): 361-3
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
Heimark LD, Wienkers L, Kunze K, et al "The mechanism of the interaction between amiodarone and warfarin in humans." Clin Pharmacol Ther 51 (1992): 398-407

Cordarone IV Intravenous

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: Cordarone IV (Intravenous)

What is Cordarone IV Intravenous?

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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