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Coumadin and Glucoten

Determining the interaction of Coumadin and Glucoten and the possibility of their joint administration.

Check result:

Coumadin <> Glucoten

Relevance: 01.06.2022 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 glucosamine 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: A case report suggests that chondroitin and/or glucosamine may potentiate the hypoprothrombinemic effect of warfarin. The mechanism of interaction is unknown. Glucosamine is a chemical component of heparin, while chondroitin is a minor component of danaparoid and has been shown in vitro and in animals to prolong prothrombin time. However, adverse effects on coagulation and bleeding complications have not been reported in clinical studies using glucosamine and chondroitin dosages of up to 1.5 and 1.2 g/day, respectively. In the case report, a 69-year-old man who had been stabilized on warfarin 47.5 mg/week for four months demonstrated an increased INR (from 2.58 to 4.52) four weeks after initiating daily self-treatment with glucosamine hydrochloride (3 g) and chondroitin sulfate (2.4 g). The patient reported no other change in his medications or diet. After two weeks at a reduced warfarin dosage of 40 mg/week, the patient's INR returned to normal, and he remained stabilized at that dose for the next three months while he continued to take glucosamine and chondroitin.

MANAGEMENT: Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients treated with warfarin, the INR should be closely monitored following addition or discontinuation of chondroitin and glucosamine, and the warfarin dosage adjusted as necessary. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking. 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

Rozenfeld V, Crain JL, Callahan AK "Possible augmentation of warfarin effect by glucosamine-chondroitin." Am J Health Syst Pharm 61 (2004): 306-7
Scott GN "Interaction of warfarin with glucosamine--chondroitin." Am J Health Syst Pharm 61 (2004): 1186; author reply 1186

Coumadin

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Coumadin?

Glucoten

Generic Name: chondroitin / glucosamine

Brand name: Cidaflex, Cosamin DS, Glucoten, OptiFlex Complete, Osteo Bi-Flex, Pryflex, Relamine, Schiff Move Free, Lacrisert, Duratears Naturale, Adsorbotear, Akwa Tears, Teargen, Aquasite, Artificial Tears Plus, Comfort Tears, Tears Plus, Liquifilm Forte, Liquifilm Tears, Murine, Natures Tears, Nu-Tears, Nu-Tears II, Tears Naturale, Tears Naturale Free, Tears Naturale II, Major Tears, Bion Tears, Natural Tears, Ocucoat PF, Puralube, Refresh Plus, Liquilube Tears, Tears Again, Tears Renewed, Hypotears P/F, Aquasite Artificial Tears, Teargen II, Murocel, Refresh PM, Duolube, Hypotonic Tears, 20/20 Tears, Tears Renew, Blairex Just Tears, Lubrifair, Tears Naturale PM, Hypotears Select, Tears Naturale Forte, Refresh Liquigel, TheraTears Contact Lens, TheraTears Liquid Gel, Tears Again Night & Day, Tears Again Gel Drops, GenTeal Mild, Visine for Contacts, For Sty Relief, Ultra Fresh PM, Altalube, Moisture Eyes PM, Lubrifresh PM, Murine Tears, Stye Sterile Lubricant, Refresh Contacts, GenTeal PM, Systane Free, Freshkote, GenTeal PF, Refresh Endura, Refresh Redness Relief, Moisture Eyes, Refresh Dry Eye Therapy, optive Sensitive, Systane Ultra, Systane Nighttime, Lubricant Eye Drops, Dry Eye Relief, Clear Eyes Tears, Systane Ultra Preservative Free, GenTeal Twin Pack, Sterilube, Oasis Tears Plus, Soothe XP, Systane Balance, Viva-Drops, Opti-Free Pure Moist Rewetting Drops, Tears Again Advanced Liposome Spray, Refresh Optive Advanced, Refresh Optive, Systane Overnight Therapy, TheraTears Sterilid, ImproVue, Soothe Night Time, Sterile Lubricating Tears, Systane Preservative Free, Opti-Free Lubricant Drops, Ultra Lubricant Eye Drops, GenTeal Tears Mild, GenTeal Tears Moderate, GenTeal PF Tears Moderate, Refresh Optive Mega-3, Refresh Repair, TheraTears Extra, Advanced Eye Relief Dry Eye, Refresh Relieva, Rohto Dry-Aid, Blink Tears, Blink Contacts, FreshKote Preservative Free

Synonyms: n.a.

What is Glucoten?

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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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