Coumadin Injection and Metformin and repaglinide
Determining the interaction of Coumadin Injection and Metformin and repaglinide 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:Consumer information for this interaction is not currently available.MONITOR: Coadministration with metformin may decrease the anticoagulant effects of vitamin K antagonists (VKAs). The mechanism has not been delineated, but it may involve metformin-mediated increase in the elimination rate of VKAs. In addition, concomitant use of VKAs with metformin may increase the risk of severe hypoglycemia. The clinical significance of this interaction is unknown. MANAGEMENT: Until more information is available, patients receiving VKAs with metformin should be closely monitored during concomitant therapy. The INR or prothrombin time should be checked frequently and the VKA dosage adjusted accordingly, particularly following initiation, change of dosage, or discontinuation of metformin therapy. In addition, patients receiving this combination should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs. References Wijnen JCF, van de Reit IR, Lijfering WM, van der Meer FJM "Metformin use decreases the anticoagulant effect of phenprocoumon." J Thromb Haemost 12 (2014): 887-90 Nam YH, Brensinger CM, Bilker WB, Leonard CE, Han X, Hennessy S "Serious hypoglycemia and use of warfarin in combination with sulfonylureas or metformin." Clin Pharmacol Ther (2018): Cerner Multum, Inc. "Australian Product Information." O 0
Professional:MONITOR: Coadministration with metformin may decrease the anticoagulant effects of vitamin K antagonists (VKAs). The mechanism has not been delineated, but it may involve metformin-mediated increase in the elimination rate of VKAs. In addition, concomitant use of VKAs with metformin may increase the risk of severe hypoglycemia. The clinical significance of this interaction is unknown.
MANAGEMENT: Until more information is available, patients receiving VKAs with metformin should be closely monitored during concomitant therapy. The INR or prothrombin time should be checked frequently and the VKA dosage adjusted accordingly, particularly following initiation, change of dosage, or discontinuation of metformin therapy. In addition, patients receiving this combination should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs.
- Wijnen JCF, van de Reit IR, Lijfering WM, van der Meer FJM "Metformin use decreases the anticoagulant effect of phenprocoumon." J Thromb Haemost 12 (2014): 887-90
- Nam YH, Brensinger CM, Bilker WB, Leonard CE, Han X, Hennessy S "Serious hypoglycemia and use of warfarin in combination with sulfonylureas or metformin." Clin Pharmacol Ther (2018):
- Cerner Multum, Inc. "Australian Product Information." O 0
Generic Name: warfarin
Brand name: Coumadin, Jantoven
Synonyms: Coumadin
Generic Name: metformin / repaglinide
Brand name: PrandiMet
Synonyms: Repaglinide and Metformin
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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