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Coumadin Injection and Zileuton

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

Check result:

Coumadin Injection <> Zileuton

Relevance: 09.11.2022 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 zileuton 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: Zileuton is believed to modestly inhibit the hepatic metabolism of warfarin, and may increase its anticoagulant effect. The proposed mechanism is inhibition of CYP450 1A2 metabolism by zileuton. In one study, concomitant administration of zileuton and warfarin resulted in a 15% decrease in R-warfarin clearance and an increase in the AUC of 22%. This interaction appears to stereospecifically inhibit metabolism of the R-enantiomer of warfarin.

MANAGEMENT: If these drugs must be used together, it may be advisable to monitor the INR or PT, and the warfarin dose adjusted accordingly, if an interaction is suspected. 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

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
Lu P, Schrag ML, Slaughter DE, Raab CE, Shou M, Rodrigues AD "Mechanism-based inhibition of human liver microsomal cytochrome P450 1A2 by zileuton, a 5-lipoxygenase inhibitor." Drug Metab Dispos 31 (2003): 1352-60
"Product Information. Zylo Filmtab (zileuton)." Abbott Pharmaceutical, Abbott Park, IL.
Awni WM, Hussein Z, Granneman GR, Patterson KJ, Dube LM, Cavanaugh JH "Pharmacodynamic and stereoselective pharmacokinetic interactions between zileuton and warfarin in humans." Clin Pharmacokinet 29(suppl 2 (1995): 67-76

Coumadin Injection

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: Coumadin

What is Coumadin Injection?

Zileuton

Generic Name: zileuton

Brand name: Zyflo, Zyflo CR

Synonyms: n.a.

What is Zileuton?

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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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