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Coumadin Injection and Zilretta

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

Check result:

Coumadin Injection <> Zilretta

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:

Triamcinolone may alter the effects of warfarin. Both increased and decreased effects have been reported. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. Also be alert to potential signs and symptoms of blood clots such as chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity, and seek immediate medical attention if they occur. 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: Corticosteroids and adrenocorticotropic agents may alter the pharmacologic effects of oral anticoagulants. Both increased anticoagulant dosage requirements as well as bleeding and increased anticoagulant sensitivity have been reported during concomitant corticosteroid therapy. Proposed mechanisms include blood hypercoagulability or diminished vascular integrity induced by corticosteroids. Conversely, the risk of gastrointestinal bleeding associated with the ulcerogenic effect of corticosteroids may be potentiated by use of oral anticoagulants.

MANAGEMENT: Close monitoring for clinical and laboratory evidence of altered anticoagulant response is recommended during concurrent treatment with corticosteroids or adrenocorticotropic agents. Patients should be advised to promptly report any signs and symptoms of bleeding or blood clots.

References

Ku LL, Ward CO, Durgin SJ "A clinical study of drug interaction and anticoagulant therapy." Drug Intell Clin Pharm 4 (1970): 300-6
Stading JA "Effects of prednisone on the International Normalized Ratio." Am J Health Syst Pharm 63 (2006): 2354-2356
Brozovic M, Gurd LJ "Prothrombin during warfarin treatment." Br J Haematol 24 (1973): 579-88
Hansen RA, Tu W, Wang J, Ambuehl R, McDonald CJ, Murray MD "Risk of adverse gastrointestinal events from inhaled corticosteroids." Pharmacotherapy 28 (2008): 1325-34
Koch-Weser J, Sellers EM "Drug interactions with coumarin anticoagulants (second of two parts)." N Engl J Med 285 (1971): 547-58
Wadman B, Werner I "Thromboembolic complications during corticosteroid treatment of temporal arteritis." Lancet 1 (1972): 907
Hamblin TJ "Interaction between warfarin and phenformin." Lancet 2 (1971): 1323
Koch-Weser J, Sellers EM "Drug interactions with coumarin anticoagulants (first of two parts)." N Engl J Med 285 (1971): 487-98

Coumadin Injection

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: Coumadin

What is Coumadin Injection?

Zilretta

Generic Name: triamcinolone

Brand name: Kenalog-40, Zilretta, Aristocort, Azmacort

Synonyms: Zilretta (injection)

What is Zilretta?

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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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