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Jantoven and Propylthiouracil

Determining the interaction of Jantoven and Propylthiouracil and the possibility of their joint administration.

Check result:
Jantoven <> Propylthiouracil
Relevance: 22.11.2022 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 propylthiouracil together with warfarin may cause you to bleed more easily or may decrease the effects of warfarin. You may need a dose adjustment in addition to monitoring of your prothrombin time or International Normalized Ratio (INR). Call your doctor promptly if you have any unusual bleeding or bruising, blood in your urine or stools, headache, dizziness, pain, swelling, 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: Anticoagulation effects may be increased or decreased with the concomitant use of antithyroid drugs and vitamin K antagonists. The proposed mechanism may relate to the effects on coagulation by a hyper- or hypothyroid state and/or the effects on vitamin K activity by antithyroid drugs. Antithyroid drugs may induce anti-vitamin K activity and thus intensify the effects of vitamin K antagonists. There have also been reports of hypoprothrombinemia and bleeding in patients taking propylthiouracil or methimazole alone or combined with vitamin K antagonists. However, in contrast, there are also case reports indicating that antithyroid drugs may cause an increase in the required dose of vitamin K antagonists.

MANAGEMENT: Bleeding parameters (e.g., INR and PT) should be monitored closely in patients on anticoagulant therapy with vitamin K antagonists who are coadministered antithyroid therapy, particularly when concomitant treatment is started, discontinued, or with any dose adjustments. Dose adjustments of either medicine may be required. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, vaginal bleeding, nosebleeds, bleeding of gums from brushing, red or brown urine, or red or black stools.

References
  • Gotta AW, Sullivan CA, Seaman J, Jean-Gilles B "Prolonged intraoperative bleeding caused by propylthiouracil-induced hypoprothrombinemia." Anesthesiology 37 (1972): 562-3
  • Akin F, Yaylali GF, Bastemir M, Yapar B "Effect of methimazole on warfarin anticoagulation in a case of Graves' disease." Blood Coagul Fibrinolysis 19 (2008): 89-91
  • Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. Available from: URL: https://cima.aemps.es/cima/publico/home.html." ([2018]):
  • Greenstein RH "Hypoprothrombinemia due to propylthiouracil therapy: report of a case." JAMA 173 (1960): 1014-5
  • Self T, Weisburst M, Wooten E, Straughn A, Oliver J "Warfarin-induced hypoprothrombinemia: potentiation by hyperthyroidism." JAMA 231 (1975): 1165-6
  • Cerner Multum, Inc. "Canadian Product Information." O 0 (2015):
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Loeliger EA, van der Esch B, Mattern MJ, Hemker HC "The biological disappearance rate of prothrombin, factors VII, IX and X from plasma in hypothyroidism, hyperthyroidism, and during fever." Thromb Diath Haemorrh 10 (1963): 267-77
  • "Product Information. Tapazole (methimazole)." King Pharmaceuticals Inc, Bristol, TN.
  • Cerner Multum, Inc "ANVISA Bulário Eletrônico. Available from: URL: http://www.anvisa.gov.br/datavisa/fila_bula/index.asp." O 0 (2015):
  • Busenbark LA, Cushnie SA "Effect of Graves' Disease and Methimazole on Warfarin Anticoagulation (June)." Ann Pharmacother (2006):
Jantoven

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

Propylthiouracil

Generic Name: propylthiouracil

Brand name:

Synonyms: n.a.

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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