Tigecycline and Warfarin

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.

Using warfarin together with tigecycline 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.

MONITOR: Coadministration with tigecycline may increase the plasma concentrations of warfarin. The mechanism of interaction has not been described, although it seems to affect the biologically less active R(+) enantiomer of warfarin more than the S(-) enantiomer. In healthy subjects, coadministration of tigecycline (100 mg followed by 50 mg every 12 hours) and warfarin (25 mg single oral dose) resulted in a decrease in clearance of R(+) and S(-) warfarin by 40% and 23%, an increase in the peak plasma concentration (Cmax) by 38% and 43%, and an increase in the systemic exposure (AUC) by 68% and 29%, respectively. However, the hypoprothrombinemic effects of warfarin were not affected as measured by the INR. Warfarin did not alter the pharmacokinetics of tigecycline.

MANAGEMENT: Given the potential for interaction and the high degree of interpatient variability with respect to warfarin metabolism, patients should be closely monitored during concomitant therapy with tigecycline. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation or discontinuation of tigecycline in patients who are stabilized on their warfarin regimen. 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.

Tigecycline

Generic Name: tigecycline

Brand name: Tygacil

Synonyms: n.a.

What is Tigecycline?

Warfarin

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Warfarin?