Coumarins(continued)
▶Disulfiramincreases the anticoagulant effect ofcoumarins.
Monitor and adjust dose.rStudy
▶Efavirenzis predicted to affect the concentration ofcoumarins.
Adjust dose.oTheoretical
▶Elvitegraviris predicted to decrease the anticoagulant effect of
coumarins.oTheoretical
▶Enteral feeds(vitamin-K containing) potentially decrease the
anticoagulant effect ofcoumarins.rAnecdotal
▶Enzalutamidepotentially decreases the exposure tocoumarins.
Avoid or adjust dose and monitor INR.rStudy
▶Erlotinibincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶Etravirineincreases the anticoagulant effect ofcoumarins.
oTheoretical
▶Fibratesare predicted to increase the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rStudy
▶Fluorouracilincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶Fosaprepitantis predicted to decrease the anticoagulant effect
ofcoumarins.oTheoretical
▶Gefitinibis predicted to increase the anticoagulant effect of
coumarins.rAnecdotal
▶Glucagonincreases the anticoagulant effect ofwarfarin.r
Study
▶Glucosamineincreases the anticoagulant effect ofwarfarin.
Avoid.oAnecdotal
▶Griseofulvinpotentially decreases the anticoagulant effect of
coumarins.oAnecdotal
▶H 2 receptor antagonists(cimetidine)increase the anticoagulant
effect ofcoumarins.rStudy
▶HIV-protease inhibitorsare predicted to affect the
anticoagulant effect ofcoumarins.oStudy
▶Imatinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Ivacaftoris predicted to increase the anticoagulant effect of
warfarin.rTheoretical
▶Ivermectinpotentially increases the anticoagulant effect of
coumarins.rAnecdotal
▶Lapatinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Leflunomideincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶Lomitapideincreases the exposure towarfarin. Monitor INR
and adjust dose.rStudy
▶Macrolides(clarithromycin, erythromycin)increase the
anticoagulant effect ofcoumarins. Monitor INR and adjust
dose.rAnecdotal
▶Mercaptopurinedecreases the anticoagulant effect of
coumarins.oAnecdotal
▶Metronidazoleincreases the anticoagulant effect ofcoumarins.
Monitor INR and adjust dose.rStudy
▶Monoclonal antibodies(blinatumomab)are predicted to
transiently increase the exposure towarfarin. Monitor and
adjust dose.oTheoretical
▶Monoclonal antibodies(sarilumab)potentially affect the
exposure towarfarin. Monitor and adjust dose.r
Theoretical
▶Monoclonal antibodies(tocilizumab)are predicted to decrease
the exposure towarfarin. Monitor and adjust dose.o
Theoretical
▶Nandroloneis predicted to increase the anticoagulant effect of
coumarins. Monitor and adjust dose.rTheoretical
▶Nevirapinepotentially alters the anticoagulant effect of
coumarins.rAnecdotal
▶Nilotinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Obeticholic aciddecreases the anticoagulant effect ofwarfarin.
rStudy
▶Oxymetholoneincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶Paracetamolincreases the anticoagulant effect ofcoumarins.
oStudy
▶Pazopanibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical▶Penicillinspotentially alter the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rAnecdotal
▶Pitolisantis predicted to decrease the exposure towarfarin.
qTheoretical
▶Ponatinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Quinolonesincrease the anticoagulant effect ofcoumarins.
rAnecdotal
▶Ranibizumabincreases the risk of bleeding events when given
withcoumarins.rTheoretical
▶Regorafenibis predicted to increase the risk of bleeding events
when given withcoumarins.rStudy
▶Rifampicindecreases the anticoagulant effect ofcoumarins.
rStudy
▶Ruxolitinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Sorafenibincreases the anticoagulant effect ofcoumarins.
rAnecdotal
▶St John’s Wortdecreases the anticoagulant effect ofcoumarins.
Avoid.rAnecdotal
▶Statins(fluvastatin, rosuvastatin)increase the anticoagulant
effect ofcoumarins. Monitor INR and adjust dose.rStudy
▶Sucralfatepotentially decreases the effects ofwarfarin.
Separate administration by 2 hours.oAnecdotal
▶Sulfinpyrazoneincreases the anticoagulant effect of
coumarins. Avoid.rStudy
▶Sulfonamides(sulfadiazine)are predicted to increase the
anticoagulant effect ofcoumarins.rTheoretical
▶Sulfonamides(sulfamethoxazole)increase the anticoagulant
effect ofcoumarins.rStudy
▶Sunitinibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Tamoxifenincreases the anticoagulant effect ofcoumarins.
rStudy
▶Tegafurincreases the anticoagulant effect ofcoumarins.
oTheoretical
▶Teriflunomideaffects the anticoagulant effect ofcoumarins.
rStudy
▶Tetracyclinesincrease the risk of bleeding events when given
withcoumarins.oAnecdotal
▶Tinidazoleis predicted to increase the anticoagulant effect of
coumarins. Monitor INR and adjust dose.rTheoretical
▶Toremifeneis predicted to increase the anticoagulant effect of
coumarins.rTheoretical
▶Trimethoprimis predicted to increase the anticoagulant effect
ofcoumarins.rStudy
▶Vandetanibis predicted to increase the risk of bleeding events
when given withcoumarins.rTheoretical
▶Venetoclaxslightly increases the exposure towarfarin.
oStudy
Cranberry juice
▶Cranberry juicepotentially increases the anticoagulant effect
ofcoumarins(warfarin). Avoid.rAnecdotal
Crisantaspase→seeTABLE 1p. 847 (hepatotoxicity),TABLE 15p. 850
(myelosuppression)
▶Crisantaspaseis predicted to increase the risk of
hepatotoxicity when given withimatinib.rTheoretical→
Also seeTABLE 15p. 850
▶Crisantaspaseaffects the efficacy ofmethotrexate.r
Anecdotal→Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
▶Crisantaspasepotentially increases the risk of neurotoxicity
when given withvinca alkaloids(vincristine).Vincristineshould
be taken 3 to 24 hours beforecrisantaspase,p. 551.r
Anecdotal→Also seeTABLE 1p. 847→Also seeTABLE 15p. 850
Crizotinib→seeTABLE 6p. 848 (bradycardia),TABLE 15p. 850
(myelosuppression),TABLE 9p. 849 (QT-interval prolongation)
GENERAL INFORMATIONCaution with concurrent use of drugs
that cause gastrointestinal perforation—discontinue
treatment if gastrointestinal perforation occurs.
▶Crizotinibis predicted to increase the exposure toaldosterone
antagonists(eplerenone). Adjusteplerenonedose.rStudy
▶Crizotinibis predicted to increase the exposure toalpha
blockers(tamsulosin).oTheoretical
▶Crizotinibis predicted to increase the exposure toalprazolam.
rStudy904 Coumarins—Crizotinib BNFC 2018 – 2019
Interactions|Appendix 1A1