Skip to content
My WebMD Sign In, Sign Up
Levaquin

Interactions

Selected Anticoagulants/Quinolones

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known.

What might happen:

You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.

What you should do about this interaction:

Contact your healthcare professional (e.g. doctor or pharmacist) about taking these two medicines together. If your doctor prescribes these medicines together, you may need to check your bleeding times more often. Your doctor may want to adjust the dose of your blood thinning medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Bianco TM, Bussey HI, Farnett LE, Linn WD, Roush MK, Wong YW. Potential warfarin-ciprofloxacin interaction in patients receiving long- term anticoagulation. Pharmacotherapy 1992;12(6):435-9.

2.Israel DS, Stotka J, Rock W, Sintek CD, Kamada AK, Klein C, Swaim WR, Pluhar RE, Toscano JP, Lettieri JT, Heller AH, Polk RE. Effect of ciprofloxacin on the pharmacokinetics and pharmacodynamics of warfarin. Clin Infect Dis 1996 Feb;22(2):251-6.

3.Mott FE, Murphy S, Hunt V. Ciprofloxacin and warfarin. Ann Intern Med 1989 Sep 15;111(6):542-3.

4.Ellis RJ, Mayo MS, Bodensteiner DM. Ciprofloxacin-warfarin coagulopathy: a case series. Am J Hematol 2000 Jan;63(1):28-31.

5.Kamada AK. Possible interaction between ciprofloxacin and warfarin. DICP 1990 Jan;24(1):27-8.

6.Linville D 2nd, Emory C, Graves L 3rd. Ciprofloxacin and warfarin interaction. Am J Med 1991 Jun;90(6):765.

7.Renzi R, Finkbeiner S. Ciprofloxacin interaction with sodium warfarin: a potentially dangerous side effect. Am J Emerg Med 1991 Nov;9(6):551-2.

8.Byrd DC, Gaskins SE, Parrish AM, Freeman LB. Warfarin and ciprofloxacin interaction: case report and controversy. J Am Board Fam Pract 1999 Nov-Dec;12(6):486-8.

9.Dugoni-Kramer BM. Ciprofloxacin-warfarin interaction. DICP 1991 Dec; 25(12):1397.

10.Morawiecka I, Djelouah I, Willcox D. Fluoroquinolones and warfarin: suspected interactions. Canadian Adverse Reaction Newsletter 2004 Jul; 14(3):1-2.

11.Toon S, Hopkins KJ, Garstang FM, Aarons L, Sedman A, Rowland M. Enoxacin-warfarin interaction: pharmacokinetic and stereochemical aspects. Clin Pharmacol Ther 1987 Jul;42(1):33-41.

12.McLeod AD, Burgess C. Drug interaction between warfarin and enoxacin. N Z Med J 1988 Apr 27;101(844):216.

13.Artymowicz RJ, Cino BJ, Rossi JG, Walker JL, Moore S. Possible interaction between gatifloxacin and warfarin. Am J Health Syst Pharm 2002 Jun 15;59(12):1205-6.

14.Efthymiopoulos C, Bramer SL, Maroli A, Blum B. Theophylline and warfarin interaction studies with grepafloxacin. Clin Pharmacokinet 1997;33 Suppl 1:39-46.

15.Yamreudeewong W, Lower DL, Kilpatrick DM, Enlow AM, Burrows MM, Greenwood MC. Effect of levofloxacin coadministration on the international normalized ratios during warfarin therapy. Pharmacotherapy 2003 Mar; 23(3):333-8.

16.Liao S, Palmer M, Fowler C, Nayak RK. Absence of an effect of levofloxacin on warfarin pharmacokinetics and anticoagulation in male volunteers. J Clin Pharmacol 1996 Nov;36(11):1072-7.

17.Ravnan SL, Locke C. Levofloxacin and warfarin interaction. Pharmacotherapy 2001 Jul;21(7):884-5.

18.Gheno G, Cinetto L. Levofloxacin-warfarin interaction. Eur J Clin Pharmacol 2001 Aug;57(5):427.

19.Jones CB, Fugate SE. Levofloxacin and warfarin interaction. Ann Pharmacother 2002 Oct;36(10):1554-7.

20.Elbe DH, Chang SW. Moxifloxacin-Warfarin Interaction: A Series of Five Case Reports (February). Ann Pharmacother 2005 Jan 4.

21.O'Connor KA, O'Mahony D. The interaction of moxifloxacin and warfarin in three elderly patients. Eur J Intern Med 2003 Jul;14(4):255-257.

22.Leor J, Levartowsky D, Sharon C. Interaction between nalidixic acid and warfarin. Ann Intern Med 1987 Oct;107(4):601.

23.Gullov AL, Koefoed BG, Petersen P. Interaction between warfarin and nalidic acid. Ugeskr Laeger 1996 Sep 9;158(37):5174-5.

24.Hoffbrand BI. Letter: Interaction of nalidixic acid and warfarin. Br Med J 1974 Jun 22;2(920):666.

25.Potasman I, Bassan H. Nicoumalone and nalidixic acid interaction. Ann Intern Med 1980 Apr;92(4):571.

26.Rocci ML Jr, Vlasses PH, Distlerath LM, Gregg MH, Wheeler SC, Zing W, Bjornsson TD. Norfloxacin does not alter warfarin's disposition or anticoagulant effect. J Clin Pharmacol 1990 Aug;30(8):728-32.

27.Linville T, Matanin D. Norfloxacin and warfarin. Ann Intern Med 1989 May 1;110(9):751-2.

28.Leor J, Matetzki S. Ofloxacin and warfarin. Ann Intern Med 1988 Nov 1; 109(9):761.

29.Baciewicz AM, Ashar BH, Locke TW. Interaction of ofloxacin and warfarin. Ann Intern Med 1993 Dec 15;119(12):1223.

30.Millar E, Coles S, Wyld P, Nimmo W. Temafloxacin does not potentiate the anticoagulant effect of warfarin in healthy subjects. Clin Pharmacokinet 1992;22 Suppl 1:102-6.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

More about Drugs and Medications

URAC: Accredited Health Web Site HONcode Seal AdChoices