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Panwarfin

Interactions

Coumarin Anticoagulants/Glucosamine-Chondroitin

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:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Anticoagulants, glucosamine, and chondroitin all decrease your body's ability to make clots. When these medicines are taken together, their effects may be increased.

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:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together or if you stop taking glucosamine and/or chondroitin. Your doctor may want to check your bleeding times more frequently when you first start taking these medicines together or when you stop taking them. Let your doctor know right away if you have any symptoms of bleeding.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.Weimann G, Lubenow N, Selleng K, Eichler P, Albrecht D, Greinacher A. Glucosamine sulfate does not crossreact with the antibodies of patients with heparin-induced thrombocytopenia. Eur J Haematol 2001 Mar; 66(3):195-9.

2.Wilde MI, Markham A. Danaparoid. A review of its pharmacology and clinical use in the management of heparin-induced thrombocytopenia. Drugs 1997 Dec; 54(6):903-24.

3.Rosenborg S, Stenberg M, Otto S, Ostervall J, Masquelier M, Yue QY, Bertilsson L, Eliasson E. Clinically significant CYP2C inhibition by noscapine but not by glucosamine. Clin Pharmacol Ther 2010 Sep; 88(3):343-6.

4.Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004 Feb 1; 61(3):306-7.

5.Knudsen JF, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: case report and review of the literature and MedWatch database. Pharmacotherapy 2008 Apr;28(4):540-8.

6.Therapeutic Goods Administration. Interaction between glucosamine and warfarin. Australian Adverse Drug Reactions Bulletin February, 2009; 27(1):3.

7.Committee on Safety of Medicines and the Medicines and the Healthcare products Regulatory Agency. Glucosamine adverse reactions and interactions. Current Problems in Pharmacovigilance May, 2006;31:8.

8.Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine potentiates the effect of warfarin (abstract). Drug Saf 2006;29(10):911.

9.Garrote Garcia M, Iglesias Pineiro MJ, Martin Alvarez R, Perez Gonzalez J. Pharmacological interaction of glucosamine sulphate and acenocoumarol. Aten Primaria 2004 Feb 28;33(3):162-3.

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.

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