Selected Anticoagulants/Propoxyphene; Tramadol
How the interaction occurs:
The cause of this 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:
If you experience any signs of bleeding or bruising while taking these medicines together, contact your healthcare professionals (e.g. doctor or pharmacist.) If your doctor prescribes these medicines together, you may need to check your bleeding times more often.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.
1.Orme M, Breckenridge A, Cook P. Warfarin and Distalgesic interaction. Br Med J 1976 Jan 24;1(6003):200.
2.Jones RV. Letter: Warfarin and distalgesic interaction. Br Med J 1976 Feb 21;1(6007):460.
3.Justice JL, Kline SS. Analgesics and warfarin. A case that brings up questions and cautions. Postgrad Med 1988 Apr;83(5):217-8, 220.
4.Smith R, Prudden D, Hawkes C. Propoxyphene and warfarin interaction. Drug Intell Clin Pharm 1984 Oct;18(10):822.
5.Dumo PA, Kielbasa LA. Successful anticoagulation and continuation of tramadol therapy in the setting of a tramadol-warfarin interaction. Pharmacotherapy 2006 Nov;26(11):1654-7.
6.Sabbe JR, Sims PJ, Sims MH. Tramadol-warfarin interaction. Pharmacotherapy 1998 Jul-Aug;18(4):871-3.
7.Scher ML, Huntington NH, Vitillo JA. Potential interaction between tramadol and warfarin. Ann Pharmacother 1997 May;31(5):646-7.
8.Penning-van Beest F, Erkens J, Petersen KU, Koelz HR, Herings R. Main comedications associated with major bleeding during anticoagulant therapy with coumarins. Eur J Clin Pharmacol 2005 Jul;61(5-6):439-44.
9.Boeijinga JK, van Meegen E, van den Ende R, Schook CE, Cohen AF. Lack of interaction between tramadol and coumarins. J Clin Pharmacol 1998 Oct; 38(10):966-70.