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Jantoven oral

Amiodarone; Dronedarone/Anticoagulants

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:

When these two medicines are taken together, amiodarone and dronedarone may prevent your body from processing your anticoagulant properly.

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

References:

1.Almog S, Shafran N, Halkin H, Weiss P, Farfel Z, Martinowitz U, Bank H. Mechanism of warfarin potentiation by amiodarone: dose--and concentration--dependent inhibition of warfarin elimination. Eur J Clin Pharmacol 1985;28(3):257-61.
2.Rees A, Dalal JJ, Reid PG, Henderson AH, Lewis MJ. Dangers of amiodarone and anticoagulant treatment. Br Med J (Clin Res Ed) 1981 May 30; 282(6278):1756-7.
3.O'Reilly RA, Trager WF, Rettie AE, Goulart DA. Interaction of amiodarone with racemic warfarin and its separated enantiomorphs in humans. Clin Pharmacol Ther 1987 Sep;42(3):290-4.
4.Heimark LD, Wienkers L, Kunze K, Gibaldi M, Eddy AC, Trager WF, O'Reilly RA, Goulart DA. The mechanism of the interaction between amiodarone and warfarin in humans. Clin Pharmacol Ther 1992 Apr;51(4):398-407.
5.Richard C, Riou B, Berdeaux A, Fournier C, Khayat D, Rimailho A, Giudicelli JF, Auzepy P. Prospective study of the potentiation of acenocoumarol by amiodarone. Eur J Clin Pharmacol 1985;28(6):625-9.
6.Multaq (dronedarone) US prescribing information. Sanofi-Aventis U.S. LLC January, 2014.
7.Woeber KA, Warner I. Potentiation of warfarin sodium by amiodarone-induced thyrotoxicosis. West J Med 1999 Jan;170(1):49-51.
8.Watt AH, Stephens MR, Buss DC, Routledge PA. Amiodarone reduces plasma warfarin clearance in man. Br J Clin Pharmacol 1985 Dec;20(6):707-9.
9.Hamer A, Peter T, Mandel WJ, Scheinman MM, Weiss D. The potentiation of warfarin anticoagulation by amiodarone. Circulation 1982 May;65(5):1025-9.
10.Martinowitz U, Rabinovich J, Goldfarb D, Many A, Bank H. Interaction between warfarin sodium and amiodarone. N Engl J Med 1981 Mar 12; 304(11):671-2.
11.Serlin MJ, Sibeon RG, Green GJ. Dangers of amiodarone and anticoagulant treatment. Br Med J (Clin Res Ed) 1981 Jul 4;283(6283):58.
12.Kerin NZ, Blevins RD, Goldman L, Faitel K, Rubenfire M. The incidence, magnitude, and time course of the amiodarone-warfarin interaction. Arch Intern Med 1988 Aug;148(8):1779-81.
13.Arboix M, Frati ME, Laporte JR. The potentiation of acenocoumarol anticoagulant effect by amiodarone. Br J Clin Pharmacol 1984 Sep; 18(3):355-60.
14.Cheung B, Lam FM, Kumana CR. Insidiously evolving, occult drug interaction involving warfarin and amiodarone. BMJ 1996 Jan 13; 312(7023):107-8.
15.El Allaf D, Sprynger M, Carlier J. Potentiation of the action of oral anticoagulants by amiodarone. Acta Clin Belg 1984;39(5):306-8.
16.Fondevila C, Meschengieser S, Lazzari MA. Amiodarone potentiates acenocoumarin. Thromb Res 1989 Jan 15;53(2):203-8.
17.Caraco Y, Raveh D, Flugelman M, Raz I. Enhanced anticoagulant effect of acenocoumarol induced by amiodarone coadministration. Isr J Med Sci 1988 Nov;24(11):688-9.
18.Pini M, Manotti C, Quintavalla R. Interaction between amiodarone and acenocoumarin. Thromb Haemost 1985 Aug 30;54(2):549.
19.Caraco Y, Chajek-Shaul T. The incidence and clinical significance of amiodarone and acenocoumarol interaction. Thromb Haemost 1989 Nov 24; 62(3):906-8.
20.Hirmerova J, Suchy D, Madr T. Long-term drug interaction of warfarin with amiodarone. Cas Lek Cesk 2003 Jan 20;142(1):39-42.
21.Naganuma M, Shiga T, Nishikata K, Tsuchiya T, Kasanuki H, Fujii E. Role of desethylamiodarone in the anticoagulant effect of concurrent amiodarone and warfarin therapy. J Cardiovasc Pharmacol Ther 2001 Oct; 6(4):363-7.
22.Sanoski CA, Bauman JL. Clinical observations with the amiodarone/warfarin interaction: dosing relationships with long-term therapy. Chest 2002 Jan; 121(1):19-23.
23.Cordarone (amiodarone hydrochloride) US prescribing information. Wyeth Pharmaceuticals January, 2014.

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