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    Nizoral Tablet

    Interactions

    Select Azole Antifungal Agents/Coumarin 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, your body may not process your blood-thinner 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:

    Make sure your healthcare professionals (e.g. doctor or pharmacist) know you are taking these medicines together.If your doctor prescribes these two drugs together, you may need to have your blood tests (e.g. INR) checked more often. If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals (e.g. doctor or pharmacist) 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.Johnson JA, Gong L, Whirl-Carrillo M, Gage BF, Scott SA, Stein CM, Anderson JL, Kimmel SE, Lee MT, Pirmohamed M, Wadelius M, Klein TE, Altman RB. Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C9 and VKORC1 genotypes and warfarin dosing. Clin Pharmacol Ther 2011 Oct;90(4):625-9.

    2.Vfend (voriconazole) US prescribing information. Pfizer Inc. July, 2017. 3.Turrentine MA. Single-dose fluconazole for vulvovaginal candidiasis: impact on prothrombin time in women taking warfarin. Obstet Gynecol 2006 Feb;107(2 Pt 1):310-3.

    3.Schelleman H, Bilker WB, Brensinger CM, Han X, Kimmel SE, Hennessy S. Warfarin with fluoroquinolones, sulfonamides, or azole antifungals: interactions and the risk of hospitalization for gastrointestinal bleeding. Clin Pharmacol Ther 2008 Nov;84(5):581-8.

    4.Yamamoto H, Habu Y, Yano I, Ozaki J, Kimura Y, Sato E, Shida A, Fukatsu S, Matsubara K. Comparison of the effects of azole antifungal agents on the anticoagulant activity of warfarin. Biol Pharm Bull 2014;37(12):1990-3.

    5.Smith AG. Potentiation of oral anticoagulants by ketoconazole. Br Med J (Clin Res Ed) 1984 Jan 21;288(6412):188-9.

    6.O'Reilly RA, Goulart DA, Kunze KL, Neal J, Gibaldi M, Eddy AC, Trager WF. Mechanisms of the stereoselective interaction between miconazole and racemic warfarin in human subjects. Clin Pharmacol Ther 1992 Jun; 51(6):656-67.

    7.Colquhoun MC, Daly M, Stewart P, Beeley L. Interaction between warfarin and miconazole oral gel. Lancet 1987 Mar 21;1(8534):695-6.

    8.Shenfield GM, Page M. Potentiation of warfarin action by miconazole oral gel. Aust N Z J Med 1991 Dec;21(6):928.

    9.Lazar JD, Wilner KD. Drug interactions with fluconazole. Rev Infect Dis 1990 Mar-Apr;12 Suppl 3:S327-33.

    10.Seaton TL, Celum CL, Black DJ. Possible potentiation of warfarin by fluconazole. DICP 1990 Dec;24(12):1177-8.

    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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