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.
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:
When these medicines are taken together, corticosteroids may change the way your blood clots.
What might happen:
You may experience an increased chance of bleeding, including bleeding from your gums, nosebleeds, unusual bruising, or dark stools. The effect of your anticoagulant may also be decreased, which could increase your chance forming a blood clot.
What you should do about this interaction:
Contact your doctor right away if you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools. If your doctor prescribes these medicines together, you may need to have your bleeding times 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 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.Cosgriff SW, Diefenbach AF, Vogt W Jr. Hypercoagulability of the blood associated with ACTH and cortisone therapy. American Journal of Medicine 1950 Dec;752-56.
- 2.Ozsoylu S, Strauss HS, Diamond LK. Effects of corticosteroids on coagulation of the blood. Nature 1962 Sept 22;195:1214-15.
- 3.Van Cauwenberge H, Jaques LB. Hemorrhagic effect of ACTH with anticoagulants. Can Med Assoc J 1958 Oct 1;79:536-40.
- 4.Hamblin TJ. Interaction between warfarin and phenformin. Lancet 1971 Dec 11;2(7737):1323.
- 5.O'Connell TX, Aston SJ. Acute adrenal hemorrhage complicating anticoagulant therapy. Surg Gynecol Obstet 1974 Sep;139(3):355-7.
- 6.Hellem AJ, Solem JH. The influence of ACTH on prothrombin-proconvertin values in blood during treatment with dicumarol and phenylindanedione. Acta Medica Scandinavica 1954;150:389-93.
- 7.Sievers J, Johansson BW, Nilsson SE. The corticosteroid treatment of acute myocardial infarction. Cardiologia 1964;45(2):65-76.
- 8.Brozovic M, Gurd LJ. Prothrombin during warfarin treatment. Br J Haematol 1973 May;24(5):579-88.
- 9.Costedoat-Chalumeau N, Amoura Z, Aymard G, Sevin O, Wechsler B, Cacoub P, Du LT, Diquet B, Ankri A, Piette JC. Potentiation of vitamin K antagonists by high-dose intravenous methylprednisolone. Ann Intern Med 2000 Apr 18; 132(8):631-5.
- 10.Stading JA. Effects of prednisone on the International Normalized Ratio. Am J Health Syst Pharm 2006 Dec 1;63(23):2354-6.
- 11.Kaufman M. Treatment of multiple sclerosis with high-dose corticosteroids may prolong the prothrombin time to dangerous levels in patients taking warfarin. Mult Scler 1997 Aug;3(4):248-9.
- 12.Chatterjea JB, Salomon L. Antagonistic effect of ACTH and cortisone on the anticoagulant activity of ethyl biscoumacetate. Br Med J 1954 Oct 2; 2:790-92.
- 13.Menczel J, Dreyfuss F, . Effect of prednisone on blood coagulation time in patients on dicumarol therapy. J Lab & Clin Med 1960 Jul;56(1):14-20.
- 14.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.
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.