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Warfarin, sold under the brand name Coumadin among others, is an anticoagulant medication. [12] While the drug is described as a "blood thinner", it does not reduce viscosity but rather prevents blood clots ( thrombus ) from forming ( coagulating ).
Warfarin [15] Papaya extract Carica papaya: Warfarin Damage to GI tract mucous membranes [3] Kava: kava-kava Piper methysticum: Sedatives, sleeping pills, antipsychotics, alcohol [15] Milkvetch: Astragalus: Astragalus may interact with medications that suppress the immune system, such as cyclophosphamide. [24] It may also affect blood sugar ...
Side effects may include bleeding, most commonly from the nose, gastrointestinal tract (GI) or genitourinary system. [2] Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain . [ 2 ]
When two drugs affect each other, it is a drug–drug interaction (DDI). The risk of a DDI increases with the number of drugs used. [1] A large share of elderly people regularly use five or more medications or supplements, with a significant risk of side-effects from drug–drug interactions. [2] Drug interactions can be of three kinds:
Type A: augmented pharmacological effects, which are dose-dependent and predictable [5]; Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant warfarin) or a low therapeutic index of the drug (e.g., nausea from digoxin), and they are therefore predictable.
There are three types of DTIs, dependent on their interaction with the thrombin molecule. Bivalent DTIs (hirudin and analogs) bind both to the active site and exosite 1, while univalent DTIs bind only to the active site. [1] The third class of inhibitors, which are gaining importance recently, is the allosteric inhibitors.
As with any medication, escitalopram may cause a range of potential side effects. These side effects are common to all SSRIs, and most are minor and temporary. These side effects are common to all ...
Therefore there is no definite evidence on the drug interaction effect on mortality. [38] For patients with high risk of gastrointestinal bleeding, the risk outweighs the possible adverse cardiovascular effects. It should therefore be recommended to those patients to combine clopidogrel with less CYP2C19 inhibiting PPI's, such as pantoprazole. [38]
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