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To see the full article, log in or purchase access.INR = International Normalized Ratio; NSAID = nonsteroidal anti-inflammatory drug; HMG-CoA = 3-hydroxy-3-methylglutaryl–coenzyme A reductase inhibitor; SSRI = selective serotonin reuptake inhibitorINR = International Normalized Ratio; NSAID = nonsteroidal anti-inflammatory drug; HMG-CoA = 3-hydroxy-3-methylglutaryl–coenzyme A reductase inhibitor; SSRI = selective serotonin reuptake inhibitor*—Combining an agent that inhibits cytochrome P450 metabolism with a substrate of cytochrome P450 may potentiate the pharmacologic effects of the substrate through inhibition of hepatic metabolism*—Combining an agent that inhibits cytochrome P450 metabolism with a substrate of cytochrome P450 may potentiate the pharmacologic effects of the substrate through inhibition of hepatic metabolismComplete database for drug interactions as well as clinically useful drug information; updated quarterlyHansten and Horn's Drug Interactions Analysis and Management (manual)Easy-to-use index that categorizes a drug interaction by clinical significance, along with a concise reference monograph discussing the interaction; updated quarterlyHandbook of Adverse Drug Interactions (manual); Adverse Drug Interactions Program (software, Internet)Software searches for interactions between two and up to 25 drugsDrug Interactions Analysis and Management (loose-leaf or bound manual); Drug Interaction Facts (loose-leaf or bound manual with software)Information about drug-drug and drug-food interactions in a quick reference format, along with descriptive monographs of drug interactions selected on the basis of their potential to alter patient outcomes; updated quarterlyComplete database for drug interactions as well as clinically useful drug information; updated quarterlyHansten and Horn's Drug Interactions Analysis and Management (manual)Easy-to-use index that categorizes a drug interaction by clinical significance, along with a concise reference monograph discussing the interaction; updated quarterlyHandbook of Adverse Drug Interactions (manual); Adverse Drug Interactions Program (software, Internet)Software searches for interactions between two and up to 25 drugsDrug Interactions Analysis and Management (loose-leaf or bound manual); Drug Interaction Facts (loose-leaf or bound manual with software)Information about drug-drug and drug-food interactions in a quick reference format, along with descriptive monographs of drug interactions selected on the basis of their potential to alter patient outcomes; updated quarterlyAddress correspondence to Paul W. Ament, Pharm.D., Clinical Pharmacy Services, Latrobe Area Hospital, 121 W. 2nd Ave., Latrobe, PA 15650.

Faul JC, For example, according to American Family Physician, a fair amount of evidence suggests that penicillins can cause moderately severe symptoms in warfarin users due to their effects on International … Access This ArticlePAUL W. AMENT, PHARM.D., is assistant director of pharmacy and a faculty member in the family medicine residency program at Latrobe (Pa.) Area Hospital. Andrews E, Damle BD, Fang A, et al. Almost all antibiotics can potentiate the effects of warfarin by inhibiting intestinal flora that produce vitamin K. Inhibition of the hepatic metabolism of warfarin is another possible mechanism for increased bleeding.Clinical trials evaluating warfarin-antibiotic combinations have had mixed outcomes.Unless the prothrombin International Normalized Ratio (INR) can be monitored every other day, ciprofloxacin, macrolide antibiotics, metronidazole and trimethoprim-sulfamethoxazole generally should not be prescribed to patients who are taking warfarin. If either combination is used, patients should be alert for muscle pain, tenderness or weakness. Rifampinphenytoin drug interaction. Lomaestro BM, The mechanisms of this interaction are antiplatelet effect and gastric mucosal damage, because most NSAIDs do not produce a hypothrombinemic response. Academic Institutions. Visapää JP, Tillonen JS, Kaihovaara PS, et al.

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