| Selected warfarin drug-drug interactions | ||||
| Contains many of the typical agents, however, there may be some omissions. Decreased effect (lower INR) | Increased INR/Potentiation | Drug-food interactions | Agents that may increase bleeding risk |
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Warfarin related Links |
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Decreased warfarin effect (Lower INR) |
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Increased warfarin effect (POTENTIATION) |
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Warfarin – Food Interactions |
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| Management of Dietary Interactions and Vitamin K: dietary consistency is the key to maintaining a sustained, stable response during warfarin therapy. Patients should be aware of vitamin K content in common foods, particularly foods high in vitamin K (green leafy vegetables: broccoli, Brussel sprouts, turnip greens, kale, spinach, beet greens), Cauliflower, legumes, mayonnaise, canola and soybean oils), and should maintain a consistent amount of these foods in their diet.
The following foods should be avoided or limited, since they also can effect warfarin therapy: caffeinated beverages (cola, coffee, tea, hot chocolate, chocolate milk). Alcohol intake greater than 3 drinks daily can increase the effect of Coumadin. As long as alcohol intake does not exceed 3 drinks daily, clotting times should not be affected. This amount of alcohol is present in 12 ounces of table wine or three 12 ounce beers. (Acute binges can raise INR. Chronic alcohol ingestion may decrease INR. ) Herbal supplements can affect bleeding time. Coenzyme Q10 is an herbal supplement whose chemical structure is similar to vitamin K, so it has the potential to affect bleeding time. Herbal teas: green tea, buckeye, horsechestnut, tonka, bean, meliot, and woodruff. Other examples include: feverfew, garlic, and ginseng. Herbal medications should either be avoided or used consistently while on warfarin therapy. |
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Increased bleeding risk |
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| Drugs: Aspirin Clopidogrel Danaparoid Dipyridamole LMWHs NSAIDs Ticlopidine Unfractionated heparin |
