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Drug Interactions between Abbokinase Open-Cath and omega-3 polyunsaturated fatty acids

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

omega-3 polyunsaturated fatty acids urokinase

Applies to: omega-3 polyunsaturated fatty acids and Abbokinase Open-Cath (urokinase)

MONITOR: Omega-3 fatty acids (e.g., fish oil) may potentiate the pharmacologic effects of anticoagulants and other drugs that affect hemostasis such as platelet inhibitors, thrombin inhibitors, thrombolytic agents, dextran, and nonsteroidal anti-inflammatory drugs (NSAIDs). The exact mechanism of interaction is unknown. Omega-3 fatty acids may possess mild antiplatelet and hypocoagulant activities. In some studies, these substances have been shown to reduce thrombin generation and plasma levels of fibrinogen, prothrombin, and coagulation factors V, VII, and X. Prolongation of bleeding time has been demonstrated, although it did not exceed normal limits and did not produce clinically significant bleeding. The interaction was suspected in a case report of a 67-year-old woman treated with warfarin for 1.5 years who exhibited an increase in INR from 2.8 the previous month to 4.3 approximately one week after doubling her fish oil dosage from 1000 to 2000 mg/day. Prior to the increase, her INR had been stable and therapeutic for 5 months on warfarin 1.5 mg/day. The patient was advised to reduce her fish oil consumption to 1000 mg/day, while her warfarin dose was withheld for one day and then reduced to 1 mg alternating with 1.5 mg per day. Eight days later, her INR was subtherapeutic at 1.6, so the warfarin dosage was increased back to 1.5 mg/day. The patient's INR subsequently returned to therapeutic range.

MANAGEMENT: In general, patients should consult a healthcare provider before taking any herbal or nutritional supplements. Patients using omega-3 fatty acids in combination with anticoagulants or other drugs that affect hemostasis should be advised of the potential for increased risk of bleeding complications.

References

  1. (2005) "Product Information. Omacor (omega-3 polyunsaturated fatty acids)." Abbott Pharmaceutical
  2. Vanschoonbeek K, Feijge MA, Paquay J, et al. (2004) "Variable hypocoagulant effect of fish oil intake in humans: modulation of fibrinogen level and thrombin generation." Arterioscler Thromb Vasc Biol, 24, p. 1734-40
  3. Buckley MS, Goff AD, Knapp WE (2004) "Fish oil interaction with warfarin." Ann Pharmacother, 38, p. 50-3
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Cerner Multum, Inc. "Australian Product Information."
  6. (2012) "Product Information. Vascepa (icosapent)." Amarin Pharmaceuticals Inc
  7. Li XL, Steiner M (1990) "Fish oil: a potent inhibitor of platelet adhesiveness." Blood, 76, p. 938-45
View all 7 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.