Drug Interactions between betrixaban and dong quai

GENERALLY AVOID: Dong quai may potentiate the effects of anticoagulants, platelet inhibitors and thrombolytic agents, possibly increasing the risk of bleeding. Dong quai has been reported to exert an antithrombotic effect by inhibiting platelet activation and aggregation. In one patient, the addition of dong quai 565 mg once or twice daily to a stabilized regimen of warfarin resulted in a sudden increase in INR after 4 weeks. The INR returned to normal 4 weeks following discontinuation of the dong quai.

MANAGEMENT: Patients should consult a healthcare provider before taking any herbal or alternative medicine. In general, consumption of dong quai should preferably be avoided during use of coagulation-modifying agents. In patients who have used this herb extensively prior to receiving anticoagulation, antiplatelet or thrombolytic therapy, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

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