Drug interactions between Bextra and Miradon
| Results for the following 2 drugs: |
|---|
| Bextra (valdecoxib) |
| Miradon (anisindione) |
Interactions between your selected drugs
anisindione ↔ valdecoxib
Applies to:Miradon (anisindione) and Bextra (valdecoxib)
MONITOR: Coadministration with valdecoxib may increase the plasma concentrations and hypoprothrombinemic effect of warfarin and other oral anticoagulants. The exact mechanism of interaction is unknown, although it is possible that valdecoxib partially inhibits the metabolic clearance of warfarin via CYP450 2C9 and 2C19. In healthy subjects given warfarin with valdecoxib (40 mg twice a day for 7 days), the area under the plasma concentration-time curve (AUC) of the biologically less active R(+) enantiomer and that of the more active S(-) enantiomer of warfarin increased by 12% and 15%, respectively. Although the average International Normalization Ratio (INR) values were only slightly increased, the day-to-day variability in individual INR values was increased. Parecoxib, a prodrug of valdecoxib, may also interact.
MANAGEMENT: Patients should be closely monitored during concomitant therapy with oral anticoagulants and valdecoxib or parecoxib. The INR should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of valdecoxib in patients who are stabilized on their anticoagulant regimen. 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.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
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