Drug interactions between Detrol and Miradon
| Results for the following 2 drugs: |
|---|
| Detrol (tolterodine) |
| Miradon (anisindione) |
Interactions between your selected drugs
anisindione ↔ tolterodine
Applies to:Miradon (anisindione) and Detrol (tolterodine)
MONITOR: Limited clinical data suggest that tolterodine may potentiate the hypoprothrombinemic effect of warfarin in some patients. There have been case reports of patients stabilized on warfarin whose INR increased following the addition of tolterodine and returned to normal after discontinuation of tolterodine, temporary withholding of warfarin doses, or reduction of warfarin dosage. The mechanism is unknown. In 20 healthy volunteers, pretreatment with tolterodine (2 mg orally twice a day for 7 days) relative to placebo had no significant effect on the pharmacokinetics of R(+) and S(-) warfarin or prothrombin times and factor VII activity following a single 25 mg dose of warfarin administered on study day 4. Warfarin also had no effect on the pharmacokinetics of tolterodine or its pharmacologically active 5-hydroxymethyl metabolite.
MANAGEMENT: Given the potential for interaction and the high degree of interpatient variability with respect to warfarin metabolism, patients should be closely monitored during concomitant therapy with tolterodine. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of tolterodine in patients who are stabilized on their warfarin regimen. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking. 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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