Drug interactions between Imuran and Miradon
| Results for the following 2 drugs: |
|---|
| Imuran (azathioprine) |
| Miradon (anisindione) |
Interactions between your selected drugs
azathioprine ↔ anisindione
Applies to:Imuran (azathioprine) and Miradon (anisindione)
MONITOR: Limited clinical data suggest that the purine analog antimetabolites, azathioprine and mercaptopurine, may reduce the hypoprothrombinemic response to warfarin and other oral anticoagulants. The mechanism has not been fully established but animal studies indicate that enhanced activation or synthesis of prothrombin may be involved. There have been case reports of patients stabilized on oral anticoagulant therapy whose prothrombin time or INR decreased following addition of the antimetabolites and returned to normal only after their discontinuation or an increase in anticoagulant dosage. Bleeding has been reported after discontinuation of the antimetabolite.
MANAGEMENT: Given the potential for interaction and the narrow therapeutic index of oral anticoagulants, patients should be closely monitored during concomitant therapy with azathioprine or mercaptopurine. The INR should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation or discontinuation of antimetabolite therapy in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of blood clots (e.g. chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity).
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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