Drug interactions between Miradon and Plavix
| Results for the following 2 drugs: |
|---|
| Miradon (anisindione) |
| Plavix (clopidogrel) |
Interactions between your selected drugs
anisindione ↔ clopidogrel
Applies to:Miradon (anisindione) and Plavix (clopidogrel)
MONITOR CLOSELY: Concomitant use of clopidogrel and oral anticoagulants such as warfarin may increase the risk of bleeding. Although often prescribed (with or without low-dose aspirin) in patients with atrial fibrillation following percutaneous coronary intervention (PCI) or revascularization surgery to prevent myocardial ischemic events, the safety and efficacy of these agents in combination have not been thoroughly evaluated. In a retrospective analysis of registry data derived from a Dutch record linkage system for a cohort of new coumarin (acenocoumarol or phenprocoumon) users, investigators found that use of antiplatelet agents was associated with a significantly increased risk of hospitalization for major bleeding during coumarin therapy, and the greatest risk was observed with clopidogrel. The odds ratio of major bleeding in coumarin users was 2.9 for clopidogrel (75 mg/day), 1.6 for aspirin (30 to 100 mg/day), and 1.5 for dipyridamole (150 to 450 mg/day), even after adjustment for use of nonsteroidal anti-inflammatory drugs, antibiotic usage, corticosteroids, and gastroprotective agents. A third of the bleeding events were gastrointestinal, with adjusted odd ratios of 3.6, 2.2 and 2.1 for clopidogrel, dipyridamole and aspirin, respectively. Approximately 20% of the nongastrointestinal bleeding events were intracranial. Other studies have also reported an increased risk of bleeding complications during coadministration of antiplatelet and oral anticoagulant therapy. However, most of the data involve aspirin alone or dual antiplatelet therapy with aspirin, thus the actual risk attributed to clopidogrel is usually unknown. In contrast, a study of 43 patients with atrial fibrillation who had been stabilized on warfarin for at least 2 months reported no bleeding and no significant changes in average INR or R(+) and S(-) warfarin levels when clopidogrel 75 mg/day was added for 8 days.
MANAGEMENT: Caution and close monitoring of the INR and other bleeding parameters are recommended if clopidogrel is used in combination with an oral anticoagulant. 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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