Drug interactions between Miradon and Vioxx
| Results for the following 2 drugs: |
|---|
| Miradon (anisindione) |
| Vioxx (rofecoxib) |
Interactions between your selected drugs
anisindione ↔ rofecoxib
Applies to:Miradon (anisindione) and Vioxx (rofecoxib)
MONITOR: Rofecoxib may potentiate the hypoprothrombinemic effect of warfarin and other oral anticoagulants as determined by the INR. In single- and multiple-dose studies in which healthy subjects received warfarin with rofecoxib or placebo, rofecoxib increased the INR by 5% to 11%, depending on the dosage used (12.5 mg to 50 mg). The higher INRs reported may be due to increased plasma concentrations of the biologically less active R(+) enantiomer of warfarin in the presence of rofecoxib. No significant changes were reported for the S(-) enantiomer. Although these results are not considered clinically significant, bleeding events associated with increases in prothrombin time have been reported in postmarketing use of the combination, particularly in the elderly.
MANAGEMENT: Patients should be closely monitored during concomitant therapy with oral anticoagulants and rofecoxib. The INR should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of rofecoxib in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of unusual bleeding or bruising to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, vaginal bleeding, nosebleeds, bleeding of gums from brushing, 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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