Drug interactions between Miradon and Virazole

Results for the following 2 drugs:
Miradon (anisindione)
Virazole (ribavirin)

Interactions between your selected drugs

ribavirin ↔ anisindione

Applies to:Virazole (ribavirin) and Miradon (anisindione)

MONITOR: Ribavirin may decrease the hypoprothrombinemic effect of warfarin. The mechanism of interaction is unknown. In an isolated case report, a 61-year-old man previously stabilized on 45 mg/week of warfarin required an approximately 40% increase in the anticoagulant dosage over a period of one month following addition of interferon alfa-2b and ribavirin therapy for hepatitis C. After discontinuation of interferon-ribavirin therapy a year later, the anticoagulant dosage decreased to 47.5 mg/week over a three-week period. A subsequent rechallenge with ribavirin appeared to confirm the interaction. The effect of ribavirin on other oral anticoagulants is unknown.

MANAGEMENT: Patients treated with warfarin should be closely monitored during concomitant therapy with ribavirin. The INR should be checked frequently (e.g., weekly) during the 4 weeks following initiation or discontinuation of ribavirin therapy in patients who are stabilized on their warfarin regimen, and the warfarin dosage adjusted accordingly. 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.


Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2012 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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