tagamet and Anisindione Interactions

Interactions between tagamet(cimetidine) and Anisindione (anisindione)

cimetidine and anisindione (Moderate Drug-Drug)

MONITOR: Cimetidine inhibits the hepatic metabolism of warfarin, and may increase its anticoagulant effect over a one to two week period. This interaction appears to involve the less active R-warfarin more than the more active S-enantiomer. This effect may occur with other oral anticoagulants.

MANAGEMENT: If given together, the INR or PT should be monitored, and the lowest possible dose of cimetidine should be used. Another histamine-2 antagonist may be used with less risk of interaction. 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.