warfarin-sodium and Abbokinase Interactions

Interactions between warfarin-sodium(warfarin) and Abbokinase (urokinase)

warfarin and urokinase (Major Drug-Drug)

MONITOR CLOSELY: Although warfarin is commonly administered for the prevention of embolism in certain patients following thrombolytic therapy (e.g., myocardial infarction), oral anticoagulants may increase the risk of serious bleeding when administered before, during, or after fibrinolytic agents. Cholesterol embolization syndrome has also been reported rarely with thrombolytics and anticoagulants, when used alone or in combination.

MANAGEMENT: Alteplase is contraindicated in patients with acute ischemic stroke who are currently taking oral anticoagulants and have an INR greater than 1.7. For other indications, risk versus benefit should be carefully weighed if patients who are currently taking oral anticoagulants (INR 2 to 3) are to receive thrombolytic therapy and patient selection should adhere to currently recommended criteria. Patients should be closely monitored for signs of bleeding, especially at arterial puncture sites. If oral anticoagulants are initiated following thrombolytic therapy, the dosage should be adjusted as appropriate to maintain therapeutic INR values. Patients should be closely monitored for clinical and laboratory signs of bleeding.