xeloda and Miradon Interactions

Interactions between xeloda(capecitabine) and Miradon (anisindione)

anisindione and capecitabine (Major Drug-Drug)

MONITOR CLOSELY: Fluorouracil and its prodrug capecitabine may significantly potentiate the hypoprothrombinemic effect of warfarin and other oral anticoagulants. The mechanism of the interaction is unknown. Altered coagulation parameters and/or bleeding have been reported in patients stabilized on a coumarin-derivative anticoagulant such as warfarin following the addition of fluorouracil or capecitabine. Based on reported cases, increases in INR or prothrombin time may occur within a couple days after initiation of chemotherapy and continue gradually over several months and even after stopping chemotherapy. Tegafur, another prodrug, may theoretically also interact.

MANAGEMENT: Patients should be closely monitored during concomitant therapy. The INR or PT should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation or discontinuation of fluorouracil or capecitabine therapy in patients who are stabilized on their anticoagulant regimen. 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.