Interactions between Anisindione and Oxymetholone
1 drug interaction and 55 additional warnings found for the following 2 drugs:
- anisindione
- oxymetholone
Drug interactions
Major drug interactions
Major:
anisindione oxymetholone
Applies to: anisindione and oxymetholone
Monitor closely
Androgens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol. In a clinical study (n=15), the concomitant administration of oxandrolone 10 to 20 mg per day increased the half-life of the more active S(-) enantiomer of warfarin from 26 to 48 hours and the systemic exposure (AUC) from 4.55 to 12.08 ng-hr/mL. R(-) warfarin half-life and AUC also increased. Microscopic hematuria and gingival bleeding were reported, and the warfarin dose had to be reduced by 80% to 85% to maintain the desired INR.
Management
During concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. 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.
References (21)
- Shaw PW, Smith AM (1987) "Possible interaction of warfarin and stanozolol." Clin Pharm, 6, p. 500-2
- Small M, Peterkin M, Lower GD, et al. (1982) "Danazol and oral anticoagulants." Scott Med J, 27, p. 331-2
- Schrogie JJ, Solomon HM (1967) "The anticoagulant response to bishydroxycoumarin. II. The effect of D-thyroxine, clofibrate, and norethandrolone." Clin Pharmacol Ther, 8, p. 70-7
- Pyorala K, Kekki M (1963) "Anabolic steroids and anticoagulant requirements." Lancet, 2, p. 360-1
- Ekert H, Muntz RH, Colebatch JH (1971) "Decreased anticoagulant tolerance with oxymetholone." Lancet, 2, p. 609-10
- Lorentz SM, Weibert RT (1985) "Potentiation of warfarin anticoagulation by topical testosterone ointment." Clin Pharm, 4, p. 333-5
- Murakami M, Odake K, Matsuda T, Onchi K, Umeda T, Nishino T (1965) "Effects of anabolic steroids on anticoagulant requirements." Jpn Circ J, 29, p. 243-50
- Robinson BH, Hawkins JB, Ellis JE, Moore-Robinson M (1971) "Decreased anticoagulant tolerance with oxymetholone." Lancet, 1, p. 1356
- Longridge RG, Gillam PM, Barton GM (1971) "Decreased anticoagulant tolerance with oxymetholone." Lancet, 2, p. 90
- Edwards MS, Curtis JR (1971) "Decreased anticoagulant tolerance with oxymetholone." Lancet, 2, p. 221
- de Oya JC, del Rio A, Noya M, Villanueva A (1971) "Decreased anticoagulant tolerance with oxymetholone in paroxysmal nocturnal haemoglobinuria." Lancet, 2, p. 259
- Husted S, Andreasen F, Foged L (1976) "Increased sensitivity to phenprocoumon during methyltestosterone therapy." Eur J Clin Pharmacol, 10, p. 209-16
- Goulbourne IA, Macleod DA (1981) "An interaction between danazol and warfarin: case report." Br J Obstet Gynaecol, 88, p. 950-1
- Wells PS, Holbrook AM, Crowther NR, Hirsh J (1994) "Interactions of warfarin with drugs and food." Ann Intern Med, 121, p. 676-83
- (2001) "Product Information. Halotestin (fluoxymesterone)." Pharmacia and Upjohn
- (2001) "Product Information. Danocrine (danazol)." Sanofi Winthrop Pharmaceuticals
- Meeks ML, Mahaffey KW, Katz MD (1992) "Danazol increases the anticoagulant effect of warfarin." Ann Pharmacother, 26, p. 641-2
- (2001) "Product Information. Androderm (testosterone topical)." SmithKline Beecham
- (2001) "Product Information. Oxandrin (oxandrolone)." Bio-Tech
- "Product Information. Android (methylTESTOSTERone)." ICN Pharmaceuticals Inc
- (2001) "Product Information. Winstrol (stanozolol)." Sanofi Winthrop Pharmaceuticals
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
anisindione Food/Lifestyle
Applies to: anisindione
Monitor
Vitamin K antagonizes the anticoagulant effect of oral anticoagulants such as warfarin. Vitamin K is a cofactor in the hepatic synthesis of clotting factors II, VII, IX, and X, which warfarin inhibits. Consumption of vitamin K through supplements or diet can reduce the effectiveness of warfarin and potentially lower the INR, while a sudden reduction in vitamin K intake after stabilization can lead to elevation of the INR, increasing the risk of bleeding. Foods with high vitamin K content include liver, broccoli, Brussels sprouts, cabbage, collard greens, kale, lettuce, spinach, and other green leafy vegetables. Moderate vitamin K levels are found in foods such as mayonnaise, green tea, and various oils including canola, olive, and soybean oil. Certain foods and products may also antagonize warfarin's anticoagulant effects, resulting in subtherapeutic INR values. High intake of soy products, particularly soy milk, has been associated with reduced response to warfarin in rare case reports; although the mechanism remains unclear, as soy milk contains little vitamin K. Patients have experienced subtherapeutic INR values after starting regular soy milk ingestion, with return to therapeutic range upon discontinuation of soy milk. There have been case reports of inadequate anticoagulation with warfarin associated with the use of smokeless tobacco products, attributed to their high vitamin K content. Discontinuation of tobacco resulted in increased INR and return to adequate anticoagulation. Alcohol may have variable effects on oral anticoagulant therapy depending on consumption patterns. Acute alcohol ingestion may inhibit the hepatic metabolism of warfarin, potentially resulting in elevated INR and increased bleeding risk. Conversely, chronic alcohol consumption may reduce warfarin's effect by increasing its metabolism and lowering INR. Additionally, alcohol may independently increase the risk of gastrointestinal bleeding through direct irritation of the gastric mucosa. Patients with alcohol-related liver disease may also exhibit unpredictable responses to oral anticoagulant therapy due to impaired synthesis of clotting factors. Conversely, several foods may enhance warfarin effects through various mechanisms. Cranberry juice consumption has been linked to INR changes and bleeding complications, potentially through flavonoid-induced alterations in warfarin metabolism, with at least one fatality reported in the U.K. Grapefruit juice, a moderate to strong CYP450 3A4 inhibitor, may decrease clearance of R(+) warfarin, though clinical significance remains uncertain. In vitro data suggest that pomegranate juice may inhibit CYP450 2C9, affecting metabolism of the more active S(-) warfarin enantiomer. Black currant products may theoretically increase bleeding risk through antiplatelet effects of gamma-linolenic acid.
Management
Patients receiving warfarin therapy should be counseled to maintain a consistent dietary intake of vitamin K-containing foods, as sudden changes may destabilize anticoagulation control. Advise patients to avoid or limit consumption of cranberry juice, grapefruit juice and pomegranate juice due to potential enhancement of warfarin effects. Patients should also be informed that high intake of soy milk or use of smokeless tobacco products may reduce anticoagulant efficacy. Regarding alcohol, patients should be advised to avoid excessive or binge drinking and to maintain consistent, moderate consumption patterns if they choose to drink; those with alcohol-related liver disease require particularly close monitoring due to unpredictable anticoagulant responses. Some authorities consider alcoholism a contraindication for the use of warfarin. For patients receiving enteral nutrition, consider assessing the vitamin K content of feeding formulations, as formulations vary in content. Interrupting continuous enteral nutrition around warfarin administration may also be considered. The INR should be monitored more frequently following any significant dietary changes, initiation or discontinuation of implicated foods or substances, or changes in alcohol consumption patterns. Patients should be instructed to report signs or symptoms of bleeding (unusual bruising, prolonged bleeding from cuts, blood in urine or stool, nosebleeds) or thromboembolic events (swelling, pain, shortness of breath) promptly to their healthcare provider. Patients should inform their provider before making substantial changes to their diet or lifestyle habits.
References (41)
- Andersen P, Godal HC (1975) "Predictable reduction in anticoagulant activity of warfarin by small amounts of vitamin K." Acta Med Scand, 198, p. 269-70
- Westfall LK (1981) "An unrecognized cause of warfarin resistance." Drug Intell Clin Pharm, 15, p. 131
- Lee M, Schwartz RN, Sharifi R (1981) "Warfarin resistance and vitamin K." Ann Intern Med, 94, p. 140-1
- Zallman JA, Lee DP, Jeffrey PL (1981) "Liquid nutrition as a cause of warfarin resistance." Am J Hosp Pharm, 38, p. 1174
- Griffith LD, Olvey SE, Triplett WC (1982) "Increasing prothrombin times in a warfarin-treated patient upon withdrawal of ensure plus." Crit Care Med, 10, p. 799-800
- Kempin SJ (1983) "Warfarin resistance caused by broccoli." N Engl J Med, 308, p. 1229-30
- Watson AJ, Pegg M, Green JR (1984) "Enteral feeds may antagonise warfarin." Br Med J, 288, p. 557
- Walker FB (1984) "Myocardial infarction after diet-induced warfarin resistance." Arch Intern Med, 144, p. 2089-90
- Howard PA, Hannaman KN (1985) "Warfarin resistance linked to enteral nutrition products." J Am Diet Assoc, 85, p. 713-5
- Karlson B, Leijd B, Hellstrom K (1986) "On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment." Acta Med Scand, 220, p. 347-50
- Pedersen FM, Hamberg O, Hess K, Ovesen L (1991) "The effect of dietary vitamin K on warfarin-induced anticoagulation." J Intern Med, 229, p. 517-20
- Parr MD, Record KE, Griffith GL, et al. (1982) "Effect of enteral nutrition on warfarin therapy." Clin Pharm, 1, p. 274-6
- Wells PS, Holbrook AM, Crowther NR, Hirsh J (1994) "Interactions of warfarin with drugs and food." Ann Intern Med, 121, p. 676-83
- O'Reilly RA, Rytand DA (1980) ""Resistance" to warfarin due to unrecognized vitamin K supplementation." N Engl J Med, 303, p. 160-1
- Kazmier FJ, Spittell JA Jr (1970) "Coumarin drug interactions." Mayo Clin Proc, 45, p. 249-55
- Chow WH, Chow TC, Tse TM, Tai YT, Lee WT (1990) "Anticoagulation instability with life-threatening complication after dietary modification." Postgrad Med J, 66, p. 855-7
- MacLeod SM, Sellers EM (1976) "Pharmacodynamic and pharmacokinetic drug interactions with coumarin anticoagulants." Drugs, 11, p. 461-70
- Sullivan DM, Ford MA, Boyden TW (1998) "Grapefruit juice and the response to warfarin." Am J Health Syst Pharm, 55, p. 1581-3
- Harrell CC, Kline SS (1999) "Vitamin K-supplemented snacks containing olestra: Implication for patients taking warfarin." Jama J Am Med Assn, 282, p. 1133-4
- Cambria-Kiely JA (2002) "Effect of soy milk on warfarin efficacy." Ann Pharmacother, 36, p. 1893-6
- MHRA. Mediciines and Healthcare products Regulatory Agency. Committee on Safety of Medicines (2003) Possible interaction between warfarin and cranberry juice. http://medicines.mhra.gov.uk/ourwork/monitorsafequalmed/currentproblems/currentproblems.htm
- Suvarna R, Pirmohamed M, Henderson L (2003) "Possible interaction between warfarin and cranberry juice." BMJ, 327, p. 1454
- Kuykendall JR, Houle MD, Rhodes RS (2004) "Possible warfarin failure due to interaction with smokeless tobacco." Ann Pharmacother, 38, p. 595-7
- Grant P (2004) "Warfarin and cranberry juice: an interaction?" J Heart Valve Dis, 13, p. 25-6
- Rindone JP, Murphy TW (2006) "Warfarin-cranberry juice interaction resulting in profound hypoprothrombinemia and bleeding." Am J Ther, 13, p. 283-4
- Brandin H, Myrberg O, Rundlof T, Arvidsson AK, Brenning G (2007) "Adverse effects by artificial grapefruit seed extract products in patients on warfarin therapy." Eur J Clin Pharmacol, 63, p. 565-70
- Griffiths AP, Beddall A, Pegler S (2008) "Fatal haemopericardium and gastrointestinal haemorrhage due to possible interaction of cranberry juice with warfarin." J R Soc Health, 128, p. 324-6
- Guo LQ, Yamazoe Y (2004) "Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines." Acta Pharmacol Sin, 25, p. 129-36
- Hamann GL, Campbell JD, George CM (2011) "Warfarin-cranberry juice interaction." Ann Pharmacother, 45, e17
- Jarvis S, Li C, Bogle RG (2010) "Possible interaction between pomegranate juice and warfarin." Emerg Med J, 27, p. 74-5
- Roberts D, Flanagan P (2011) "Case report: Cranberry juice and warfarin." Home Healthc Nurse, 29, p. 92-7
- Ge B, Zhang Z, Zuo Z (2014) "Updates on the clinical evidenced herb-warfarin interactions." Evid Based Complement Alternat Med, 2014, p. 957362
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
- Bodiford AB, Kessler FO, Fermo JD, Ragucci KR (2013) "Elevated international normalized ratio with the consumption of grapefruit and use of warfarin." SAGE Open Med Case Rep, p. 1-3
- (2025) "Product Information. Jantoven (warfarin)." Upsher-Smith Laboratories LLC
- (2018) "Product Information. Taro-Warfarin (warfarin)." Taro Pharmaceuticals Inc
- (2025) "Product Information. Warfarin (warfarin)." Strides Pharma UK Ltd
- (2021) "Product Information. ALDOCUMAR (warfarina)." ALDO-UNION, S.A.
- NHS Choices (2025) "Managing interactions between medicines and enteral feeds" Spec Pharm Servi, -, p. 1-2
- T L MacMath (1990) "Alcohol and gastrointestinal bleeding" Emerg Med Clin North Am, 8, p. 859-872
- Gish RG, Flamm SL (2021) "Anticoagulation in Patients With Chronic Liver Disease" Gastroenterol Hepatol (N Y), 17, p. 10-15
Moderate:
anisindione multivitamins with minerals
Applies to: anisindione
Monitor
Multivitamin preparations containing vitamin K may antagonize the hypoprothrombinemic effect of oral anticoagulants in some patients. Vitamin K1 in its active, reduced form serves as a cofactor in the generation of functional clotting factors, during which it becomes oxidized. It is reactivated in a process that is inhibited by oral anticoagulants, thus intake of additional vitamin K through supplements or diet can reverse the action of oral anticoagulants. Although the amount of vitamin K in over-the-counter multivitamin preparations is generally well below the dose thought to affect anticoagulation, there have been isolated case reports of patients stabilized on warfarin whose INR decreased following initiation of a multivitamin supplement and returned to therapeutic levels upon cessation of the multivitamin. Increases in warfarin dosage were required in some cases when the multivitamin was continued. One patient whose warfarin dosage was increased developed a subcapsular hematoma in her right kidney two weeks after she discontinued the multivitamin without informing her physician. Her INR was 13.2 and she was treated with vitamin K and fresh frozen plasma. It is possible that patients with low vitamin K status may be particularly susceptible to the interaction. Investigators have shown that vitamin K deficiency can cause an oversensitivity to even small increases in vitamin K intake. In one study where warfarin-stabilized patients were given a multivitamin tablet containing 25 mcg of vitamin K1 daily for 4 weeks, subtherapeutic INRs occurred in 9 of 9 patients with low vitamin K1 levels (<1.5 mcg/L) and only 1 of 7 patients with normal vitamin K1 levels (>4.5 mcg/L). INR decreased by a median of 0.51 and warfarin dosage had to be increased by 5.3% in patients with low vitamin K1 levels, whereas INR and warfarin dosage did not change significantly in patients with normal vitamin K1 levels. The prevalence of vitamin K deficiency may be small, but significant in the anticoagulated population. In a survey of 179 consecutive ambulatory patients on stable warfarin therapy attending an anticoagulation clinic, 22 (12.3%) were found to have vitamin K1 deficiency (<0.1 ng/mL).
Management
The potential for multivitamin supplements containing even low levels of vitamin K to affect anticoagulation should be recognized. In particular, elderly and/or malnourished patients may require more frequent monitoring of INR following the initiation or discontinuation of a multivitamin supplement, and the anticoagulant dosage adjusted as necessary.
References (3)
- Kurnik D, Loebstein R, Rabinovitz H, Austerweil N, Halkin H, Almog S (2004) "Over-the-counter vitamin K1-containing multivitamin supplements disrupt warfarin anticoagulation in vitamin K1-depleted patients. A prospective, controlled trial." Thromb Haemost, 92, p. 1018-24
- Kumik D, Lubetsky A, Loebstein R, Almog S, Halkin H (2003) "Multivitamin supplements may affect warfarin anticoagulation in susceptible patients." Ann Pharmacother, 37, p. 1603-6
- Ducharlet KN, Katz B, Leung S (2011) "Multivitamin supplement interaction with warfarin therapy." Australas J Ageing, 30, p. 41-2
Disease interactions
53 potential interactions Applies to: 42 conditions, including High Blood Pressure, High Cholesterol, Underactive Thyroid, Heart Failure, and Benign Prostatic Hyperplasia.
Aortic Aneurysm
Major:
anisindione
Anisindione has a major potential interaction with Aortic Aneurysm.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Benign Prostatic Hyperplasia
Major:
oxymetholone
Oxymetholone has a major potential interaction with Benign Prostatic Hyperplasia.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Bleeding Disorder
Major:
anisindione
Anisindione has a major potential interaction with Bleeding Disorder.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Major:
oxymetholone
Oxymetholone has a major potential interaction with Bleeding Disorder.
Androgenic anabolic steroids may cause suppression of clotting factors II, V, VII, and X, and an increase in prothrombin time. Androgen therapy should be administered cautiously in patients with bleeding disorders.
Breast Cancer
Major:
oxymetholone
Oxymetholone has a major potential interaction with Breast Cancer.
When treated with androgenic anabolic steroids, patients with metastatic breast cancer may develop hypercalcemia due to osteolysis. Frequent determination of urine and serum calcium levels is recommended during therapy with androgenic agents. If hypercalcemia occurs, therapy should be stopped. The development of hypercalcemia may indicate progression of metastases to the bone.
Breast Cancer, Male
Major:
oxymetholone
Oxymetholone has a major potential interaction with Breast Cancer, Male.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Cerebral Aneurysm
Major:
anisindione
Anisindione has a major potential interaction with Cerebral Aneurysm.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Coagulation Defects and Disorders
Major:
anisindione
Anisindione has a major potential interaction with Coagulation Defects and Disorders.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Collagen Vascular Disease
Moderate:
anisindione
Anisindione has a moderate potential interaction with Collagen Vascular Disease.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
Colonic Ulceration
Major:
anisindione
Anisindione has a major potential interaction with Colonic Ulceration.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Diabetes Mellitus
Major:
anisindione
Anisindione has a major potential interaction with Diabetes Mellitus.
Therapy with oral anticoagulants should be administered cautiously in patients with severe diabetes because they may be at increased risk for hemorrhage. The INR should be monitored closely, and 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.
Moderate:
oxymetholone
Oxymetholone has a moderate potential interaction with Diabetes Mellitus.
The metabolic effects of androgenic anabolic steroids may lower blood glucose. Decreased glucose tolerance and increased insulin resistance have also been reported. Patients with diabetes mellitus should be monitored more closely during therapy with androgenic agents, and their antidiabetic regimen adjusted accordingly.
Diarrhea
Moderate:
anisindione
Anisindione has a moderate potential interaction with Diarrhea.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
Diverticulitis
Major:
anisindione
Anisindione has a major potential interaction with Diverticulitis.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Esophageal Ulceration
Major:
anisindione
Anisindione has a major potential interaction with Esophageal Ulceration.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Fever
Moderate:
anisindione
Anisindione has a moderate potential interaction with Fever.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
Fluid Retention
Major:
oxymetholone
Oxymetholone has a major potential interaction with Fluid Retention.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
anisindione
Anisindione has a moderate potential interaction with Fluid Retention.
Patients with edema, hereditary coumarin resistance, hyperlipidemia, hypothyroidism, or nephrotic syndrome may exhibit lower than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition.
Heart Failure
Major:
oxymetholone
Oxymetholone has a major potential interaction with Heart Failure.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
anisindione
Anisindione has a moderate potential interaction with Heart Failure.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
High Blood Pressure
Major:
anisindione
Anisindione has a major potential interaction with High Blood Pressure.
In general, the use of oral anticoagulants is contraindicated in patients with malignant or severe, uncontrolled hypertension. These patients may be at increased risk for cerebral hemorrhage. Therapy with oral anticoagulants should be administered cautiously in patients with moderate hypertension.
High Cholesterol
Major:
oxymetholone
Oxymetholone has a major potential interaction with High Cholesterol.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Moderate:
anisindione
Anisindione has a moderate potential interaction with High Cholesterol.
Patients with edema, hereditary coumarin resistance, hyperlipidemia, hypothyroidism, or nephrotic syndrome may exhibit lower than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition.
Hypercalcemia
Moderate:
oxymetholone
Oxymetholone has a moderate potential interaction with Hypercalcemia.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperparathyroidism
Moderate:
oxymetholone
Oxymetholone has a moderate potential interaction with Hyperparathyroidism.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Hyperthyroidism
Moderate:
anisindione
Anisindione has a moderate potential interaction with Hyperthyroidism.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
Minor:
oxymetholone
Oxymetholone has a minor potential interaction with Hyperthyroidism.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
Infectious Endocarditis
Major:
anisindione
Anisindione has a major potential interaction with Infectious Endocarditis.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Ischemic Heart Disease
Major:
oxymetholone
Oxymetholone has a major potential interaction with Ischemic Heart Disease.
Androgenic anabolic steroids may adversely affect serum lipids, including lowering HDL and elevating LDL levels. These changes can be marked, particularly with the 17-alpha-alkyl derivatives (i.e., fluoxymesterone, methyltestosterone, oxandrolone, oxymetholone, and stanozolol), and may significantly impact the risk of atherosclerosis and coronary artery disease. Patients with preexisting hyperlipoproteinemia may require closer monitoring during therapy with androgenic agents, and adjustments made accordingly in their lipid-lowering regimen. Androgen therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
Liver Disease
Major:
anisindione
Anisindione has a major potential interaction with Liver Disease.
Oral anticoagulants (coumarin and indandione derivatives) are primarily metabolized by the liver. Patients with hepatic impairment may have a heightened response to these agents due to decreased clearance of the drugs as well as defective hemostasis associated with impaired synthesis of clotting factors by the liver. Therapy with oral anticoagulants should be administered cautiously in patients with severe or moderate liver disease. The INR should be monitored closely, and 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
Major:
oxymetholone
Oxymetholone has a major potential interaction with Liver Disease.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Major:
oxymetholone
Oxymetholone has a major potential interaction with Liver Disease.
The use of androgenic anabolic steroids may be associated with development of cholestatic hepatitis and jaundice. Other, more serious hepatotoxicities such as peliosis hepatis and hepatocellular neoplasms are rare but may occur with prolonged use or high dosages. These latter toxicities may be fatal and often not recognized until they become life-threatening. Patients with preexisting liver diseases should be monitored more closely during therapy with anabolic steroids if they are used. If liver function declines or toxicity occurs, therapy should be withdrawn and the cause investigated.
Malabsorption Syndrome
Moderate:
anisindione
Anisindione has a moderate potential interaction with Malabsorption Syndrome.
Patients with a collagen vascular disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, scleroderma), congestive heart failure (especially decompensated disease), severe or prolonged diarrhea, fever, hyperthyroidism, malabsorption, or steatorrhea may exhibit greater than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition. 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.
Malnourishment
Major:
anisindione
Anisindione has a major potential interaction with Malnourishment.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Myeloproliferative Disorders
Major:
anisindione
Anisindione has a major potential interaction with Myeloproliferative Disorders.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Peptic Ulcer
Major:
anisindione
Anisindione has a major potential interaction with Peptic Ulcer.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Pericarditis
Major:
anisindione
Anisindione has a major potential interaction with Pericarditis.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Pheochromocytoma
Major:
anisindione
Anisindione has a major potential interaction with Pheochromocytoma.
In general, the use of oral anticoagulants is contraindicated in patients with malignant or severe, uncontrolled hypertension. These patients may be at increased risk for cerebral hemorrhage. Therapy with oral anticoagulants should be administered cautiously in patients with moderate hypertension.
Polycythemia
Major:
oxymetholone
Oxymetholone has a major potential interaction with Polycythemia.
Androgenic anabolic steroids may cause polycythemia when given in high dosages or for prolonged periods. Patients with preexisting polycythemia may experience worsening of their condition. Frequent monitoring of clinical status and hemoglobin and hematocrit levels is recommended if androgen therapy is administered to these patients.
Prostate Cancer
Major:
oxymetholone
Oxymetholone has a major potential interaction with Prostate Cancer.
The use of androgenic anabolic steroids is contraindicated for male patients with carcinoma of the breast or prostate. Circulating androgens can be converted in peripheral tissues to estrogens and dihydrotestosterone, which may act as promoters of tumor growth in the breast and prostate, respectively. Likewise, androgenic agents may cause enlargement of the prostate and should be used cautiously in patients with or predisposed to prostatic hypertrophy.
Protein C Deficiency
Major:
anisindione
Anisindione has a major potential interaction with Protein C Deficiency.
Tissue necrosis is a rare complication that develops during the initiation of oral anticoagulant therapy due to thrombotic occlusion of venules in the dermis and subcutaneous tissues. Hereditary, familial, or clinical deficiencies of protein C or its cofactor, protein S, may be associated with a hypercoagulable state and an increased risk of the complication. Therapy with oral anticoagulants should be administered cautiously in patients with known or suspected deficiency in protein C-mediated anticoagulant response. Concomitant administration with heparin for the first 5 to 7 days of oral anticoagulant therapy may minimize the risk. If tissue necrosis develops, oral anticoagulant therapy should be discontinued promptly and vitamin K or frozen plasma administered at once. Heparin should then be considered for anticoagulation.
Renal Dysfunction
Major:
oxymetholone
Oxymetholone has a major potential interaction with Renal Dysfunction.
Androgenic anabolic steroids may cause sodium and water retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with fluid overload or are at risk for developing edema. The manufacturers consider the use of androgenic agents to be contraindicated in patients with severe cardiac, renal and/or hepatic dysfunction.
Moderate:
anisindione
Anisindione has a moderate potential interaction with Renal Dysfunction.
There is no evidence that hypoprothrombinemic response to oral anticoagulants (coumarin and indandione derivatives) is altered in renal impairment due to decreased plasma protein binding, thus dosage adjustments are generally not necessary. However, patients with renal impairment may demonstrate platelet defects and may be at increased risk for bleeding. Therapy with oral anticoagulants should be administered cautiously in patients with severe or moderate renal dysfunction. The INR should be monitored closely, and 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.
Moderate:
oxymetholone
Oxymetholone has a moderate potential interaction with Renal Dysfunction.
Androgenic anabolic steroids decrease urinary excretion of calcium, which may result in hypercalcemia. Therapy with androgenic agents should be administered cautiously in patients with hypercalcemia, disorders of bone metabolism such as hyperparathyroidism, or renal dysfunction. Some manufacturers consider the use of androgenic anabolic steroids to be contraindicated in patients with hypercalcemia.
Thrombocytopathy
Major:
anisindione
Anisindione has a major potential interaction with Thrombocytopathy.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Thrombocytopenia
Major:
anisindione
Anisindione has a major potential interaction with Thrombocytopenia.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Toxemia of pregnancy
Major:
anisindione
Anisindione has a major potential interaction with Toxemia of pregnancy.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Ulcerative Colitis
Major:
anisindione
Anisindione has a major potential interaction with Ulcerative Colitis.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Underactive Thyroid
Moderate:
anisindione
Anisindione has a moderate potential interaction with Underactive Thyroid.
Patients with edema, hereditary coumarin resistance, hyperlipidemia, hypothyroidism, or nephrotic syndrome may exhibit lower than expected hypoprothrombinemic response to oral anticoagulants. Thus, more frequent laboratory (PT/INR) monitoring and dosage adjustment of anticoagulant may be required based on changes in the patient's condition.
Minor:
oxymetholone
Oxymetholone has a minor potential interaction with Underactive Thyroid.
When androgenic anabolic steroids are used in patients with thyroid disorders, clinicians should be aware that these agents may affect thyroid function tests. Specifically, thyroid-binding globulin levels may be decreased, resulting in lower total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however.
Vasculitis
Major:
anisindione
Anisindione has a major potential interaction with Vasculitis.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Vitamin C Deficiency
Major:
anisindione
Anisindione has a major potential interaction with Vitamin C Deficiency.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
Vitamin K Deficiency
Major:
anisindione
Anisindione has a major potential interaction with Vitamin K Deficiency.
In general, the use of oral anticoagulants is contraindicated in patients with active bleeding or a hemorrhagic diathesis or other significant risks for bleeding, including hemostatic and/or coagulation defects associated with hemophilia, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, severe hepatic impairment, and myeloproliferative disorders such as leukemia or polycythemia vera. Additionally, oral anticoagulants are usually contraindicated in the presence of any active ulceration of the gastrointestinal, respiratory, or genitourinary tracts; cerebrovascular hemorrhage; aneurysms (cerebral, dissecting aortic); pericarditis and pericardial effusions; bacterial endocarditis; and eclampsia, preeclampsia, or threatened abortion. These patients may be at increased risk for uncontrollable hemorrhage or bleeding complications during therapy with oral anticoagulants. Other potential contraindications include diverticulitis, vasculitis, malnutrition, and vitamin C or vitamin K deficiency. The decision to administer anticoagulants must be based upon clinical judgment in which the risks are weighed against the benefits in each patient.
More resources
anisindione
A total of 537 drugs are known to interact with anisindione.
- Anisindione is in the drug class coumarins and indandiones.
- Anisindione is used to treat Prevention of Thromboembolism in Atrial Fibrillation.
oxymetholone
A total of 90 drugs are known to interact with oxymetholone.
- Oxymetholone is in the drug class androgens and anabolic steroids.
- Oxymetholone is used to treat Anemia.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.