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Drug interactions between B-Nexa and caplacizumab

Results for the following 2 drugs:
B-Nexa (calcium/folic acid/ginger/pyridoxine)
caplacizumab

Interactions between your drugs

Moderate

ginger caplacizumab

Applies to: B-Nexa (calcium / folic acid / ginger / pyridoxine) and caplacizumab

Consumer information for this interaction is not currently available.

MONITOR: Ginger may potentiate the effects of anticoagulants, platelet inhibitors and thrombolytic agents, possibly increasing the risk of bleeding. Limited data suggest that ginger may decrease platelet aggregation via the inhibition of thromboxane synthetase, although some studies have found no effect on platelet function or thromboxane production or activity. Nevertheless, the interaction was suspected in a 76-year-old patient stabilized on coumarin therapy who developed epistaxis following use of ginger products (pieces of dried ginger, tea from ginger powder) for several weeks. Her INR was greater than 10 (target INR 2.0 to 3.0) and partial thromboplastin time (PTT) was 84.4 seconds (normal less than 35 seconds) upon hospital admission. INR and PTT values normalized after ginger intake was stopped and vitamin K given. In contrast, an investigative study found no significant effect of ginger pretreatment for 7 days on clotting status or the pharmacokinetics or pharmacodynamics of a single 25 mg dose of warfarin in 12 healthy volunteers.

MANAGEMENT: Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients who have used ginger and ginger supplements extensively prior to receiving anticoagulation, antiplatelet or thrombolytic therapy, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. 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

  1. Miller LG "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med 158 (1998): 2200-11
  2. Jiang X, Williams KM, Liauw WS, et al. "Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects." Br J Clin Pharmacol 59 (2005): 425-32
  3. Heck AM, DeWitt BA, Lukes AL "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm 57 (2000): 1221-7; quiz 1228-30
  4. Kruth P, Brosi E, Fux R, Morike K, Gleiter CH "Ginger-associated overanticoagulation by phenprocoumon." Ann Pharmacother 38 (2004): 257-60
  5. Vaes LP, Chyka PA "Interactions of warfarin with garlic, ginger, or ginseng: nature of evidence." Ann Pharmacother 34 (2000): 1478-82
View all 5 references

Drug and food interactions

No results found in our database - however, this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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