Drug interactions between glyburide / metformin and Miradon
Interactions between your drugs
Applies to: glyburide / metformin and Miradon (anisindione)
Before taking anisindione, tell your doctor if you also use glyBURIDE. You may need dose adjustments or special tests in order to safely take both medications together. You should check your blood sugar regularly. Symptoms of low blood sugar may include headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, or sweating. You should promptly report any signs of bleeding such as swelling, headache, dizziness, weakness, nosebleeds, bleeding of gums from brushing, prolonged bleeding from cuts, red or brown urine, or red or black stools. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.
Applies to: Miradon (anisindione) and glyburide / metformin
Consumer information for this interaction is not currently available.
MONITOR: Coadministration with metformin may decrease the anticoagulant effects of vitamin K antagonists (VKAs). The mechanism has not been delineated, but it may involve metformin-mediated increase in the elimination rate of VKAs. In addition, concomitant use of VKAs with metformin may increase the risk of severe hypoglycemia. The clinical significance of this interaction is unknown.
MANAGEMENT: Until more information is available, patients receiving VKAs with metformin should be closely monitored during concomitant therapy. The INR or prothrombin time should be checked frequently and the VKA dosage adjusted accordingly, particularly following initiation, change of dosage, or discontinuation of metformin therapy. In addition, patients receiving this combination should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs.
- Wijnen JCF, van de Reit IR, Lijfering WM, van der Meer FJM "Metformin use decreases the anticoagulant effect of phenprocoumon." J Thromb Haemost 12 (2014): 887-90
- Cerner Multum, Inc. "Australian Product Information." O 0
- Nam YH, Brensinger CM, Bilker WB, Leonard CE, Han X, Hennessy S "Serious hypoglycemia and use of warfarin in combination with sulfonylureas or metformin." Clin Pharmacol Ther (2018):
Drug and food interactions
Applies to: Miradon (anisindione)
Nutrition and diet can affect your treatment with anisindione. Therefore, it is important to keep your vitamin supplement and food intake steady throughout treatment. For example, increasing vitamin K levels in the body can promote clotting and reduce the effectiveness of anisindione. While there is no need to avoid products that contain vitamin K, you should maintain a consistent level of consumption of these products. Foods rich in vitamin K include beef liver, broccoli, Brussels sprouts, cabbage, collard greens, endive, kale, lettuce, mustard greens, parsley, soy beans, spinach, Swiss chard, turnip greens, watercress, and other green leafy vegetables. Moderate to high levels of vitamin K are also found in other foods such as asparagus, avocados, dill pickles, green peas, green tea, canola oil, margarine, mayonnaise, olive oil, and soybean oil. However, even foods that do not contain much vitamin K may occasionally affect the action of anisindione. There have been reports of patients who experienced bleeding complications and increased INR or bleeding times after consuming large quantities of cranberry juice, mangos, grapefruit, grapefruit juice, grapefruit seed extract, or pomegranate juice. Again, you do not need to avoid these foods completely, but it may be preferable to limit their consumption, or at least maintain the same level of use while you are receiving anisindione. Talk to a healthcare provider if you are uncertain about what foods or medications you take that may interact with anisindione. It is important to tell your doctor about all medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
When anisindione is given with enteral (tube) feedings, you may interrupt the feeding for one hour before and one hour after the anisindione dose to minimize potential for interaction. Feeding formulas containing soy protein should be avoided.
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
|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.|
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.