Drug Interactions between hemin and inotersen

GENERALLY AVOID: Theoretically, hemin may potentiate the risk of bleeding in patients treated with agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. Hemin has exhibited mild, transient anticoagulant effects during clinical studies. Thrombocytopenia and coagulopathy including prolonged prothrombin time and prolonged partial thromboplastin time have been reported during postmarketing use. The extent and duration of the hypocoagulable state induced by hemin are not known.

MANAGEMENT: The use of hemin with concurrent anticoagulant therapy should be avoided. Caution is advised if hemin is used in combination with other drugs that affect hemostasis such as platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. 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.