Effect of tenidap sodium on the pharmacodynamics and plasma protein binding of warfarin in healthy volunteers.

Apseloff, Glen; Wilner, K.; Gerber, Nicholas

doi:10.1111/j.1365-2125.1995.tb04499.x

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…This increase was similar at both the pre- [11] showed that tenidap does not displace tolbutamide from plasma protein binding sites. On the other hand, tenidap has been found to displace warfarin, although the extent to which this occurred was not considered to be clinically meaningful [13].…”

Section: Discussionmentioning

confidence: 99%

The effect of tenidap sodium on the disposition and plasma protein binding of phenytoin in healthy male volunteers.

Blum

Schentag

Gardner

et al. 1995

Brit J Clinical Pharma

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Section: Discussionmentioning

confidence: 99%

The effect of tenidap sodium on the disposition and plasma protein binding of phenytoin in healthy male volunteers.

Blum

Schentag

Gardner

et al. 1995

Brit J Clinical Pharma

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“…It can also cause gastrointestinal ulceration, hemorrhage, and inhibition of platelet aggregation 19,69,70 . Of the other non-steroidal anti-inflammatory drugs, flurbiprofen 71 83 .…”

Section: Drugs Affecting Haemostasismentioning

confidence: 99%

“…It should also be noted that for many of these drugs no enhancement of warfarin activity has been demonstrated. The non-steroidal anti-inflammatory drugs with an apparently minimal effect on warfarin activity include etodolac 80 , ibuprofen 81 , naproxen 82 and tenidap 83 .…”

Section: Drugs Affecting Haemostasismentioning

confidence: 99%

“…Hence, there was a reduction in the free warfarin concentration and a loss of anticoagulant effect 98 . Mefenamic acid 74 , etodolac 80 , ibuprofen 81,99 and tenidap 83 may also displace coumarin anticoagulants from protein binding sites. However, the influence of etodolac, ibuprofen and tenidap on warfarin anticoagulant effect is minimal.…”

Section: Drugs Causing Protein Binding Displacementmentioning

confidence: 99%

“…It can also cause gastrointestinal ulceration, hemorrhage, and inhibition of platelet aggregation 19,69,70 . Of the other non-steroidal anti-inflammatory drugs, flurbiprofen 71 83 .The effects on haemostasis are also seen rarely with penicillins, particularly carbenicillin and relative compounds 84 .Abciximab, alteplase, clopidogrel, lepirudin and reteplase have an additive anticoagulant effect at concurrent use with warfarin, thus they may significantly enhance the risk of bleeding.Dipyridamole concurrently used with warfarin may cause bleeding without any alteration in prothrombin time. This interaction has involved a small number of patients 85 and its mechanism consists in inhibition of platelet function by dipyridamole.…”

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Interactions of Warfarin

Rehulková¹

2001

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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In this article, the author reviews and updates the basis of interactions with warfarin, illustrated with appropriate examples. The interactions with drugs, medicinal herbs and foods are summarised. 28Cholestyramine binds vitamin K in the gut, thus preventing its absorption 18 . It also decreases the absorption and may interrupt the enterohepatic recirculation of warfarin, resulting in a reduced anticoagulant effect 19,20 .Colestipol does not affect the absorption of warfarin. When colestipol is administered with warfarin, no depressant effects on blood levels are seen 21 . Drugs affecting receptor sensitivityEstrogens increase the synthesis of various clotting factors and may thus reduce the effect of anticoagulants 22, 23 . Oral contraceptives increase clotting factor concentrations and inhibit warfarin metabolism. The net effect depends on balance between these factors. Oral contraceptives are generally contraindicated in most patients taking warfarin since they are trombogenic 1, 24 .Steroids with anabolic or androgenic properties, such as oxymetholone 25, 26, 27 , stanozolol 28, 29 and danazol 30, 31, 32 , may potentiate the action of warfarin allegedly by reducing clotting factor synthesis. The 17-alpha-alkylated steroids appear to be more likely to induce this reaction than the non-substituted steroids 25, 26, 27, 33 . However, there has been a report of topically applied testosterone, which does not have 17-alpha-alkyl substituent, enhancing warfarin 34 .Diuretics may antagonise the action of warfarin by two pharmacodynamic mechanisms 18 : (a) patients in cardiac failure have impaired clotting factor synthesis due to hepatic congestion -correction of this state leads to increased clotting factor synthesis; (b) diuretics also reduce the plasma volume producing an increased concentration of clotting factors which may alter the anticoagulant effect of warfarin 35 . Chlorthalidone 36 and spironolactone 35 have both been associated with a reduction of warfarin activity probably as a consequence of diuresis concentrating the circulating clotting factors. Bumetanide, furosemide and thiazides appear to have no effect on warfarin 23 .Certain cephalosporines, such as cefotetan, cefamandole, cefoperazone, or moxalactam may cause marked hypoprothrombinemia and/or prolonged bleeding time at concurrent use with warfarin 38, 39, 40, 41 . The main mechanism of interaction consists in decreasing synthesis of vitamin K-dependent clotting factors.Clofibrate may potentiate warfarin action, probably by altering receptor sensitivity 23, 37 . Although clofibrate displaces warfarin from albumin binding sites this does not appear to be a principal mechanism of the interaction 42 .Drugs altering thyroid function may affect anticoagulant control, since rates of synthesis and degradation of clotting factors are dependent on thyroid function 7 . Thyroid compounds do enhance the activity of oral anticoagulants by increased metabolism of clotting factors 12 . Dextrothyroxine increases the anticoagulant effect of warfarin ...

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Celecoxib Does Not Significantly Alter the Pharmacokinetics or Hypoprothrombinemic Effect of Warfarin in Healthy Subjects

Karim¹,

Tolbert²,

Piergies

et al. 2000

The Journal of Clinical Pharma

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The objective of this study was to determine the effects of celecoxib, an anti-inflammatory/analgesic agent that primarily inhibits COX-2 and not COX-1 at therapeutic doses, on the steady-state pharmacokinetic profile and hypoprothrombinemic effect of racemic warfarin in healthy volunteers. Twenty-four healthy adult volunteers on maintenance doses of racemic warfarin (2-5 mg daily), stabilized to prothrombin times (PT) 1.2 to 1.7 times pretreatment PT values for 3 consecutive days, were randomized to receive concomitant celecoxib (200 mg bid) or placebo for 7 days in an open-label, multiple-dose, randomized, placebo-controlled, parallel-group study of warfarin pharmacokinetics and PT. Steady-state exposure of S- and R-warfarin (area under the curve [AUC]) and maximum plasma concentration (Cmax) in subjects receiving celecoxib were within 2% to 8% of the warfarin AUC and Cmax in subjects receiving placebo during the concomitant treatment period. In addition, PT values were not significantly different in subjects receiving warfarin and celecoxib concomitantly compared with subjects receiving warfarin and placebo. In conclusion, concomitant administration of celecoxib has no significant effect on PT or steady-state pharmacokinetics of S- or R-warfarin in healthy volunteers.

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Effect of tenidap sodium on the pharmacodynamics and plasma protein binding of warfarin in healthy volunteers.

Cited by 13 publications

References 17 publications

The effect of tenidap sodium on the disposition and plasma protein binding of phenytoin in healthy male volunteers.

The effect of tenidap sodium on the disposition and plasma protein binding of phenytoin in healthy male volunteers.

Interactions of Warfarin

Celecoxib Does Not Significantly Alter the Pharmacokinetics or Hypoprothrombinemic Effect of Warfarin in Healthy Subjects

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