Treating DVT: Answers to 7 key questions
The Journal of Family Practice. 2010 November;59(11):616-622a
November 1, 2010|The Journal of Family Practice
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Complex recommendations for anticoagulant therapy raise questions for family physicians. Here are the evidence-based answers you need to manage DVT patients successfully.
TABLE W1
Important warfarin interactions*
| Anti-infectives | Cardiovascular drugs | Analgesics | Agents that affect the central nervous system | Agents that affect the GI tract | Herbal supplements | Other | |
|---|---|---|---|---|---|---|---|
| Potentiation | Ciprofloxacin Clarithromycin Cotrimoxazole Erythromycin Fluconazole Gatifloxacin Itraconazole Levofloxacin Metronidazole Tetracycline Voriconazole | Amiodarone Atorvastatin Fenofibrate Fluvastatin Gemfibrozil Lovastatin Propafenone Ropinirole Simvastatin | Acetaminophen Celecoxib Interferon Piroxicam Propoxyphene Tramadol | Alcohol (binge) Citalopram Entacapone Phenytoin Sertraline | Cimetidine Fish oil Mango Omeprazole | Boldo-fenugreek Danshen Dong quai Lyceum barbarum L Quilinggao | Anabolic steroids Fluorouracil Gemcitabine Levamisole/fluorouracil Levothyroxine Tamoxifen Tolterodine Zileuton |
| Inhibition | Dicloxacillin Griseofulvin Nafcillin Rifampin | Bosentan Cholestyramine | Azathioprine Mesalamine | Alcohol Barbiturates Carbamazepine | Avocado (large amounts) Foods and enteral nutrition high in vitamin K Soy milk Sucralfate | Ginseng Green tea | Chelation therapy Mercaptopurine Methimazole Multivitamins Propylthiouracil Raloxifene |
| Increase bleeding risk | Anticoagulants Antiplatelets | NSAIDs | Alcohol | Garlic Ginkgo Ginseng | |||
| GI, gastrointestinal; NSAIDs, nonsteroidal anti-inflammatory drugs. | |||||||
| *Not a complete list. | |||||||
| Adapted from: Ansell J, et al. Chest. 2008.4 | |||||||
CORRESPONDENCE Anne H. Metzger, PharmD, BCPS, University of Cincinnati, The James L. Winkle College of Pharmacy, 3225 Eden Avenue, Cincinnati, OH 45267; metzgean@ucmail.uc.edu
