Drug Interaction

[patty22mack]

I have recently retired and would like to get my drug costs down. I have been taking since valve replacement in 2001. One of the other medications I have been taking (for ulcerative colitis) is Dipentum which is very costly. The other option is azulfidine (fairly inexpensive) and when my gastroenterologist wrote a prescription for it, my mail order pharmacy said it could/would interact with coumidin. Does any one know if I can go ahead with the azulfidine and the coumidin?

 

[Ross]

WARFARIN SODIUM (in Coumadin) may interact with SULFASALAZINE (in Azulfidine EN-tabs)

Although the causes of these potential interactions are not clearly understood, sulfasalazine may increase or decrease the anticoagulant effect of warfarin. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When sulfasalazine and warfarin are used at the same time, you may be at increased risk of excessive bleeding or developing a clot. Your doctor may want to monitor you closely for signs of a bleeding or clotting disorder. Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is poorly documented and is considered major in severity.

http://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html

Sure you can take it, but your going to have to adjust your Coumadin dosage depending on which way it goes.

 

[Guest]

A key point that many people (even physiciansand especially pharmacists) fail to grasp is that an interaction does not preclude being able to use a combination of drugs. When things interact, the answer is to have your INR checked more closely and adjust the warfarin dose.

My experience has been that people who have problems with the intestinal tract tend to have fluctuating INRs. I think it is an absorption problem and would explain why this interaction can either increase or decrease the INR. I suspect that it is not really and interaction bujt an observation.

If your INR did not fluctate on dipentum then you might do well on sulfasalazine. Just be sure to get your INR checked about 3 to 5 days after starting the new drug and do not let the person adjusting your warfarin make a change greater than about 15%.