Drug Reaction

[Sierra Bob]

I currently have a severe infection in the surgical site where 2.6 inches of my right jaw bone was removed and replaced with a titanium reconstruction plate on January 16, due to osteoradionecrosis resulting from radiation for Squamous Cell Carcinoma in my neck. My oral surgeon has had me on Augmentin (Amoxicillin & Clavulanate) for the past week. However, it has not helped. The swelling in my cheek and gum and the drainage of pus through a fissure in my neck has increased rather than decreased. My surgeon plans to add Metronidazole (Flagyl) to the Augmentin. Drugs.com indicates there is a major reaction between Flagyl and Warfarin by increasing the PT time.

If any of you have used this combination of drugs, I would appreciate your advising me of the affect on your PT time (INR). Thanks

 

[Blanche]

Sierra Bob:
I'm sorry that I can not answer your questions but I am sure others will be of assistance.

I sincerely hope that you find an answer to this painful problem and that you wil soon be yourself again. Best wishes. Please know that Al and I are sending kind thoughts and wishes for an early recovery for you.

Blanche

 

[Ross]

Bob if you start it. Test your INR 3 days after starting so that adjustments can be made. You will be lowering your Coumadin dose.

METRONIDAZOLE (in Flagyl Oral) may interact with WARFARIN SODIUM (in Coumadin)

Metronidazole may block the breakdown of warfarin by the liver. If this happens, blood levels of warfarin could be increased and this could increase its anticoagulant effect. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When metronidazole and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If these drugs are taken together, your doctor may want to monitor you more closely for signs of a bleeding 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 well-documented and is considered major in severity.

Last Updated: December 2003

 

[Sierra Bob]

Drug Reaction

Thanks Ross. I'm aware of the effect Flagyl has on Warfarin and I self test, so tracking my INR and adjusting the warfarin will be no problem. My surgeon has decided to change the protocol and get a culture and select a different drug than Augmentin. Sierra Bob

 

[Guest]

I manage this interaction a couple of times per month. You will need your INR closely watched after it is started and again after it is stopped.

 

[bvdr]

Bob, I usually take Flagyl and Cipro when I have a colitis flare-up. I didn't have a major change but reduced my warfarin a little bit. The problem was getting my INR back where it belonged when it dropped too low. I think the issues are different through because colitis all by itself messes with my INR.

I am so sorry to hear about your infection. You've been through so much I had been hoping things were going smoothly for you. I hope you soon are feeling better again.