Warfarin and Zithromax?

[Taylor]

Hi all. I'd love some advice on a drug interaction. I've been prescribed Zithromax (taking a course of 4 250 mb tablets just once). I understand that there is most likely an interaction and that it may/will cause my INR to rise a bit. Can anyone advise on whether I would need to adjust my dose even if this is just one course of 4 tablets instead of a prolonged course over several days? I am currently taking 7.5 mg daily except 10 on Thursdays and have been at the high end of my 2-3 range lately. I also home-test so can monitor it closely if I need to.

Thanks, Taylor

 

[Freddie]

Sounds like your going to the dentist - here's what I found:

AZITHROMYCIN (in Zithromax) may interact with WARFARIN SODIUM (in Warfarin Tablets)

Azithromycin 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 azithromycin 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 closely when therapy with azithromycin is either started or stopped. 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.

Now this is just me, but since its a one time thing, I wouldn't adjust my dosage, it would just cause a roller-coaster ride.

Hope this helps

 

[Freddie]

Here's the web site I use to find out about interactions with warfarin.
http://www.drugdigest.org/wps/portal/ddigest

 

[catwoman]

Taylor:

Zith has a very long life. That's why you don't have to take very many of those expensive little pills (thank heavens!).

Best to check this out:

http://www.warfarinfo.com/azithromycin.htm.

Based on that, I'd test after the first 3 days, as Al Lodwick recommends in the link above. Do you have your own tester? If so, this will be a snap. Otherwise, you may need to pay your doctor or Coumadin clinic an extra visit.

 

[Bina]

Taylor, Freddie is right. Don't adjust anything now.
Wait a couple of days after taking the antibs and then test your INR. I'm sure you will be fine.

 

[ALCapshaw2]

Why the Rx for 1000 mg of Zithromax ?

The standard recommendation for Dental Work is 500 mg ONE time, one hour before the procedure.

I've not had any problem (that I am aware of) taking 500 mg prior to Dental appointments.

As others have suggested, just Test after 3 days to see if there was an interaction.

Good Luck.

 

[KristyW]

Al,

I don't think Taylor is taking the Zith for dental work. He or she didn't say why they were taking the antibiotic.

 

[Taylor]

Thanks all. Very helpful. I'll test in a couple of days to make sure I'm fine.

 

[Kathleen]

Thanks for this post Taylor. I started on the z-pac last night for pneumonia and last week my INR was on the high side. I am going to do another home test today and in another everytwo days just to watch it. Helps to have boxes and boxes of strips to use at will before they expire. Hope your INR does not get out of hand on the med.
Kathleen

 

[Cooker]

Zithromax has had no effect on my INR but I am on Levaquin and they are checking my INR weekly .... pain in the ass