What are the drug interactions for Coumadin vs. Plavix?

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Coumadin drug interactions

Many drugs, both prescription and nonprescription (OTC), can affect the anticoagulant action of warfarin or increase the risk of bleeding. Patients on warfarin should regularly consult their doctor before instituting any medications on their own. It also is advisable for patients on warfarin to carry identification such as bracelets to alert other health professionals to the presence of anticoagulation.

Drugs that increase the effect of warfarin by reducing the breakdown of warfarin include:

Drugs and herbal products that may reduce the effect of warfarin by increasing its breakdown include:

Bleeding is increased by other anticoagulants, for example, heparin, argatroban (Acova), dabigatran (Pradaxa).

Bleeding is increased by antiplatelet drugs such as aspirin and other nonsteroidal anti-inflammatory drugs (for example, ibuprofen [Motrin], naproxen [Alleve]), clopidogrel (Plavix), and prasugrel (Effient); serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil).

Garlic and ginkgo also increase the risk of bleeding because they cause bleeding when taken alone.

Foods with high vitamin K content (for example, green leafy vegetables) reduce the effect of warfarin. Maintenance of a consistent intake of vitamin K containing foods is important to avoid fluctuations in the effect of warfarin.

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Plavix drug interactions

The combination of clopidogrel with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of bleeding. Examples of NSAIDs include:

Combining Plavix with warfarin (Coumadin) or other drugs that cause bleeding increases the risk of bleeding.

Clopidogrel is converted to its active form by enzymes in the liver. Drugs that reduce the activity of these enzymes, for example, omeprazole (Prilosec, Zegerid) or esomeprazole (Nexium) may reduce the activity of clopidogrel and should not be used with clopidogrel.

Other drugs that also may react with clopidogrel in a similar way include: