Taking warfarin 1 mg and Synpid (Fenofibrate) Micronized Capsules 200 mg may affect the effectiveness of warfarin or lead to abnormal coagulation test results. Fenofibrate can potentially increase the anticoagulant effect of warfarin, which may result in an increased risk of bleeding. It is important to monitor INR (International Normalized Ratio) closely when these medications are used together to ensure safe and effective anticoagulation management. Always consult with a healthcare provider before making any changes to medication regimens?
In the past, I had a calf embolism, and now I am experiencing hemoptysis.
After medical evaluation, there are slight shadows in my lungs suspected to be a pulmonary embolism.
The doctor prescribed warfarin 1 mg, to take 2 tablets in the morning.
However, I also have chronic conditions, including hypertension and hyperlipidemia, for which I am taking a triglyceride-lowering medication at night (Synpid [Fenofibrate] Micronized Capsules 200 mg).
Since these medications were prescribed by different doctors, I would like to know if it is safe to take warfarin alongside this lipid-lowering medication.
Will it affect the efficacy of warfarin, potentially leading to bleeding or abnormal coagulation test results? Additionally, what dietary considerations should I keep in mind while taking warfarin?
Zhen Ge, 50~59 year old female. Ask Date: 2020/03/26
Dr. Huang Shenggang reply Pharmacology
Hello, Zhen Ge: First of all, thank you for your question.
According to relevant literature, the concurrent use of warfarin and fenofibrate is classified as a major drug interaction, which may lead to abnormal coagulation test results and an increased risk of bleeding.
It is recommended to reduce the dosage of warfarin and closely monitor prothrombin time (PT) when using both medications together.
When taking anticoagulants, what dietary and medication precautions should be observed? It is important to avoid excessive intake of foods high in vitamin K, such as broccoli, spinach, amaranth, lettuce, celery, pork liver, beef liver, cabbage, purple cabbage, kale, green beans, green peas, pea shoots, Chinese cabbage, Brussels sprouts, scallions, onions, green cauliflower, white cauliflower, radishes, mustard greens, asparagus, seaweed, water spinach, bok choy, A-choy, Sichuan pepper, cucumbers, napa cabbage, rutabaga, garlic chives, sweet potato leaves, Chinese flowering cabbage, sea vegetables, black fungus, and shredded lettuce.
Fruits high in vitamin K include avocados, papayas, and green kiwis.
The following should be discussed with a physician: coenzyme Q10, high doses of vitamin C, and supplements or vitamins containing vitamin K (such as Centrum or multivitamins).
Additionally, it is advisable to avoid consuming ginseng, American ginseng, Chinese ginseng, Dong Quai, Jilin ginseng, red dates, and Lonicera japonica.
Foods such as red yeast rice, pomelo, white grapefruit, grapefruit, and mushrooms should not be consumed in excess.
This information is provided for your reference.
Thank you.
Reply Date: 2020/03/26
More Info
Taking Warfarin, an anticoagulant medication, alongside Fenofibrate, a lipid-lowering agent, raises important considerations regarding blood clotting and safety. Warfarin works by inhibiting vitamin K-dependent clotting factors, thereby reducing the blood's ability to clot. Fenofibrate, on the other hand, is primarily used to lower triglyceride levels and improve cholesterol profiles. However, there is a significant interaction between these two medications that patients and healthcare providers must be aware of.
Research indicates that the combination of Warfarin and Fenofibrate can lead to an increased risk of bleeding. This is primarily due to Fenofibrate's potential to enhance the anticoagulant effects of Warfarin, which can result in prolonged prothrombin time (PT) and international normalized ratio (INR) values. When INR levels are elevated, the risk of bleeding complications increases, which can manifest as easy bruising, prolonged bleeding from cuts, or more severe internal bleeding. Therefore, if you are prescribed both medications, it is crucial to have your INR monitored closely by your healthcare provider. Adjustments to the Warfarin dosage may be necessary to maintain safe INR levels.
In your specific case, where you have a history of deep vein thrombosis and are currently experiencing symptoms suggestive of a pulmonary embolism, the careful management of your anticoagulation therapy is vital. The presence of a potential clot in the lungs necessitates effective anticoagulation, but it must be balanced against the risk of excessive bleeding. Therefore, communication between your healthcare providers is essential to ensure that all medications are managed appropriately.
Regarding dietary considerations while taking Warfarin, it is important to maintain a consistent intake of vitamin K-rich foods. Foods high in vitamin K, such as green leafy vegetables (e.g., spinach, kale, broccoli), can counteract the effects of Warfarin and lead to fluctuations in INR levels. Therefore, rather than avoiding these foods entirely, aim for a consistent daily intake to help stabilize your INR. Additionally, be cautious with supplements and herbal products, as some can interact with Warfarin. For instance, vitamin E and certain herbal supplements like ginkgo biloba can increase bleeding risk, while vitamin K can reduce Warfarin's effectiveness.
Moreover, it is advisable to avoid alcohol consumption while on Warfarin, as alcohol can interfere with the metabolism of the drug and increase the risk of bleeding. Regular monitoring of your INR, maintaining a stable diet, and communicating any changes in your health or medication regimen with your healthcare provider are key steps in managing your treatment safely.
In summary, while it is possible to take Warfarin and Fenofibrate together, it requires careful monitoring and potential dosage adjustments to mitigate the risk of bleeding. Always consult with your healthcare provider before making any changes to your medication or diet, and ensure that all your healthcare providers are aware of all the medications you are taking to provide the best coordinated care.
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