Drug Interactions of Anticoagulants (Part 2)

Drug Interactions of Heparin:

More Presentations from Naina Mohamed, PhD

©   Heparin is used to treat and prevent Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE) and Arterial Thromboembolism.

©   Heparin is also used in the treatment of Myocardial Infarction (Heart Attack) and Unstable Angina.

©   Regular blood monitoring of Partial Thromboplastin Time (aPTT) (Time taken by blood plasma to clot) is recommended to check the effectiveness and safety of Heparin.

©   Concomitant use of Heparin and Telavancin or Oritavancin is Contraindicated due to artificial prolongation of activated Partial Thromboplastin Time (aPTT) test results.

©   Drugs increasing the risk of Heparin associated bleeding, include…

·      Enoxaparin

·      Dalteparin

·      Bivalirudin

·      Danaparoid

·      Rivaroxaban

·      Apixaban

·      Dabigatran

ª    Drugs increasing Anticoagulants associated bleeding risk, include…

·      NSAIDs (Ibuprofen, Diclofenac, Naproxen, etc)

·      Selective serotonin reuptake inhibitors (SSRIs) (Fluvoxamine, Paroxetine, Vortioxetine,  Escitalopram, Sertraline, Nefazodone, vilazodone)

·      Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) (Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran, Sibutramine)

·      Fibrinolytics (Alteplase, Retaplase, Tenecteplase, Streptokinase, Urokinase)

·      Antiplatelet agents (Aspirin, Clopidogrel, Ticagrelor, etc)

·      Fenofibrate

·      Orlistat

·      Alprostadil (Prostaglandin E1)

·      Ginkgo

·      Garlic

·      Papaya

·      Chamomile (Matricaria chamomilla)

·      Ginger

·      Fenugreek

·      Anise

·      Clove oil

·      Asafetida

·      Capsaicin

·      Evening primrose oil

·      Licorice

·      Celery

©   Drug interactions can result in significant morbidity and mortality and thus minimizing the risk for drug interactions should be a goal in drug therapy.

©   The patients with clotting disorders should bring a list of all of the drugs they are taking including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist.

©   The risk of adverse effects could be reduced by healthcare professionals through the screening, education, and follow up on suspected drug interactions.

©   If possible, the patients are recommended to fill all their prescriptions at one pharmacy.

©   Pharmacists can play a crucial role in identifying possible drug interactions by asking patients on Anticoagulants about their herbal and other alternative medicine product use.