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Tricor oral

Anticoagulants/Fibrates

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known. Your cholesterol medication may increase the effect of your blood-thinning medicine.

What might happen:

You may experience an increased chance for bleeding, including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.

What you should do about this interaction:

Ask your healthcare professionals (e.g. doctor or pharmacist) about taking these medicines together. If your doctor prescribes these medicines together, you may need to have your bleeding times checked more often. You may need an adjustment in the dose of your blood-thinner. This interaction may be more severe in patients with high levels of fat in the blood, who are taking larger doses of cholesterol medicine, or who are older. If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Beringer TR. Warfarin potentiation with bezafibrate. Postgrad Med J 1997 Oct;73(864):657-8.
2.Bjornsson TD, Meffin PJ, Blaschke TF. Interaction of clofibrate with warfarin. I. Effect of clofibrate on the disposition of the optical enantiomorphs of warfarin. J Pharmacokinet Biopharm 1977 Oct;5(5):495-505.
3.Eastham RD. Warfarin dosage influenced by clofibrate plus age. Lancet 1973 Jun 23;1(7817):1450.
4.Eastham RD. Warfarin dosage, clofibrate, and age of patient. Br Med J 1973 Jun 2;2(5865):554.
5.Solomon RB, Rosner F. Massive hemorrhage and death during treatment with clofibrate and warfarin. N Y State J Med 1973 Aug 1;73(15):2002-3.
6.Ascah KJ, Rock GA, Wells PS. Interaction between fenofibrate and warfarin. Ann Pharmacother 1998 Jul-Aug;32(7-8):765-8.
7.Aldridge MA, Ito MK. Fenofibrate and warfarin interaction. Pharmacotherapy 2001 Jul;21(7):886-9.
8.Kim KY, Mancano MA. Fenofibrate potentiates warfarin effects. Ann Pharmacother 2003 Feb;37(2):212-5.
9.Rindone JP, Keng HC. Gemfibrozil-warfarin drug interaction resulting in profound hypoprothrombinemia. Chest 1998 Aug;114(2):641-2.
10.Ahmad S. Gemfibrozil interaction with warfarin sodium (coumadin). Chest 1990 Oct;98(4):1041-2.
11.Dixon DL, Williams VG. Interaction between gemfibrozil and warfarin: case report and review of the literature. Pharmacotherapy 2009 Jun; 29(6):744-8.
12.Bjornsson TD, Meffin PJ, Swezey SE, Blaschke TF. Effects of clofibrate and warfarin alone and in combination on the disposition of vitamin K1. J Pharmacol Exp Ther 1979 Sep;210(3):322-6.
13.Pond SM, Graham GG, Wade DN, Sudlow G. The effects of allopurinol and clofibrate on the elimination of coumarin anticoagulants in man. Aust N Z J Med 1975 Aug;5(4):324-8.
14.O'Reilly RA, Sahud MA, Robinson AJ. Studies on the interaction of warfarin and clofibrate in man. Thromb Diath Haemorrh 1972 Apr 30; 27(2):309-18.
15.Lilja JJ, Backman JT, Neuvonen PJ. Effect of gemfibrozil on the pharmacokinetics and pharmacodynamics of racemic warfarin in healthy subjects. Br J Clin Pharmacol 2005 Apr;59(4):433-9.
16.Blum A, Seligmann H, Livneh A, Ezra D. Severe gastrointestinal bleeding induced by a probable hydroxycoumarin- bezafibrate interaction. Isr J Med Sci 1992 Jan;28(1):47-9.
17.Schrogie JJ, Solomon HM. The anticoagulant response to bishydroxycoumarin. II. The effect of D- thyroxine, clofibrate, and norethandrolone. Clin Pharmacol Ther 1967 Jan-Feb;8(1):70-7.
18.Zimmermann R, Ehlers W, Walter E, Hoffrichter A, Lang PD, Andrassy K, Schlierf G. The effect of bezafibrate on the fibrinolytic enzyme system and the drug interaction with racemic phenprocoumon. Atherosclerosis 1978 Apr;29(4):477-85.

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