Interactions
Dicumarol is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementHydrocortisoneMethyltestosteroneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.MitotaneMitotane may decrease the effectiveness of orally administered anticoagulants. The mechanism is induction of hepatic microsomal enzymatic clearance. Data are available for warfarin. ModerateClose monitoring for clinical and laboratory evidence of altered anticoagulant efficacy is recommended. The dosage requirements for orally administered anticoagulants are expected to increase after mitotane is added. The clinician should be also be aware that the risk of bleeding from over-anticoagulation is increased when mitotane is withheld.OxandroloneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.OxpentifyllineConcurrent use increases the anticoagulant effect.OxymetholoneAndrogens and anabolic steroids may potentiate the hypoprothrombinemic response to oral anticoagulants and increase the risk of bleeding. The onset of interaction is generally observed within 2 to 3 days. The mechanism is unknown. There have been case reports of patients stabilized on oral anticoagulant therapy who developed bleeding complications following the addition of various androgenic agents including danazol, oxymetholone, testosterone, methyltestosterone, and stanozolol.MajorDuring concomitant therapy, the INR and/or PT should be monitored closely and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the androgenic agent in patients who are stabilized on their anticoagulation regimen. Significant anticoagulant dose reductions may be required. Some experts recommend avoiding this combination altogether. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.Piroxicam-beta-cyclodextrinPiroxicam potentiates the anticoagulent effect of Dicumarol because of its effect on plateletsTenecteplaseConcurrent use is usually not recommended but may be required in some cases. If both medicines are prescribed together, change of dose may be required. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.