Interaction between Warfarin and Glucosamine
Moderate
Others
| ID | DDInter1951 and DDInter829 |
| Interaction | A case report suggests that chondroitin and/or glucosamine may potentiate the hypoprothrombinemic effect of warfarin. The mechanism of interaction is unknown. Glucosamine is a chemical component of heparin, while chondroitin is a minor component of danaparoid and has been shown in vitro and in animals to prolong prothrombin time. |
| Management | Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients treated with warfarin, the INR should be closely monitored following addition or discontinuation of chondroitin and glucosamine, and the warfarin dosage adjusted as necessary. The same precaution may be applicable during therapy with other oral anticoagulants, although clinical data are lacking. 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. |
| References | |
| Alternative for Warfarin |
B01A
More
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| Alternative for Glucosamine | - |
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.