Drug General Information (ID: DDI0BLOWDU)
  Drug Name Protein C Drug Info Selumetinib Drug Info
  Drug Type Protein/peptide Small molecule
  Therapeutic Class Coagulation Modifiers Multikinase Inhibitors

 Mechanism of Protein C-Selumetinib Interaction (Severity Level: Moderate)
     Increased risk of bleeding Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Protein C Selumetinib
      Mechanism Risk of bleeding
Anticoagulant effects 
Risk of bleeding
Antiplatelet/anticoagulant effects 
      Key Mechanism Factor 1
Factor Name Bleeding
Factor Description Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
      Mechanism Description
  • Increased risk of bleeding by the combination of Protein C and Selumetinib 

Recommended Action
      Management Close clinical and laboratory observation for hematologic complications may be appropriate when selumetinib is initiated in patients stabilized on anticoagulant or antiplatelet therapy. 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
1 Booth SL, Golly I, Sacheck JM, Roubenoff R, Dallal GE, et al "Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status." Am J Clin Nutr 80 (2004): 143-8. [PMID: 15213041]
2 Murohara T, Ikeda H, Otsuka Y, Aoki M, Takajo Y, et al "Inhibition of platelet adherence to Mononuclear cells by alpha-tocopherol: role of P-selection." Circulation 110 (2004): 141-8. [PMID: 15197142]
3 Vitamin K, vitamin E and the coumarin drugs. Nutr Rev 40 (1982): 180-2. [PMID: 7121898]