Drug General Information (ID: DDI0FSGHTQ)
Drug Name			Lepirudin		Drug Info		Clove		Drug Info
Drug Type		Small molecule				Natural product
Therapeutic Class		Antithrombotic Agents				Herbal Products

Mechanism of Lepirudin-Clove Interaction (Severity Level: Minor)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Lepirudin				Clove
Mechanism		Risk of bleeding Anticoagulant				Risk of bleeding Antiplatelet 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 Lepirudin and Clove

Recommended Action
Management		Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients who have used clove and clove oil extensively prior to receiving treatment with anticoagulants or other drugs that may affect hemostasis, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. 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	Heck AM, DeWitt BA, Lukes AL "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm 57 (2000): 1221-7 quiz 1228-30. [PMID: 10902065]
2	Saeed SA, Gilani AH "Antithrombotic activity of clove oil." J Pak Med Assoc 44 (1994): 112-5. [PMID: 8078176]
3	Srivasta KC "Antiplatelet principles from a food spice clove (Syzygium aromaticum L) [corrected]" Prostaglandins Leukot Essent Fatty Acids 48 (1993): 363-72. [PMID: 8321872]
4	Srivstava KC, Malhotra N "Acetyl eugenol, a component of oil of cloves (Syzygium aromaticum L.) inhibits aggregation and alters arachidonic acid metabolism in human blood platelets." Prostaglandins Leukot Essent Fatty Acids 42 (1991): 73-81. [PMID: 2011614]