Drug General Information (ID: DDI12E5TS7)
Drug Name			Dicoumarol		Drug Info		Colesevelam		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anticoagulants				Bile Acid Sequestrants
Structure

Mechanism of Dicoumarol-Colesevelam Interaction (Severity Level: Moderate)
Altered Fat-soluble drugs absorption Click to Show/Hide Mechanism Graph
Drug Name		Dicoumarol				Colesevelam
Mechanism		Fat-soluble agent (vitamin K)				Decrease fat-soluble agent absorption
Key Mechanism Factor 1
		Factor Name		Pharmacokinetic
		Factor Description		Alters the absorption of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
Mechanism Description		Decreased absorption of Dicoumarol caused by Colesevelam

Recommended Action
Management		Patients receiving warfarin and other oral anticoagulants should have INR monitored frequently during initiation of colesevelam, then periodically thereafter.

References
1	Bodiford AB, Kessler FO, Fermo JD, Ragucci KR "Elevated international normalized ratio with the consumption of grapefruit and use of warfarin." SAGE Open Med Case Rep 0 (2013): 1-3. [PMID: 27489634]
2	Canadian Pharmacists Association.
3	Product Information. Welchol (colesevelam) Daiichi Sankyo, Inc., Parsippany, NJ.