Drug General Information (ID: DDI1YSEKCN)
  Drug Name Argatroban Drug Info Bismuth subsalicylate Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticoagulants Antidiarrheals
  Structure

 Mechanism of Argatroban-Bismuth subsalicylate Interaction (Severity Level: Moderate)
     Increased risk of bleeding Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Argatroban Bismuth subsalicylate
      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 Argatroban and Bismuth subsalicylate 

Recommended Action
      Management Until further data are available, products containing salicylates, especially if given chronically or in high dosages, should preferably be avoided in patients receiving anticoagulants. Close clinical and laboratory observation for bleeding complications is recommended if concurrent therapy is necessary. The same precaution should be observed with the use of salicylate-related agents such as salicylamide because of their structural and pharmacological similarities.

References
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6 Penning-van Beest F, Erkens J, Petersen KU, Koelz HR, Herings R "Main comedications associated with major bleeding during anticoagulant therapy with coumarins." Eur J Clin Pharmacol 61 (2005): 439-44. [PMID: 15947920]
7 Weiss HJ, Aledort LM, Kochwa S "The effect of salicylates on the hemostatic properties of platelets in man." J Clin Invest 47 (1968): 2169-80. [PMID: 5675432]
8 Wells PS, Holbrook AM, Crowther NR, Hirsh J "Interactions of warfarin with drugs and food." Ann Intern Med 121 (1994): 676-83. [PMID: 7944078]