Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDI4IENLM3)
  Drug Name Dicoumarol Drug Info Capecitabine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticoagulants Antineoplastics
  Structure

 Mechanism of Dicoumarol-Capecitabine Interaction (Severity Level: Major)
     Increased risk of bleeding Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Dicoumarol Capecitabine
      Mechanism Vitamin K antagonist Potentiate the hypoprothrombinemic effect of vitamin K antagonist
      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 Dicoumarol and Capecitabine 

Recommended Action
      Management Patients should be closely monitored during concomitant therapy. The INR or PT should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation or discontinuation of fluorouracil or capecitabine therapy in patients who are stabilized on their anticoagulant regimen. 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 Aki Z, Kotiloglu G, Ozyilkan O "A patient with a prolonged prothrombin time due to an adverse interaction between 5-fluorouracil and warfarin." Am J Gastroenterol 95 (2000): 1093-4.[PMID: 10763974]
2 Brown MC "An adverse interaction between warfarin and 5-fluorouracil: A case report and review of the literature." Chemotherapy 45 (1999): 392-5.[PMID: 10473927]
3 Brown MC "Multisite mucous membrane bleeding due to a possible interaction between warfarin and 5-flourouracil." Pharmacotherapy 17 (1997): 631-3.[PMID: 9165571]