Drug General Information (ID: DDI5LK6HP1)
Drug Name			Spironolactone		Drug Info		Anisindione		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Diuretics				Anticoagulants
Structure

Mechanism of Spironolactone-Anisindione Interaction (Severity Level: Minor)
Antagonize the effect of antithrombotic agents Click to Show/Hide Mechanism Graph
Drug Name		Spironolactone				Anisindione
Mechanism		Decrease the hypoprothrombinemic effect of vitamin K antagonist				Vitamin K antagonist
Key Mechanism Factor 1
		Factor Name		Antithrombotic agents
		Factor Description		The beneficial effects of antithrombotic agents are reduced, leading to an increased risk of thromboembolism, stroke and/or myocardial infarction.
Mechanism Description		Antagonize the effect of Anisindione when combined with Spironolactone

Recommended Action
Management		The INR or PT should be monitored, and oral coagulant dosage should be increased as needed.

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	Guo LQ, Yamazoe Y "Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines." Acta Pharmacol Sin 25 (2004): 129-36. [PMID: 14769198]
3	O'Reilly RA "Spironolactone and warfarin interaction." Clin Pharmacol Ther 27 (1980): 198-201