Drug General Information (ID: DDI5NTKPFX)
  Drug Name Dicoumarol Drug Info Amoxicillin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anticoagulants Antibiotics
  Structure

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

Recommended Action
      Management Caution is recommended if a penicillin is prescribed during oral anticoagulant therapy, especially in the elderly and patients with uremia or hepatic impairment. The INR should be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation or discontinuation of penicillin therapy in patients who are stabilized on their anticoagulant regimen. Patients should be advised to promptly report any signs of bleeding to their doctor, 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 Alexander DP, Russo ME, Fohrman DE, Rothstein G "Nafcillin-induced platelet dysfunction and bleeding." Antimicrob Agents Chemother 23 (1983): 59-62. [PMID: 6830209]
2 Andrassy K, Ritz E, Weisschedel E "Bleeding after carbenicillin administration." N Engl J Med 292 (1975): 109. [PMID: 1109431]
3 Ku LL, Ward CO, Durgin SJ "A clinical study of drug interaction and anticoagulant therapy." Drug Intell Clin Pharm 4 (1970): 300-6.