Drug General Information (ID: DDIAXTKJE1)
Drug Name			Warfarin		Drug Info		Trastuzumab emtansine		Drug Info
Drug Type		Small molecule				Monoclonal antibody
Therapeutic Class		Anticoagulants				Antineoplastics/Her2 Inhibitors

Mechanism of Warfarin-Trastuzumab emtansine Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Warfarin				Trastuzumab emtansine
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 Warfarin and Trastuzumab emtansine

Recommended Action
Management		Caution is recommended and additional monitoring should be considered if trastuzumab emtansine must be used with anticoagulant or antiplatelet drugs. In general, monitoring of platelet counts is recommended prior to each dose of trastuzumab emtansine.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Kadcyla (ado-trastuzumab). Genentech, South San Francisco, CA.