Drug General Information (ID: DDIG0RAFDM)
  Drug Name Cycloserine Drug Info Anisindione Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antiinfective Agents Anticoagulants
  Structure

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

Recommended Action
      Management Caution is advised when coumarin anticoagulants are coadministered with cycloserine or terizidone. The INR should be checked frequently and coumarin dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of the antituberculosis agent. 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 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2 Watson PG, Lochan RG, Redding VJ "Drug interaction with coumarin derivative anticoagulants." Br Med J 285 (1982): 1045-6. [PMID: 6812734]
3 Arbex MA, Varella Mde C, Siqueira HR, Mello FA "Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs." J Bras Pneumol 36 (2010): 641-56