Drug General Information (ID: DDIMOT3ZBQ)
Drug Name			Dicoumarol		Drug Info		Gemfibrozil		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anticoagulants				Antihyperammonia Agents
Structure

Mechanism of Dicoumarol-Gemfibrozil Interaction (Severity Level: Major)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Dicoumarol				Gemfibrozil
Mechanism		Competition for plasma protein binding sites				Competition for plasma protein binding sites
Key Mechanism Factor 1
		Factor Name		Plasma protein binding
		Factor Description		Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
Mechanism Description		Increased plasma concentration of Gemfibrozil and Dicoumarol due to competitive binding of plasma proteins

Recommended Action
Management		Caution should be exercised when fibrates are prescribed to patients receiving oral anticoagulant therapy. Frequent prothrombin determinations are advisable until prothrombin level has stabilized. Patients should be advised to notify their physician if they experience potential signs of excessive anticoagulation such as unusual or prolonged bleeding, bruising, vomiting, change in stool or urine color, headache, dizziness, or weakness.

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Lopid (gemfibrozil). Parke-Davis, Morris Plains, NJ.