Methylprednisolone Acenocoumarol

Intravenous methylprednisolone (1 g/day for 3 days) has been reported to inhibit the metabolism of oral anticoagulants (acenocoumarol and fluindione) in 10 patients, increasing the INR by 8 (range 5-20) (478). 

Potentiation of the effects of vitamin K antagonists by high-dose intravenous methylprednisolone has been prospectively studied in 10 consecutive patients and 5 controls after the observation of a sharp increase in the International Normalized Ratio (INR) in a patient taking oral anticoagulation after concomitant administration of methylprednisolone (1 g/day for 3 days) (262). The mean INR was 2.8 (range 2.0-3.8) at baseline and increased to 8.0 (5.3-20). The maximum increase in INR occurred after a mean of 93 (29-156) hours. The coumarins taken by these patients were fluindione in eight and acenocoumarol in two. The prothrombin time in the controls... 

Clinically important, potentially hazardous interactions with acenocoumarol, anagrelide, anticoagulants, bismuth, boswellia, calcium hydroxylapatite, capsicum, cholestyramine, desvenlafaxine, devil s claw, dexamethasone, dexibuprofen, dicumarol, etodolac, evening primrose, flunisolide, ginkgo biloba, ginseng, heparin, ibuprofen, indomethacin, ketoprofen, ketorolac, lumiracoxib, methotrexate, methylprednisolone, nilutamide, NSAIDs, phellodendron, prednisone, resveratrol, reteplase, rivaroxaban, sermorelin, sulfites, tirofiban, triamcinolone, urokinase, valdecoxib, valproic acid, verapamil, warfarin... 

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