Anticoagulants clofibrate

Drugs that may affect sulfonylureas include androgens, anticoagulants, azole antifungals, barbiturates, beta blockers, calcium channel blockers, charcoal, chloramphenicol, cholestyramine, ciprofloxacin, clofibrate, corticosteroids, diazoxide, estrogens, ethanol, fluconazole, gemfibrozil, histamine H2 antagonists, hydantoins,... 

Rifampin is known to induce the hepatic microsomal enzymes that metabolize various drugs such as acetaminophen, oral anticoagulants, barbiturates, benzodiazepines, beta blockers, chloramphenicol, clofibrate, oral contraceptives, corticosteroids, cyclosporine, disopyramide, estrogens, hydantoins, mexiletine, quinidine, sulfones, sulfonylureas, theophyllines, tocainide, verapamil, digoxin, enalapril, morphine, nifedipine, ondansetron, progestins, protease inhibitors, buspirone, delavirdine, doxycycline, fluoroquinolones, losartan, macrolides, sulfonylureas, tacrolimus, thyroid hormones, TCAs, zolpidem, zidovudine, and ketoconazole. The therapeutic effects of these drugs may be decreased. 

Synergism Increased anticoagulation of warfarin with clofibrate, corticosteroids, tetracycline, vitamin K and naloxone. 

Warfarin antagonists include vitamin K, barbiturates, glutethimide. rifampin, and cholestyramine. Warfarin potentiators include phenylbutazone. oxyphenbutazone, anabolic steroids, clofibrate, aspirin, hepatotoxins, disnlfirain, and metronidazole. In patients undergoing anticoagulation therapy with warfann, it has been found that cimetidine (used in therapy of duodenal ulcer) may increase anticoagulant blood levels and consequently prolong the prothrombin time. 

Clofibrate is tolerated well by must patients the mo.st common side effects are 0.111504 and. to a smaller extent, other gastrointestinal distress. The dosage of anticoagulants, if u.scd in conjunction with this drug, should be reduced by one third to one half, depending on the individual response, so that the prothrombin time may be kept within the desired limits. 

Niacin in the CDP significantly reduced definite, nonfatal MI as compared with placebo (10.1% versus 13.9%), whereas clofibrate did not reduce death from any cause or nonfatal or fatal MI at the 5-year follow-up period. Clofibrate did increase the rate of definite or suspected fatal or nonfatal pulmonary embolism or thrombophlebitis compared with placebo (5.8% versus 3.6%) after adjusting for baseline characteristics for total follow-up. Other findings with clofibrate that occurred more frequently than with placebo included intermittent claudication, arrhythmias, palpable spleen, cholelithiasis (including cholecystectomy), and more frequent use of anticoagulants. Skin reactions, gastrointestinal complaints, and the use of gout... 

Clofibric acid Nicotinic acid Etofibrate Dicumaiol Anticoagulant... 

Schrc ie JJ, Solomon HM The anticoagulant response to bishy droxy coumarin. II. The effect of d-thyroxine, clofibrate, and norethandFolone. Clin Pharmacol Ther (1967) 8, 70-7. 

Clofibrate increases the effects of coumarin and indanedione anticoagulants. This has been fatal in some cases. Other fibrates appear to interact similarly, although data in many cases is limited to case reports. 

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