Coumarin derivatives interaction

Drugs that may interact with lepirudin and increase the risk of bleeding include thrombolytics (eg, tPA, streptokinase) and coumarin derivatives (vitamin K antagonists). 

Sweet clover also contains coumarin derivatives and therefore poses an increased risk of bleeding if given with warfarin. There have been no reports of an interaction between sweet clover and warfarin or hemorrhagic disease in humans. However, several cases of severe hemorrhage and death have been reported in cattle. 

The effect of an electrical field on the absorption/emission of spectra of a probe such as fluorescein or a coumarin derivative. It is derived from the interaction of the induced dipole(s) in the probe interacting with the charged group. See Sitkoff, D., Lockhart, D.J., Sharp, K.A., and Honig, B., Calculation of electrostatic effects at the amino terminal of an helix, Biophys. J. 67,2251-2260,1994 Pierce, D.W. and Boxer, S.A., Stark effect spectroscopy of tryptophan, B/opfiyx. J. 68,1583-1591,1995 Klymchenko, A.S., Avilov, S.V., and Demchenko, A.P., Resolution of Cys and Lys labeling of a-crystalUn with site-sensitive fluorescent 3-hydroxyflavone dye. Anal. Biochem. 329, 43-57, 2004. 

Watson PG, Lochan RG, Redding VJ. Drug interactions with coumarin derivative anticoagulants. BMJ (Clin Res Ed) 1982 285(6347) 1045-6. 

Clinically important, potentially hazardous interactions with beta andrenergic blocking agents, chloramphenicol, cimetidine, dofibrate, coumarin deriveratives, disopyramide, MAO inhibitors, miconazole, phenylbutazone, salicylates, sulphonamides, tetracycline... 

Wittkowsky AK. Warfarin and other coumarin derivatives pharmacokinetics, pharmacodynamics, and drug interactions. Semin Vase Med 2003 3(3) 221-30. 

A potentially dangerous interaction may occur between fluvoxamine and warfarin. There is a 65% increase in plasma warfarin concentration and a significant prolongation of prothrombin time. The selective serotonin reuptake inhibitors (SSRIs) increase the risk of upper gastrointestinal bleeding, and this effect is potentiated by the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin. There are anecdotal reports of bleeding disorder with the concomitant use of nicoumalone (a coumarin derivate), ibuprofen, and warfarin. 

Interactions between the enantiomers of coumarin derivatives with commonly used drugs are presented in Table 4 [60,7(R80]. A number of interactions have been reported at the level of displacement of enantiomers from plasma proteins and enzyme induction and inhibition. Although the addition of displacing drugs might increase the unbound fractions of the enantiomers of coumarins, only a transient increase in pharmacodynamic response is expected because of the restricted elimination of these drugs. Of a more serious nature, from the perspective of the clinician, are those interactions that influence the clearance of the unbound anticoagulant enantiomer (Table 4). 

Boeijinga JK, Breimer DD, Kraay CJ, Kleinbloesem CH. Absence of interaction between the ACE ii bitor cilazapril and coumarin derivatives in elderly patients on loi term oral anticoagulants. BrJ Clin Pharmacol (1992) 33,553P. 

Boeijinga JK, Matroos AW, van Maarschalkerweerd MW, Jeletich-Bastiaanse A, Breimer DD. No interaction shown between ramipril and coumarine derivatives. Curr TherRes (1988) 44, 902-8. 

Canadian Adverse Drug Reaction Monitoring Program, Communique. Orlistat (Xenical) interaction with coumarin derivatives increased INR. Can Adverse Drug React News (2001) 11 (Jul), 7. 

Chamomile has been indicated as an herb with the theoretical potential for interacting with warfarin due to the coumarin content of the herb (Heck et al. 2000). The cou-marin content, however, consists of the coumarin derivatives herniarin and umbelliferone. Herniarin has been shown to have hemostatic activity (Ahmad and Misra 1997) and umbelliferone has shown no evidence of anticoagulant activity (Egan et al. 1990 Feuer 1974 Pelkonen et al. 1997). The flavonoid apigenin has been shown to inhibit platelet aggregation in vitro (Landolfi et al. 1984 Teng et al. 1985). 

Minamikawa T, Akazawa T, Uritani I (1964) Two glucosides of coumarin derivatives in sweet potato roots infected by Cemtocystis fimbriata. Agr Biol Chem 28 230-233 Mistry TV, Cai Y, Ltiley TH, Haslam E (1991) Polyphenol interactions. Part 5. Anthocyanin co-pimentation. J Chem Soc Perkin Trans 2 1287-1296 Mplgaard P, Ravn H (1988) Evolutionary aspects of caffeoyl ester distribution in dicotyledons. Phytochemistry 27 2411-2421... 

Various by-side interactions can also improve the efficiency of II Dye and III Dye PISs (see below) in for example the coumarin derivative/titanocene system [ALL 04],... 

Shobini, J. Mishra, A. K. Sandhya, K. Chandra, N. Interaction of coumarin derivatives with human serum albumin investigation by fluorescence spectroscopic technique and modeling studies. Spectrochim. Acta, Part A Mol. Biomol. Spectrosc. 2001, 57A,1133-1147. 

On the Ability of Coumarin Derivatives to Interact with Photoinitiators. Allonas, X. Fouassier, J.P. Kaji, M. Miyasaka, M. Departement de Photochimie Generate, UMR No. 7525, Ecole Nationale... 

Two and Three Component Photoinitiating Systems Based on Coumarin Derivatives. AUonas, X. Fouassier, J.P. Kaji, M. Miyasaka, M. Hidaka, T. Departement de Photochimie Genetale, UMR No. 7525, Ecole Nationale Superieure de Chimie, Mulhouse, Fr. Polymer (2001), 42 (18), 7627-7634 (Eng.). Several coumarin or ketocoumarin/additives combinations (bisimidazole deriv., mercapto-benzoxazole, titanocene, oxime ester) can initiate quite efficiently radical polymn. The interactions between the excited states of coumarins or aketocoumarin and various additives have also been studied by laser absorption spectroscopy, time resolved fluorescence and photocond. the redox potentials of these different compds. have been measured and allowed the calcn. of free enthalpy variations for a possible electron transfer reaction. The whole results explain the interaction mechanism and show that the coumarins are able to form radicals through an electron transfer reaction with the different additives whereas the ketocoumarin leads to an energy transfer with bisimidazole and to an hydrogen abstraction with the benzoxazole deriv. 

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