Moxifloxacin Warfarin

Significant drug interactions with theophylline [268], itraconazole [269], warfarin, yS-acetyldigoxin, ranitidine, probenecid and oral contraceptives have not been reported with moxifloxacin [12,237]. 

Moxifloxacin had no effect on the pharmacokinetics of warfarin in combination steady-state conditions (4)... 

Clinically important, potentially hazardous interactions with abarelix, acenocoumarol, amisulpride, amprenavir, anisindione, anticoagulants, arsenic, astemizole, carbimazole, celiprolol, ciprofloxacin, dabigatran, degarelix, dicumarol, digoxin, diltiazem, enoxacin, fentanyl, fosamprenavir, gatifloxacin, grapefruit juice, lomefloxacin, methotrexate, moxifloxacin, nilotinib, norfloxacin, ofloxacin, oxprenolol, quinidine, quinolones, rifabutin, rifampin, rifapentine, ritonavir, simvastatin, sparfloxacin, sulpiride, tacrolimus, tipranavir, verapamil, warfarin, zuclopenthixol... 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

Most studies show that the quinolones have, at most, a small, clinically insigniilcant effect on the pharmacokinetics and pharmacodynamics of warfarin. Despite this, increased effects and even bleeding have been seen quite unpredictably in isolated cases in patients taking warfarin with ciprofloxacin, gatifloxacin, levo-floxacin, moxifloxacin, nalidixic acid, norfloxacin or ofloxacin or while taking acenocoumarol when given nalidixic acid, norfloxacin or pefloxacin, or phenprocoumon with norfloxacin. Fur-... 

In contrast, one report describes 2 patients stabilised on warfarin who had marked rises in their INRs (to 6.2 and 7.3), and another patient recently started on warfarin who had a more modest rise (to 4.2) within 1 to 5 days of starting moxifloxacin. All these patients had recently been receiving other antibacterials, which complicates interpretation. For the period October 2000 to January 2004, Health Canada h received 12 reports of suspected coagulation disorders associated with moxifloxacin and warfarin, 11 of which were considered serious. Similarly, in February 2006, the Australia Adverse Drug Reactions Advisory Committee stated they had received one report of a suspected interaction between warfarin and moxifloxacin. In this patient the DSTR rose from around 2 to greater than 10, four days after starting moxifloxacin. ... 

Arnold LM, Nissen LR, Ng TMH. Moxifloxacin and warfarin additional evidence for a clinically relevant intemetioa Pharmacotiterapy (2005) 25,904-7. 

Fluoroquinolone antibiotics Moxifloxacin 400 mg/day markedly increased the action of warfarin in a 74-year-old patient with a prosthetic mitral valve, whose INR rose to 12 [40 ]. 

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