Norfloxacin Warfarin

Rocci ML Jr, Vlasses PH, Distlerath LM, Gregg MH, Wheeler SC, Zing W, Bjomsson TD. Norfloxacin does not alter warfarin s disposition or anticoagulant effect. J Clin Pharmacol 1990 30(8) 728-32. 

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... 

Noninterfering acetaminophen, cefuroxime, cloxaciUin, dextropropoxyphene, digoxin, dox-ycycline, erythromycin, furosemide, metronidazole, netilmicin, penicillin G, prednisolone, salicylic acid, sulfamethoxazole, trimethoprim, warfarin Interfering norfloxacin... 

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 10 healthy subjects norfloxacin 400 mg twice daily for 9 days was found not to alter either the pharmacokinetics or anticoagulant effects of a single 30-mg dose of warfarin given on day 4. ... 

Health Canada had received 6 reports of suspected coagulation disorders associated with norfloxacin and warfarin, 4 of which were considered serious. Similarly, in February 2006, the Australia Adverse Drug Reactions Advisory Committee stated they had received 11 reports of a suspected interaction between warfarin and norfloxacin. ... 

Ofloxacin 200 mg daily for 7 days did not signifrcantly affect the prothrombin times of 7 healthy subjects stabilised on phenprocoumon. In a population-based cohort study, there were no cases of over-anticoagu-lation (USTR greater than 6) in patients taking acenocoumarol or phenprocoumon with ofloxacin (33 received ofloxacin. Note that this study did find an increased risk for norfloxacin, see (j) above. Furthermore, for the period December 1990 to January 2004, Health Canada had not received any reports of suspected coagulation disorders associated with ofloxacin and warfarin. ... 

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