Pioglitazone Warfarin

Clinically important, potentially hazardous interactions with atorvastatin, bexarotene, cyclosporine, dicumarol, ezetimibe, fluvastatin, interferon alfa, lovastatin, nicotinic acid, pioglitazone, pravastatin, repaglinide, rosuvastatin, roxithromycin, simvastatin, statins, warfarin... 

Pioglitazone does not appear to alter the pharmacokinetics or anticoagulant effect of warfarin or phenprocoumon. Rosiglitazone did not affect the pharmacokinetics of warfarin. 

Pioglitazone 45 mg daily for 7 days did not alter the steady-state pharmacokinetics ofR- or 5-warfarin and there was no significant change in prothrombin time. Similar results were noted with phenprocoumon. Pioglitazone had no effect on prothrombin time when it was given to patients stabilised on warfarin. ... 

Controlled studies have shown no interaction between pioglitazone and warfarin or phenprocoumon, or between rosiglitazone and warfarin. This suggests that coumarin dose adjustments are unlikely to be needed when these antidiabetics are used. 

A 71-year-old man with type 2 diabetes taking amlodipine, warfarin, valsartan, hydrochlorothiazide, atenolol, and rosiglitazone was given fenofibrate. The HDL cholesterol fell from 0.96 to 0.60 mmol/1 but rose to 0.80 mmol/1 on changing the rosiglitazone to pioglitazone. 

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