Sulfinpyrazone Coumarins

Besides alcohol, some cephalosporins (cefamandole, cefimetazole, cefopera-zone, or cefotetan) expose the patient to an increased risk of hemorrhaging if administered with anticoagulants such as coumarin or indanedione, heparin, and with clot-busting drugs such as thrombol5 cs. The same adverse reaction might occur if the patient takes NSAlDs, especially aspirin, or sulfinpyrazone (Anturane) while on cephalosporins. 

The anticoagulant effects of warfarin are markedly increased by sulfinpyrazone, and there are case reports of moderate to serious bleeding on concurrent use. Acenocoumarol is modestly affected. Phenprocoumon does not appear to be significantly affected. Bear in mind that the antiplatelet effects of sulfinpyrazone might increase the risk of bleeding with coumarins. 

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