alternative analgesic such as

loss paracetamol or pentazocine




etacrynic acid


mefenamic acid loss

Higher blood levels of warfarin with risk of haemorrhage

Displacement from protein

Increased blood level of Displacement from protein warfarin with haemorrhage risk

Enhanced anticoagulant blood levels with risk of haemorrhage and enhanced risk of GI bleeding

Displacement from protein paracetamol or pentazocine

Warfarin dose may require a reduction of one-third to one-half according to coagulation test

Monitor patient with initiation and cessation of therapy

Concurrent administration is best avoided. If necessary, coagulation times should be monitored

Reminder: Use this appendix only to illustrate the range of problems that may arise from physicochemical interactions in vivo. Ivan Stockley's book28 is an authoritative source of information on interactions between drugs.

B: Interactions involving protein binding


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