This document discusses the important drug and food interactions of warfarin, an anticoagulant medication. It lists which drugs increase or decrease the anticoagulant effect and bleeding risk of warfarin when taken together. It also categorizes different foods as having low, medium, or high vitamin K content and how that can impact warfarin's efficacy when consumed. The document provides an extensive list of potential drug-drug and drug-food interactions patients taking warfarin should be aware of.

1. WARFARIN Most Important Drugs/Food-Interactions
Anticoagulant effect Bleeding risk
increament
INR
changes
Warfarin efficacy Vitamin K
content in food
Increased Reduced Clopidogrel Β-blockers Increased decreased Low level:
Caulisflower ‫قرنبيط‬
Green beans ‫بقوليات‬
‫خضراء‬
Carrot ‫جزر‬
Onion ‫بصل‬
Potatoes ‫بطاطا‬
Cucumber ‫خيار‬
Mushroom ‫فطر‬
Pumpkin ‫يقطين‬
Tomato ‫طماطا‬
Corns ‫ذرة,قمح‬
Peppers ‫فلفل‬
Apples ‫تفاح‬
Blue berry ‫عنب,توت‬
‫البري‬
Lemon ‫الليمون‬
Orange ‫البرتقال‬
Peach ‫الخوخ‬
Shrimp ‫الروبيان‬
Tuna ‫التونا‬
Peanut oil ‫افول‬ ‫زيت‬
‫السوداني‬
Seasame oil ‫زيت‬
Alcohol Aminogluteth
mide
Diclofenac
(may)
Flu
vaccine
(Increase
INR with 7
days)
Antifungals Oral
contraceptives
Allopurinol Anabolic
steroids
Ginkobiloba Simvastati
n
(Increase
INR with 7
days)
Dexamethas
on
(high doses)
St.john’swort
herbs
Amiodaron Anti
epileptics
Ginseng Grapefruit
(increase)
‫السندي‬
Fluvastatin Vitamin C
Aspirin Barbiturates Glucosamine Mefenamic
acid
Vitamin K
Azathioprine Carbamazepi
ne
Chondroitin Mirtazepine Menthol ‫نعناع‬
Broccoli ‫بروكلي‬
Brussel ‫كرنب‬
Spinach ‫سبانغ‬
Chard ‫سلق‬
Coriander ‫كزبرة‬
Water cress
‫جرجير‬
Cabbage ‫ملفوف‬
Cefaclor Cholestyrami
ne
Indometacin Prednisolon
e
(high doses)
Celecoxib Co enzyme Q
10
Ketorolac
(serious GI
Quinidine

2. bleeding) ‫السمسم‬
Sunflower oil ‫زيت‬
‫الشمس‬ ‫زهرة‬
Chloramphenic
ol
Griseofulvin Lansoprazol Tramadol
Cimitidine Phenobarbito
ne
NSAID
(GIirritation
& prevent pl.
Aggregation)
Vitamin E
Ciprofloxacin
(may)
Rifampicin Evening prime
rose oil
‫الربيع‬ ‫زهرة‬ ‫زيت‬
‫المسائية‬
Fish oil
‫السمك‬ ‫زيت‬
Flaxseed oil
‫الكتان‬ ‫بذور‬ ‫زيت‬
Aniseed
‫الينسون‬
Chamomile
‫البابونج‬
Feverfew
‫االقحوان‬
Ginger
‫الزنجبيل‬
Liquorice
‫السوس‬ ‫عرق‬
Red clover
‫االحمر‬ ‫البرسيم‬
Clarithromycin Rifabutin
Cotrimoxazole
Danazol
Disulfiram
Erythromycin Mediumcontent:
Oliveoil ‫الزيتون‬ ‫زيت‬
Margarine ‫المرجرين‬
Fibrates
Fluconazol
Gemfibrozile
Glucagon
High doses
Metronidazole
Miconazole
Omprazol
Paracetamol
High doses &
Long time
Piroxicam
Sulphonamides

3. Sulindac
Tamoxifen
Thyroxine
Cranberry
‫التوت‬
Garlic
‫الثوم‬
papaya