Basic Information
ID DDInter541 and DDInter1951
Interaction Dicloxacillin and nafcillin may diminish the hypoprothrombinemic effect of warfarin. The exact mechanism of interaction is unknown but may involve induction of hepatic warfarin metabolism by these penicillins.
Management Coagulation parameters should be monitored more closely during coadministration of warfarin with dicloxacillin or nafcillin and for several weeks after discontinuation of the antibiotic. The same precaution may be applicable during therapy with other oral anticoagulants.
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Alternative for Dicloxacillin J01C
Tazobactam Sulbactam
Alternative for Warfarin B01A
Ticagrelor Betrixaban Apixaban Cilostazol Rivaroxaban Iloprost
Lepirudin Acenocoumarol Urokinase Cangrelor Dipyridamole
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.