Coumadin and NSAIDs
Coumadin and NSAIDs(Advil, Aleve, Nabumetone, etc.) probably one of the worst drug-drug interactions, in fact the AMDA lists it as one of its top ten in long-term-care/geriatrics. http://www.amda.com/tools/clinical/m3/topten.cfm – NSAIDs can cause issues with GI bleeding and ulcers by themselves. With the addition of an NSAID on top of Coumadin which can thin the blood as described before can dramatically increase the risk of this bleeding. I’ve seen numerous cases of this and we need to try to avoid using this drugs together if at all possible. If the healthcare team deems that this combination can’t be avoided, then extra careful monitoring is of high importance.
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