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Triptans used to treat migraine headache medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, buspirone, ssris, snris or maois tramadol and fentanyl amphetamines cimetidine the antibiotics ciprofloxacin, enoxacin medicine to treat irregular heart rate like propafenone, flecainide, quinidine theophylline the blood thinner warfarin coumadin, jantoven non-steroidal anti-inflammatory drug nsaid like ibuprofen, naproxen or aspirin .

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The treatment of excessive anticoagulation is based on the level of the INRthe presence or absence of bleedingand clinical circumstancesReversal of COUMADIN anticoagulation may be obtained by discontinuing COUMADIN therapy andif necessaryby administration of oral or parenteral vitamin K 1

It is not known whether warfarin passes into breast milkWatch for signs of bruising or bleeding in the baby if you take Coumadin while you are breast-feeding a baby.

No dosage adjustment is necessary for patients with renal failureMonitor INR more frequently in patients with compromised renal function to maintain INR within the therapeutic rangesee WARNINGS AND PRECAUTIONS and Use In Specific Populations

Examples of drugs known to increase the risk of bleeding are presented in Table 3Because bleeding risk is increased when these drugs are used concomitantly with warfarinclosely monitor patients receiving any such drug with warfarin.

Few adequatewell-controlled studies evaluating the potential for metabolic and/or pharmacologic interactions between botanicals and COUMADIN existDue to a lack of manufacturing standardization with botanical medicinal preparationsthe amount of active ingredients may varyThis could further confound the ability to assess potential interactions and effects on anticoagulation.

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