Drug Interaction between Ciprofloxacin and Warfarin

Ciprofloxacin is a fluoroquinolone antibiotic agent used for the treatment of bacterial infections.
Warfarin is a coumarin anticoagulant used for the treatment of blood clots in cases of deep vein thrombosis or pulmonary embolism. It is also employed in the prevention of thrombosis in high risk patients like stroke, atrial fibrillation, heart attack, etc.

The concomitant use of both Ciprofloxacin and Warfarin can lead to a major drug interaction. This is because Ciprofloxacin, and other quinolone antibiotics, has been observed to potentiate the hypoprothrombinemic effect of Warfarin, and other coumarin anticoagulants. The mechanism of interaction is unknown but it has been proposed that there is inhibition of coumarin metabolism through reduction in vitamin K-producing intestinal flora by the quinolone antibiotics.

This is considered a major drug interaction in which very close monitoring or an alternative is strongly advised.

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