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Is there an interaction between warfarin and proton pump inhibitors?

Publisher: East Anglia Medicines Information Service

Keywords: Warfarin; Rabeprazole; Proton Pump Inhibitors; Lansoprazole; Omeprazole; Pantoprazole; Drug Interactions; esomeprazole

Date published: 29/07/2011 17:30

Review date: 31/07/2013 00:00

Summary
by: Katie Smith
  • Generally, the evidence for an interaction between warfarin and proton pump inhibitors is poor, but rarely and unpredictably raised INRs and bleeding may occur.
  • In practice, whilst there is no reason for avoiding concurrent use of any proton pump inhibitor with warfarin, close monitoring of the prothrombin time or INR may be required.
  • If any increase in the INR is seen, the dose of warfarin should be adjusted as necessary to maintain the desired level of anticoagulation.
Warfarin_PPI_0711

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