## Primary Drug Warfarin ## Interacting Drug NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) ## Type of Interaction Pharmacokinetic ## Mechanism NSAIDs can displace warfarin from protein binding sites, leading to an increase in the free fraction of warfarin in the bloodstream. ## Clinical Significance This interaction can potentiate the anticoagulant effects of warfarin, increasing the risk of bleeding in the patient. ## Management / Monitoring Monitor the patient's INR (International Normalized Ratio) closely when starting or stopping NSAID therapy in patients taking warfarin. Consider adjusting the warfarin dosage based on INR levels. ## Pharmacy Technician Notes - Counsel patients to avoid or use NSAIDs cautiously while taking warfarin to minimize the risk of bleeding complications. - Encourage patients to report any signs of bleeding, such as prolonged bleeding from minor cuts, easy bruising, or blood in the urine or stool. - Examples of NSAIDs include ibuprofen, naproxen, and aspirin. Patients should consult their healthcare provider before taking any new medications while on warfarin therapy.