## Primary Drug Warfarin ## Interacting Drug NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) ## Type of Interaction Pharmacodynamic ## Mechanism NSAIDs can displace warfarin from protein binding sites, leading to an increased level of free (unbound) warfarin in the blood. This can potentiate the anticoagulant effects of warfarin. ## Clinical Significance This interaction can result in an increased risk of bleeding due to the exaggerated anticoagulant activity of warfarin when combined with NSAIDs. ## Management / Monitoring Patients should be closely monitored for signs of bleeding, such as easy bruising, red or dark urine, black/tarry stools, or unusual bleeding. Dosage adjustments of warfarin may be necessary if NSAIDs are initiated or discontinued. ## Pharmacy Technician Notes - Advise patients to inform healthcare providers about all medications they are taking, including over-the-counter NSAIDs. - Caution patients to watch for signs of bleeding and seek medical attention if any occur. - Encourage patients to consult with a pharmacist before taking NSAIDs while on warfarin therapy to assess the risk of bleeding.