Описание
Naproxen combined with warfarin increases the risk of GI and other hemorrhagic complications through additive effects on hemostasis and direct gastric mucosal damage.
Механизм
Naproxen inhibits COX-1–mediated platelet aggregation and damages gastric mucosa, compounding warfarin's anticoagulant effect and creating a site for bleeding.
Клиническое значение
Significant increase in upper GI bleeding risk; the interaction is pharmacodynamic and does not require INR to be supratherapeutic for bleeding to occur.
Тактика ведения
Avoid if possible; use acetaminophen instead. If required, add a PPI, use the lowest effective naproxen dose for the shortest duration, and monitor for signs of bleeding.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.