LEVOTHYROXINE AND WARFARIN AND OTHER ORAL ANTICOAGULANTS

The anticoagulant effects of acenocoumarol, dicoumarol, phenindione, and warfarin are increased by thyroid hormones and bleeding has been seen. This is largely due to alteration of thyroid function, rather than a direct drug-drug interaction.
Hypothyroid patients taking an anticoagulant who are subsequently given thyroid hormones as replacement therapy will need a downward adjustment of the anticoagulant dosage as treatment proceeds. Monitor the INR and adjust the warfarin as necessary.
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