Case reports suggest that most
NSAIDs can occasionally enhance the effects of
warfarin and other coumarins (acenocoumarol, phenprocoumon), resulting in increased anticoagulant effects and sometimes severe bleeding events.
Monitor the anticoagulant effect if
NSAIDs are added to or withdrawn from the treatment of patients taking anticoagulants. Note that since
NSAIDs reduce platelet aggregation and cause
gastrointestinal irritation they can prolong and worsen any bleeding events.