Warfarin and many traditional Chinese medicines

Warfarin is a classical anticoagulant drug with long duration of action, ease of administration, relatively small side effects, and low cost. It is widely used in artificial heart valve replacement, atrial fibrillation, recurrent stroke, deep vein thrombosis and Long-term anticoagulant therapy and prevention in patients with pulmonary embolism, diabetic nephropathy, and myocardial infarction. Warfarin has an irreplaceable position in oral anticoagulant therapy and is the drug of choice for anticoagulant therapy.

However, during the usual rounds of visits, I often heard patients taking warfarin complain that their legs showed large or small ecchymosis. When asked if they were taking other medicines at the same time, I 3. Both Chinese medicines or proprietary Chinese medicines that cannot be taken together with warfarin are found.

Traditional Chinese medicine has unique advantages in the treatment of cardio-cerebrovascular diseases, etc. It has a wide range of clinical applications, and there are more opportunities to use it with warfarin. However, studies have shown that some Chinese herbs may affect warfarin and increase or decrease its effect. , resulting in increased risk of bleeding or weakened anticoagulant effects.

The traditional Chinese medicines or proprietary Chinese medicines that can enhance the anticoagulant effect of warfarin include: Salvia miltiorrhiza, Ginkgo biloba, Angelica, safflower, Chinese wolfberry, ergan, whole medlar, ganoderma lucidum, horse chestnut seeds, garlic, ginger, and preparations of these drugs. 2. Patches of holly oil (including R. edulis ingredients), Spiraea plant preparations, etc.; Compound Chinese medicine preparations: Compound Danshen Dripping Pills, Shuxuetong Injection, Xinhuang Tablets, Shengmai Yin, Tortoise Cream, etc.

The traditional Chinese medicines or proprietary Chinese medicines that can weaken the anticoagulant effect of warfarin include: ginseng and American ginseng and their preparations, St. John's wort and their preparations.

When Chinese herbal medicine is used in combination with warfarin, the possible influence of anticoagulant action of warfarin should be fully considered, blood coagulation indicators should be closely monitored, and the safety and efficacy of the drug should be ensured. The patient should advance with the use of any drug, including Chinese medicine or proprietary Chinese medicine. Contact the clinician or clinical pharmacist and monitor the INR (ie, the international normalized ratio, based on the prothrombin time and the international sensitivity index of the test reagent). If you have nosebleeds, black stools, hematuria, etc., please seek medical advice as soon as possible.

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