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Is It Safe To Take Levofloxacin With Coumadin?

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Posted on Wed, 22 Apr 2015
Question: would it be better to take levofloxacin or clarithromycin with coumadin?
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Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
levofloxacin would be safer

Detailed Answer:
HI, thanks for using healthcare magic

Both of these drugs can affect warfarin levels causing an increase in warfarin and therefore an increase in bleeding.

The mechanism by which clarithromycin does this is well known, it affects the chemicals or the pathway in the liver that is involved in the breakdown of warfarin. By decreasing warfarin breakdown, it causes increased levels.
It is recommended that clarithromycin is never used with warfarin because of these very known effect.

Levofloxacin also causes an increase but the exact way it does this is not known. It may be related to affecting vitamin K levels in the gut.
This interaction is monitored closely.

Between the two, it would be safer to use levofloxacin once there is very careful monitoring for any bleeding.

I hope this helps,feel free to ask any other questions
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Is It Safe To Take Levofloxacin With Coumadin?

Brief Answer: levofloxacin would be safer Detailed Answer: HI, thanks for using healthcare magic Both of these drugs can affect warfarin levels causing an increase in warfarin and therefore an increase in bleeding. The mechanism by which clarithromycin does this is well known, it affects the chemicals or the pathway in the liver that is involved in the breakdown of warfarin. By decreasing warfarin breakdown, it causes increased levels. It is recommended that clarithromycin is never used with warfarin because of these very known effect. Levofloxacin also causes an increase but the exact way it does this is not known. It may be related to affecting vitamin K levels in the gut. This interaction is monitored closely. Between the two, it would be safer to use levofloxacin once there is very careful monitoring for any bleeding. I hope this helps,feel free to ask any other questions