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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Azathioprine Reduce The Efficacy Of Coumadin?

I am taking oral azathioprine and Coumadin. I have been told to increase my dosage to 150 mg. daily. Since doing so my taking of Coumadin , my INR , protine, has been 1.5-1.6. It should be in the 2.00-3.00 range. I have increased , dosage of Coumadin to 7.5 mg. 3/week, and 5 mg. daily. I was also taking mycophenolate till recently. Can the increased dose of azathioprine be diminishing the effect,of the Coumadin. I am taking Coumadin ,for Atrial Fibrilation
Tue, 31 Jul 2018
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General & Family Physician,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Great care should be taken to use other drugs when in coumadin. Your suspicion is very right, though not very commonly but azathioprine can possibly reduce the effects of coumarin. This looks to be the cause here in your case. You can discuss this with your doctor. Probably you would need a bit higher dose of the latter to achieve your INR.

Hope I have answered your query. Let me know if I can assist you further.
Regards,     
Dr. Mahboob Ur Rahman
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Does Azathioprine Reduce The Efficacy Of Coumadin?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Great care should be taken to use other drugs when in coumadin. Your suspicion is very right, though not very commonly but azathioprine can possibly reduce the effects of coumarin. This looks to be the cause here in your case. You can discuss this with your doctor. Probably you would need a bit higher dose of the latter to achieve your INR. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahboob Ur Rahman