Drug Interaction Checker

Check interactions between concurrently prescribed medications

Medication List to Check

Warfarin
Metformin
Aspirin
3 interaction(s) found
Contraindicated: 1
Major: 2
Moderate: 0
Minor: 0

WarfarinAspirin

Major

Concurrent use significantly increases bleeding risk.

Mechanism: Both have anticoagulant/antiplatelet effects. Aspirin also displaces warfarin from protein binding.

Management: Avoid combination unless benefit clearly outweighs risk. If concurrent use necessary, monitor INR closely and watch for bleeding signs.

MetforminIV Contrast Dye

Contraindicated

Risk of lactic acidosis — potentially fatal if metformin not held before contrast.

Mechanism: Contrast agents can cause acute kidney injury; reduced renal function leads to metformin accumulation and lactic acidosis.

Management: Hold metformin 48h before and 48h after IV contrast. Restart only when renal function confirmed stable.

CiprofloxacinWarfarin

Major

Fluoroquinolones inhibit CYP1A2 and CYP3A4 — significantly increases warfarin effect and INR.

Mechanism: CYP enzyme inhibition reduces warfarin metabolism; also displaces warfarin from albumin.

Management: Monitor INR closely after starting or stopping ciprofloxacin. Reduce warfarin dose preemptively if INR typically stable.