MajorNSAID, propionic acid derivative×Vitamin K antagonist anticoagulants
Updated · Methodology
Mechanism
Naproxen (NSAID) inhibits platelet aggregation and injures the gastric mucosa. On warfarin, GI bleeding risk multiplies, particularly in older patients and with prior peptic ulcer disease.
Symptoms
Gum bleeding, epistaxis, bruising without trauma, blood in urine or stool, menorrhagia. Severe cases include gastrointestinal or intracranial haemorrhage. Risk rises in patients over 65 and with prior peptic ulcer disease.
Management
Avoid chronic naproxen on warfarin. For analgesia, choose paracetamol. For chronic NSAID needs, use a selective COX-2 inhibitor (celecoxib) under pantoprazole cover.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Naproxen tablet (Glenmark Pharmaceuticals Inc., USA) – Prescribing Information section 7 (2010)– ; DailyMed setid 6c5bb008-e66f-4ef0-bf84-aca7eb5983e9
- AEMPS: Ficha técnica: Naproxeno (nº registro 68435), sección 4.5 (2024)– AEMPS, CIMA, nº registro 68435, revisión 08/2024, sección 4.5
- AEMPS: Ficha técnica: Warfarina (nº registro 63064), sección 4.3 (2023)– AEMPS, CIMA, nº registro 63064, revisión 01/2023, sección 4.3