Is there an interaction between warfarin and proton pump inhibitors?

This updated Medicines Q&A evaluates the evidence for an interaction between warfarin and proton pump inhibitors.

Summary

  • Generally, the evidence for an interaction between warfarin and proton pump inhibitors is poor, but rarely and unpredictably raised INRs and bleeding may occur.
  • In practice, whilst there is no reason for avoiding concurrent use of any proton pump inhibitor with warfarin, close monitoring of the prothrombin time or INR may be required.
  • If any increase in the INR is seen, the dose of warfarin should be adjusted as necessary to maintain the desired level of anticoagulation.

Attachments