A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily, 30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily
The nurse will contact the provider to discuss
a. decreasing the dose of gemfibrozil.
b. giving the warfarin at noon.
c. increasing the dose of warfarin.
d. ordering frequent INR levels.
ANS: D
Gemfibrozil is highly protein-bound and competes for receptor sites with drugs such as warfarin. The anticoagulant dose should be decreased, and the INR should be closely monitored. Decreasing the dose of gemfibrozil is not recommended. Giving the warfarin at a different time of day does not change this drug interaction. The warfarin dose should be decreased not increased.
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