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Metronidazole can increase the blood thinning effects of warfarin coumadin, jantoven and increase the risk of bleeding probably by reducing the breakdown of warfarin.

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Select the initial dose based on the expected maintenance dosetaking into account the above factorsModify this dose based on consideration of patient-specific clinical factorsConsider lower initial and maintenance doses for elderly and/or debilitated patients and in Asian patientssee Use In Specific Populations and CLINICAL PHARMACOLOGYRoutine use of loading doses is not recommended as this practice may increase hemorrhagic and other complications and does not offer more rapid protection against clot formation.

You will need frequentINRor prothrombin time teststo measure your blood-clotting time and determine your warfarin doseYou must remain under the care of a doctor while taking Coumadin.

Get emergency medical help if you have any of these signs of an allergic reactionhivesdifficult breathingswelling of your facelipstongueor throat.

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