Warfarin and NSAIDs have important interactions. Two NSAIDs (phenylbutazone and naproxen) have been reported to displace warfarin from plasma proteins, leading to increased warfarin levels in serum and elevated prothrombin times. Phenylbutazone has also been shown to decrease elimination of warfarin. Other NSAIDs have not been reported to change warfarin protein binding or elimination, but the use of any NSAID is contraindicated in warfarin users because NSAID inhibition of platelet aggregation may significantly increase the risk for bleeding.
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