*Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS* website.**
	Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the NHS website, or see this week's feature O: Orthodontics.

Taking Warfarin With Other Medicines And Herbal Supplements

NHS medicines information on possible interactions with warfarin and other medicines, herbal remedies and supplements.

Cautions with other medicines

Many medicines and supplements can affect warfarin. This can make you more likely to bleed.

You might need a blood test to check the other medicine is not affecting how your blood clots.

Check with your doctor before taking any of these medicines with warfarin:

medicines for heart problems, such as amiodarone, quinidine or propafenone
non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin
tramadol, a strong painkiller
cholesterol-lowering medicines, such as bezafibrate, gemfibrozil, clofibrate or cholestyramine
antibiotics, such as erythromycin, co-trimoxazole or norfloxacin
miconazole gel for fungal infections like thrush

Taking warfarin with everyday painkillers

It's safe to take paracetamol while you're on warfarin. But take the lowest dose that controls your pain. Taking more than four, 500mg tablets over 24 hours for longer than a few days may make your blood clot more slowly. This puts you at risk of bleeding.

If you're still in pain after taking paracetamol for 3 or 4 days, speak to your pharmacist or doctor.

Do not take aspirin or ibuprofen while you're taking warfarin unless a doctor has said it's OK. They increase the chance of bleeding.

Mixing warfarin with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you're taking warfarin. It can increase your risk of side effects.

Tell your doctor if you're taking vitamin K supplements before you start taking warfarin. Do not start taking vitamin K supplements while you are taking warfarin without checking with your doctor first.

There's not enough information to say that other herbal remedies and supplements are safe to take with warfarin. They're not tested in the same way as pharmacy and prescription medicines.

OutUK's A to Z of Gay Health continues and you can read this week's feature O: Orthodontics. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features. If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.
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