Warfarin and tramadol risk of interaction – Medicines and Healthcare products Regulatory Authority advice

· warfarin can interact with some medicines, such as tramadol, leading to an increased risk of bleeding

· you should seek medical treatment and have an urgent International Normalised Ratio test should you experience any of the following symptoms:

· prolonged nose bleeds (more than 10 minutes)

· blood in vomit, sputum (phlegm), stool (poo) or urine (pee)

· severe or unexplained bruising

· severe bleeding gums

· unusual headaches (headaches with blurred vision, slurred speech, loss of movement, feeling or being sick, fits, loss of consciousness, dizziness)

· women who experience heavy or increased bleeding during their menstrual period or any other heavy vaginal bleeding

· inform your healthcare professional that you are taking warfarin and carry your anticoagulant alert card with you at all times

· inform your healthcare professional of all the medicines you are currently taking

· do not take any new medicines without first discussing this with your healthcare professional

· do not stop taking warfarin without first discussing this with your healthcare professional · report suspected adverse drug reactions to the Yellow Card scheme