Aspirin Rectal and Acenocoumarol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acenocoumarol
No brand names on recordAspirin Rectal
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of bleeding
Interaction Deep Dive
Coadministration of anticoagulants and antiplatelet agents may increase the risk of bleeding. Promptly evaluate any signs or symptoms of blood loss that occur in a patient treated concomitantly1.
Why it happens (mechanism)
Additive effects on hemostasis
Literature reports
2 reports — tap to read
a) Data were retrospectively analyzed on 109 patients who underwent coronary angioplasty alone (group II) and on 138 patients who underwent coronary angioplasty plus coronary stent placement (group I) over a four-year period. Group II received aspirin 325 mg daily beginning immediately after angioplasty but no anticoagulation. Group I was given heparin and warfarin until INR reached 2.5. Heparin was then discontinued, and warfarin and aspirin 325 mg daily were continued for three months. An upper gastrointestinal bleed (UGIB) occurred in 28 of the 138 patients (20.3%) in group I, while no patients in group II developed an UGIB. An average of 2.5 days of combination therapy with aspirin and warfarin elapsed before the onset of the UGIB. It is postulated that aspirin causes local injury to the gastrointestinal mucosa which is normally not clinically significant. However, in patients also receiving anticoagulants, this injury becomes magnified and results in a gastrointestinal bleeding episode 2.
b) In a meta-analysis of six randomized clinical trials, the use of aspirin was associated with more than double the frequency of intracranial hemorrhage. The trials included 3874 patients with 31 diagnosed intracranial hemorrhages. The frequency of intracranial hemorrhage was not dependent on the dose of aspirin used or on the range of anticoagulation. These data suggest that even low doses of aspirin should be used cautiously in anticoagulated patients with a high risk of intracranial hemorrhage, such as the elderly 3.
Common questions
Can I take Aspirin Rectal and Acenocoumarol together?
Increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.
How serious is the Aspirin Rectal and Acenocoumarol interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Aspirin Rectal or Acenocoumarol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: SAVAYSA(R) oral tablets, edoxaban oral tablets. Daiichi Sankyo Inc (per manufacturer), Basking Ridge, NJ, 2021. DailyMed
- Younossi ZM, Strum WB, Schatz RA, et al: Effect of combined anticoagulation and low-dose aspirin treatment on upper gastrointestinal bleeding. Dig Dis Sci 1997; 42:79-82. PubMed
- Hart RG, Benavente O, & Pearce LA: Increased risk of intracranial hemorrhage when aspirin is combined with warfarin: a meta-analysis and hypothesis. Cerebrovasc Dis 1999; 9:215-217. DOI
Keep reading about Acenocoumarol
Keep reading about Aspirin Rectal
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