Drug Interaction Report

Warfarin and Dexlansoprazole: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Warfarin

Coumadin Jantoven
+

Dexlansoprazole

Dexilant Dexilant® (formerly available as Kapidex®)
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 210 documented Warfarin interactions, 48 are rated moderate — including this one.
Onset
delayed
Evidence
probable
Severity
Moderate

What happens

Elevations in INR serum values and potentiation of anticoagulation effects

Interaction Deep Dive

There were no significant changes in pharmacokinetics of warfarin or INR when dexlansoprazole was coadministered with a single dose of warfarin compared with warfarin use alone in a study of healthy volunteers. However, elevations in prothrombin time and INR have been reported after coadministration of other proton pump inhibitors with warfarin. Therefore, monitoring patients for increases in INR and/or prothrombin time may be required1.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) There were no significant changes in pharmacokinetics of warfarin or INR when dexlansoprazole 90 mg/day for 11 days was coadministered with a single 25-mg oral dose of warfarin on day 6 compared with administration of warfarin and placebo in a study of healthy volunteers (n=20). However, concomitant use of other proton pump inhibitors and warfarin has resulted in elevated INR and prothrombin time 1.

Common questions

Can I take Warfarin and Dexlansoprazole together?

Elevations in INR serum values and potentiation of anticoagulation effects Always confirm with your pharmacist or prescriber before making any change.

How serious is the Warfarin and Dexlansoprazole interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Warfarin or Dexlansoprazole 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 anything you'd monitor while I'm on both?

References (1)

  1. Product Information: DEXILANT(R) delayed release oral capsules, dexlansoprazole delayed release oral capsules. Takeda Pharmaceuticals America, Inc. Deerfield, IL, 2010. DailyMed
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.