Abstract
EVIDENCE-BASED ANSWER The answer is not entirely clear. COX-2 inhibitors appear safer than nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) for patients taking warfarin (SOR: B, cohort and case-control studies). Acetaminophen increases the international normalized ratio (INR) in patients taking warfarin by 0.67 to 0.83 over placebo, but with unclear clinical effect (SOR: C, small RCTs with disease-oriented outcomes).
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