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In summary, the new oral anticoagulants represent a giant step forward in the quest to replace warfarin. In addition to their enhanced convenience, the new agents are not only safer than warfarin because of the reduced risk of intracranial bleeding, but they also have the potential to be more effective.
In a recent study of 38,762 Medicare patients taking warfarin, researchers found that azole antifungals and all classes of antibiotics increased the risk of bleeding within two weeks, but to different degrees (American Journal of Medicine, February 2012).y preventing blood clots from forming in the brain, heart, legs, and lungs, warfarin lowers the risk of stroke, heart attack, and death. Many antibiotics and related medications, including azole antifungal agents, heighten warfarin's blood-thinning ability and raise the risk of internal bleeding.