Which medication poses a safety risk when taken with long-term fludrocortisone therapy?

Fludrocortisone is a synthetic corticosteroid with mineralocorticoid properties, which means it helps regulate sodium and potassium levels in the body. When taken long-term, fludrocortisone can lead to fluid retention, increased blood pressure, and electrolyte imbalances, particularly hypokalemia (low potassium levels). These changes can significantly affect how other medications are metabolized and their effects in the body.

Warfarin is an anticoagulant that has a narrow therapeutic index, meaning that the correct dosage range is very close to the dose that would be harmful. The interaction of fludrocortisone with warfarin presents a significant safety risk. Fludrocortisone can alter the effects of warfarin by affecting coagulation parameters and metabolic pathways, potentially leading to either increased anticoagulation (risk of bleeding) or decreased anticoagulation (risk of thrombosis). Regular monitoring of prothrombin time (PT) and International Normalized Ratio (INR) is essential when these two medications are used together, as their interaction can lead to unpredictable effects on blood clotting.

In contrast, although medications like aspirin, ibuprofen, and acetaminophen can also interact with various medications and have side effects, they do