Abstract
Drug interactions with warfarin vary from useful to disastrous. The pharmacologic combination of warfarin and a platelet inhibitor can be clinically efficacious. Contrarily, the increasing number of drugs that interact with warfarin can potentiate its anticoagulant effect and cause life-threatening hemorrhagic events. To avoid the futility of memorizing long lists of these drugs, guidelines will be presented for the prescribing physician. These concepts are understood best after the metabolism of warfarin in man is reviewed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
P. J. Kearns, and R. A. O’Reilly, Bioavailability of warfarin in a patient with short bowel syndrome, J. Paren. Ent. Nutr. 10:10.0 (1986).
R. A. O’Reilly, Drug-induced vitamin K deficiency, resistance and drug interactions, in: “Prothrombin and Other Vitamin K Proteins,” Vol. II. W. H. Seegers and D. A. Walz, ed., CRC Press, Boca Raton (1986).
R. A. O’Reilly and P. A. Aggeler, Determinants of the response to oral anticoagulant drugs in man, Pharmacol. Rev. 22:35 (1970).
R. J. Lewis, W. F. Trager, K. K. Chan, A. Breckenridge, M. Orme, M. Roland, and W. Schary, Warfarin: stereochemical aspects of its metabolism and the interaction with phenylbutazone, J. Clin. Invest. 53:1607 (1974).
R. A. O’Reilly, Anticoagulant, antithrombotic, and thrombolytic drugs, in: “Goodman and Gilman’s The Pharmacological Basis of Therapeutics,” A. G. Gilman, L. S. Goodman, T. W. Rall, and F. Murad, eds., Chap. 58, Macmillan, New York (1985).
B. M. Rifkind, Lipid Research Clinics Program, J.A.M.A. 252:2547 (1984).
R. A. O’Reilly, Drug interactions involving oral anticoagulants, Cardiovasc. Cl. 6:23 (1974).
D. B. Hunninghake and D. M. Hibbard, Influence of time intervals for cholestyramine dosing on the absorption of hydrochlorothiazide, Clin. Pharmacol Ther. 39:329 (1986).
J. M. Van den Broek, H. C. Ten Wolde-Kraamwinkel, C. H. Kleinbloesem and D. D. Breimer, Effect of rifampicin treatment on in vitro drug-metabolizing activities in the pig, Biochem. Pharmacol. 33:325 (1984).
R. A. O’Reilly, Interaction of chronic, daily warfarin therapy and rifampin, Ann. Int. Med. 83:506 (1975).
R. A. O’Reilly, Lack of effect of mealtime wine on the hypoprothrombinemia or oral anticoagulants, Am. J. Med. Sci. 277:189 (1979).
R. A. O’Reilly, Lack of effect of fortified wine ingested during fasting and anticoagulant therapy, Arch. Int. Med. 141:458 (1981).
R. A. O’Reilly, M. A. Sahud, and P. M. Aggeler, Impact of aspirin and chlorthalidone on the pharmacodynamics of oral anticoagulant drugs in man, Ann N. Y. Acad. Sci. 179:173 (1971).
R. A. O’Reilly, Interaction of spironolactone and racemic warfarin in man, Clin. Pharmacol. Ther. 27:198 (1980).
P. G. Frick, G. Riedler, and H. Brogli, Dose response and minimal daily requirement for vitamin K in man, J. Appl. Physiol. 23:387 (1967).
L. Uotila, J. W. Suttie, Inhibition of vitamin K-dependent carboxylase in vitro by cefamandole and its structured analogs, J. Infect. Dis. 148:571 (1983).
R. A. O’Reilly and D. A. Rytand, “Resistance” to warfarin due to unrecognized vitamin K supplementation, N. Engl. J. Med. 303:160 (1980).
S. J. Kempin, Warfarin resistance caused by broccoli, N. Engl. J. Med. 308:1229 (1983).
R. A. O’Reilly, M. A. Sahud, and A. J. Robinson, Studies on the interaction of warfarin and Clofibrate in man, Throm. Diath. Haemorrh. 27:309 (1972).
R. A. O’Reilly, Editorial: complications of anticoagulant therapy, West. J. Med. 132:453 (1980).
T. W. Meade, Safety of oral anticoagulation, Lancet 1:1387 (1986).
R. Hull, J. Hirsh, R. Jay, C. Carter, C. England, M. Gent, A. G. G. Turpie, D. McLoughlin, P. Dodd, M. Thomas, G. Raskob, and P. Ockelford, Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis, N. Engl.J. Med. 307:1676 (1982).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Springer Science+Business Media New York
About this chapter
Cite this chapter
O’Reilly, R.A. (1987). Warfarin Metabolism and Drug-Drug Interactions. In: Wessler, S., Becker, C.G., Nemerson, Y. (eds) The New Dimensions of Warfarin Prophylaxis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-5985-3_18
Download citation
DOI: https://doi.org/10.1007/978-1-4757-5985-3_18
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-5987-7
Online ISBN: 978-1-4757-5985-3
eBook Packages: Springer Book Archive