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Decrease in Efficacy of Warfarin as a Result of Drug-Drug Interaction (Case Report)

https://doi.org/10.20996/1819-6446-2020-02-01

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Abstract

The one of the main aims in modern clinical pharmacology is to provide safe and effective therapy considering a frequent administration of several drugs having different drug-drug interactions. Warfarin belongs to the number of popular anticoagulants which along with its efficiency not infrequently alters anticoagulant characteristics when administered with other drugs and food products. A case of a decrease in the efficacy of warfarin in a patient with mitral stenosis while taking a combined choleretic drug is presented in the article. The components of this choleretic drug (dry animal bile, dry garlic extract, dry nettle extract, activated charcoal) could impair the absorption of warfarin, increase intestinal absorption of vitamin K, and have a negative effect on the anticoagulant effect of warfarin. Management of patients receiving anticoagulants should be performed in accordance with clinical recommendations. Prescription of drugs, including multicomponent ones, without proven efficacy, for such patients should be considering the potential drug interaction.

About the Authors

N. T. Vatutin
Donetsk National Medical University named after M. Gorky; Institute of Urgent and Reconstructive Surgery named after V.K. Gusak
Ukraine

Nikolay T. Vatutin – MD, PhD, Professor, Head of Chair of Hospital Therapy, Donetsk National Medical University named after M. Gorky; Head of Division of Cardiac Surgery and Urgent Cardiology, Institute of Urgent and Reconstructive Surgery named after V.K. Gusak

Ilyicha pr. 16, Donetsk, 83000 Donetsk People Republic/Ukraine;
Leninskij pr. 47, Donetsk, 83000 Donetsk People Republic/ Ukraine



G. G. Taradin
Donetsk National Medical University named after M. Gorky; Institute of Urgent and Reconstructive Surgery named after V.K. Gusak
Ukraine

Gennadiy G. Taradin – MD, PhD, Associate Professor, Chair of Hospital Therapy, Donetsk National Medical University named after M. Gorky; Senior Researcher, Division of Cardiac Surgery and Urgent Cardiology, Institute of Urgent and Reconstructive Surgery named after V.K. Gusak

Ilyicha pr. 16, Donetsk, 83000 Donetsk People Republic/Ukraine;
Leninskij pr. 47, Donetsk, 83000 Donetsk People Republic/ Ukraine



G. A. Ignatenko
Donetsk National Medical University named after M. Gorky
Ukraine

Grigorij A. Ignatenko – MD, PhD, Professor, Corresponding Member of National Academy of Medical Sciences of Ukraine, Head of Chair of Propaedeutic and Internal Medicine, Rector of Donetsk National Medical University named after M. Gorky

Ilyicha pr. 16, Donetsk, 83000 Donetsk People Republic/Ukraine



E. S. Gasendich
Donetsk National Medical University named after M. Gorky
Ukraine

Ekaterina S. Gasendich – MD, Assistant, Chair of Hospital Therapy

Ilyicha pr. 16, Donetsk, 83000 Donetsk People Republic/Ukraine



A. V. Harchenko
Donetsk National Medical University named after M. Gorky
Ukraine

Anastasija V. Harchenko – MD, Assistant, Chair of Hospital Therapy

Ilyicha pr. 16, Donetsk, 83000 Donetsk People Republic/Ukraine



I. B. Povaljaeva
Institute of Urgent and Reconstructive Surgery named after V.K. Gusak
Ukraine

Irina B. Povaljaeva – MD, Doctor, Department of Functional Diagnostics

Leninskij pr. 47, Donetsk, 83000 Donetsk People Republic/ Ukraine



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For citation:


Vatutin N.T., Taradin G.G., Ignatenko G.A., Gasendich E.S., Harchenko A.V., Povaljaeva I.B. Decrease in Efficacy of Warfarin as a Result of Drug-Drug Interaction (Case Report). Rational Pharmacotherapy in Cardiology. 2020;16(1):40-45. (In Russ.) https://doi.org/10.20996/1819-6446-2020-02-01

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