Drug Interactions Update: Drugs, Herbs, and Oral Anticoagulation
- Ann K. Wittkowsky
- … show all 1 hide
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Management of warfarin drug interactions is often complicated by lack of information regarding interactions with new drugs and with herbal medicinals. The pharmaceutical industry has increased both the number and quality of drug interaction studies prior to marketing new agents. Interactions may still occur in patients, however, despite negative pre-marketing studies in healthy volunteers. The clinical significance and intensity of warfarin interactions with prescription drugs (e.g., celecoxib, proton pump inhibitors, and selective serotonin reuptake inhibitors) can often be predicted on the basis of known metabolic characteristics of the drugs and warfarin enantiomers. Drug interactions with herbal medicinals are much more difficult to characterize and predict because of the lack of federal regulations regarding safety, efficacy, and manufacturing standards. Published case reports of interactions between warfarin and even the most widely used herbal medicinals are limited. Practitioners are encouraged to report such interactions through the FDA MedWatch program.
- Marroum PJ, Uppoor RS, Parmelee T, et al. In vivo drug–drug interaction studies: a survey of all new molecular entities approved from 1987 to 1997. Clin Pharmacol Ther 2000;86:280–285.
- Karim A, Tolbert D, Piergies A, et al. Celecoxib does not significantly alter the pharmacokinetics or hypoprothrombinemic effects of warfarin in healthy subjects. J Clin Pharmacol 2000;40:655–663.
- Mersfelder TL, Stewart LR. Warfarin and celecoxibinteraction. Ann Pharmacotherapy 2000;34: 325–326.
- Haase KK, Rojas–Fernandez CH, Lane L, Frank DA. Potential interaction between celecoxib and warfarin. Ann Pharmacotherapy 2000;34:667–668.
- Testa B, Jenner P. Inhibitors of cytochrome P450s and their mechanism of action. Drug Metab Rev 1981; 12:1–117.
- Suftin T, Balmer K, Bostrom H, Eriksson S, Hoglund P, Paulson O. Stereoselective interaction of omeprazole with warfarin in healthy men. Ther Drug Monitoring 1989;11:176–184.
- Unge P, Svedberg LE, Nordgren A, Blom H, Andersson T, Lagerstrom PO. A study of the interaction of omeprazole and warfarin in anticoagulated patients. Br J Clin Pharmacol 1992;34:509–512.
- Andersson T. Pharmacokinetics, metabolism, and interactions of acid pump inhibitors. Focus on omeprazole, lansoprazole and pantoprazole. Clin Pharmacokinetics 1996;31:9–28.
- Ahmad S. Omeprazole–warfarin interaction. South J Med 1991;84:674–675.
- Duncan D, Sayal K, McConnell H, Taylor D. Antidepressant interactions with warfarin. Int Clin Psychopharm 1998;13:87–94.
- Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997: results of a follow–up national survey. JAMA 1998;280:1569–1575.
- Miller LG, Hume A, Harris IM, et al. White paper on herbal products. Pharmacotherapy 2000;20:877–891.
- Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy 2000;20:257–269.
- Liberti LE, Der Marderosian A. Evaluation of commercial ginseng products. J Pharm Sci 1978;67: 1487–1489.
- Lui J, Garle M, Eneroth P, Bjorkhelm I. What do commercial ginseng preparations contain? Lancet 1994;344:134.
- Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692–693.
- Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health–Syst Pharm 1999;56: 125–138.
- Heck AM, De Witt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health–System Pharm 2000;57:1221–1230.
- Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;344:1372–1373.
- Vaes LPJ, Chyka PA. Interactions of warfarin with garlic, ginger, ginko, or ginseng: nature of the evidence. Ann Pharmacotherapy 2000;34:1478–1482.
- Yue QY, Bergquist C, Gerden B. Safety of St John's wort (Hypericum perforatum). Lancet 2000;355:567–570.
- Roby CA, Anderson GD, Kantor E, Dryer DA, Burstein AH. St John's Wort: effect on CYP3A4 activity. Clin Pharmacol Ther 2000;67:451–457.
- Drug Interactions Update: Drugs, Herbs, and Oral Anticoagulation
Journal of Thrombosis and Thrombolysis
Volume 12, Issue 1 , pp 67-71
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- drug interactions
- herbal medicinals
- Industry Sectors
- Ann K. Wittkowsky (1) (2)
- Author Affiliations
- 1. University of Washington Medical Center, USA
- 2. University of Washington School of Pharmacy, USA