Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Macrolides and Oral Anticoagulants: A Dangerous Association

Macrolides and Oral Anticoagulants: A Dangerous Association IntroductionUntil recently, erythromycin and the newer macrolide antibiotics have been used extensively in the treatment of infectious processes in patients receiving anticoagulant therapy. Furthermore, macrolides have been part of the recommendations for endocarditis prophylaxis in those patients who were unable to take penicillins [1, 2]. However, it is well known that macrolides inhibit cytochrome P450, which appears to be the most common metabolic enzyme in human liver tissue. It is involved in the metabolism of many drugs, including oral anticoagulants. Several reports have confirmed that macrolides can potentiate the effect of oral anticoagulants [3, 4]. We report a new case in whom erythromycin potentiated acenocoumarol anticoagulant treatment.A 68-year-old man was treated with acenocoumarol for 14 years because he was a heart double-valve prosthesis carrier. Anticoagulation control presented no major problem under acenocoumarol, 3 mg/day, as his international normalized ratio (INR) stayed in the range 3–4.5. He started oral erythromycin ethylsuccinate 1.5 g/day for an upper respiratory tract infection. A week later, in a routine control, his INR was found to be 15. There was no macroscopic bleeding. No other drugs were being administered at that time. Results of a blood cell count, platelet count, and liver function tests were http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Haematologica Karger

Macrolides and Oral Anticoagulants: A Dangerous Association

Grau, Enric; Real, Esperanza; Pastor, Emilio
Acta Haematologica , Volume 102 (2): 2 – Oct 1, 1999
Download PDF
2 pages

Loading next page...
 
/lp/karger/macrolides-and-oral-anticoagulants-a-dangerous-association-lShUZ39QUW

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
Karger
Copyright
© 1999 S. Karger AG, Basel
ISSN
0001-5792
eISSN
1421-9662
DOI
10.1159/000040983
Publisher site
See Article on Publisher Site

Abstract

IntroductionUntil recently, erythromycin and the newer macrolide antibiotics have been used extensively in the treatment of infectious processes in patients receiving anticoagulant therapy. Furthermore, macrolides have been part of the recommendations for endocarditis prophylaxis in those patients who were unable to take penicillins [1, 2]. However, it is well known that macrolides inhibit cytochrome P450, which appears to be the most common metabolic enzyme in human liver tissue. It is involved in the metabolism of many drugs, including oral anticoagulants. Several reports have confirmed that macrolides can potentiate the effect of oral anticoagulants [3, 4]. We report a new case in whom erythromycin potentiated acenocoumarol anticoagulant treatment.A 68-year-old man was treated with acenocoumarol for 14 years because he was a heart double-valve prosthesis carrier. Anticoagulation control presented no major problem under acenocoumarol, 3 mg/day, as his international normalized ratio (INR) stayed in the range 3–4.5. He started oral erythromycin ethylsuccinate 1.5 g/day for an upper respiratory tract infection. A week later, in a routine control, his INR was found to be 15. There was no macroscopic bleeding. No other drugs were being administered at that time. Results of a blood cell count, platelet count, and liver function tests were

Journal

Acta Haematologica – Karger

Published: Oct 1, 1999

There are no references for this article.