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Erythromycin-Warfarin Interaction

Erythromycin-Warfarin Interaction Abstract To the Editor.—In a recent letter, Dr Husserl1 reported the third case in the literature of a patient who had an exaggerated hypoprothrombinemic response to a maintenance dose of warfarin sodium following the addition of erythromycin to the regimen. It is necessary to clarify some statements made in the letter by Husserl and the reply of Dr Bartle.2 Husserl stated that the time lapse prior to detection of the increased prothrombin time (PT) in the case reported by Schwartz et al3 was four weeks. Only four days passed prior to discovering that the PT increased to 120 s, providing additional support to Husserl's comment that a clinically apparent interaction requires only a few days. However, either symptoms of the drug interaction, awareness of the interaction, or a chance PT determination would be needed to identify the drug interaction shortly following the addition of erythromycin to therapy. References 1. Husserl FE: Erythromcyin-warfarin teraction . Arch Intern Med 1983;143:1831-183Crossref 2. Bartle WR: Erythromycin-warfarin in action . Arch Intern Med 1983;143:1836.Crossref 3. Schwartz J, Bachmann K, Perrigo E: [ill]teraction between warfarin and erythromy South Med J 1983;76:91-93.Crossref 4. Prandota J, Tilement JP, D'Athis P, et[ill] Binding of erythromycin base to human pla[ill] proteins . J Int Med Res 1980;8( (suppl 2) ):1-8. 5. Bachmann K, Schwartz JI, Forney R, e[ill] The effect of erythromycin on the disposi[ill] kinetics of warfarin . Pharmacology , 1984171-176. 6. Larrey D, Tinel M, Pessayre D: Format of inactive cytochrome P-450 (Fe(II)-metab[ill] complexes with several erythromycin der[ill] tives, but not with josamycin and midecamyci[ill] rats . Biochem Pharmacol 1983;32:1493-1497. 7. Dawan G, Descatoire V, Pessayre D: [ill] induction by erythromycin of its own transfor[ill] tion into a metabolite forming an active com[ill] with reduced cytochrome P-450 . J Pharm[ill] Exp Ther 1981;218:509-514. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Erythromycin-Warfarin Interaction

Abstract

Abstract To the Editor.—In a recent letter, Dr Husserl1 reported the third case in the literature of a patient who had an exaggerated hypoprothrombinemic response to a maintenance dose of warfarin sodium following the addition of erythromycin to the regimen. It is necessary to clarify some statements made in the letter by Husserl and the reply of Dr Bartle.2 Husserl stated that the time lapse prior to detection of the increased prothrombin time (PT) in the case reported by Schwartz et...
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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1984.04400010221042
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.—In a recent letter, Dr Husserl1 reported the third case in the literature of a patient who had an exaggerated hypoprothrombinemic response to a maintenance dose of warfarin sodium following the addition of erythromycin to the regimen. It is necessary to clarify some statements made in the letter by Husserl and the reply of Dr Bartle.2 Husserl stated that the time lapse prior to detection of the increased prothrombin time (PT) in the case reported by Schwartz et al3 was four weeks. Only four days passed prior to discovering that the PT increased to 120 s, providing additional support to Husserl's comment that a clinically apparent interaction requires only a few days. However, either symptoms of the drug interaction, awareness of the interaction, or a chance PT determination would be needed to identify the drug interaction shortly following the addition of erythromycin to therapy. References 1. Husserl FE: Erythromcyin-warfarin teraction . Arch Intern Med 1983;143:1831-183Crossref 2. Bartle WR: Erythromycin-warfarin in action . Arch Intern Med 1983;143:1836.Crossref 3. Schwartz J, Bachmann K, Perrigo E: [ill]teraction between warfarin and erythromy South Med J 1983;76:91-93.Crossref 4. Prandota J, Tilement JP, D'Athis P, et[ill] Binding of erythromycin base to human pla[ill] proteins . J Int Med Res 1980;8( (suppl 2) ):1-8. 5. Bachmann K, Schwartz JI, Forney R, e[ill] The effect of erythromycin on the disposi[ill] kinetics of warfarin . Pharmacology , 1984171-176. 6. Larrey D, Tinel M, Pessayre D: Format of inactive cytochrome P-450 (Fe(II)-metab[ill] complexes with several erythromycin der[ill] tives, but not with josamycin and midecamyci[ill] rats . Biochem Pharmacol 1983;32:1493-1497. 7. Dawan G, Descatoire V, Pessayre D: [ill] induction by erythromycin of its own transfor[ill] tion into a metabolite forming an active com[ill] with reduced cytochrome P-450 . J Pharm[ill] Exp Ther 1981;218:509-514.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1984

References